{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:48:42Z","timestamp":1785433722209,"version":"3.56.0"},"reference-count":40,"publisher":"International Journal of Sports Physical Therapy","issue":"2","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background and Purpose<\/jats:title>\n Evidence concludes that aerobic exercise, exercise therapy, and manual therapy effectively improve pain and function in individuals with hip osteoarthritis (OA). The American College of Rheumatology (ACR) reports there is no consensus on which type of exercise elicits the greatest benefit for those with OA. The American Academy of Orthopedic Surgeons (AAOS) cites gaps in the physical therapy literature regarding failure to stratify severity of hip OA in the context of exercise interventions. The purpose of this case report was to examine the benefits of a stratified, tailored multimodal approach for an individual with moderate hip OA.<\/jats:p>\n <\/jats:sec>\n \n Case Description<\/jats:title>\n A 75-year-old male and recreational runner of more than 40 years presented with an insidious onset of worsening hip pain. The Lower Extremity Functional Scale (LEFS) and Visual Analog Scale (VAS) at rest were utilized to stratify the subject\u2019s hip OA severity, and the subject was assessed as moderate severity. Long run mileage and total weekly running mileage were tracked as a measure of progress towards the subject\u2019s functional goals. The subject\u2019s therapeutic goals included decreasing pain and improving function to complete a half-marathon scheduled for four months after the initial evaluation. The subject completed a physical therapy plan of care spanning twice weekly for six weeks, twelve total visits. The multimodal approach consisted of manual therapy, supervised exercise therapy, and an unsupervised home exercise program (HEP).<\/jats:p>\n <\/jats:sec>\n \n Outcomes<\/jats:title>\n The subject improved in all primary outcomes. The LEFS improved from 32\/80 to 50\/80; the VAS improved from 61\/100 to 52\/100; and hip active range of motion improved for flexion 90\u00b0 to 110\u00b0, IR 10\u00b0 to 20\u00b0, and ER 30\u00b0 to 35\u00b0. The subject\u2019s functional measures improved from long runs spanning 4.0 miles to 8.0 miles and total weekly running mileage from 10.0 miles to 28.0 miles without limitation.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n The six-week, multimodal approach effectively reduced pain and increased function in this recreational runner. Individualized exercise therapy and the use of a critical magnitude of force used during manual therapy were two important tenets of an effective multimodal program for this subject. Moreover, the severity of OA and contextual factors might be significant considerations to guide future interventions.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 5<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.155001","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T18:05:19Z","timestamp":1769882719000},"source":"Crossref","is-referenced-by-count":0,"title":["A Multimodal Approach for the Management of Moderate Hip Osteoarthritis in A Runner: A Case Report"],"prefix":"10.26603","volume":"21","author":[{"given":"Steve","family":"Ferrah","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02mpq6x41","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Illinois Chicago","department":["College of Applied Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"ref1","article-title":"American Academy of Orthopaedic Surgeons Management of osteoarthritis of the hip evidence-based clinical practice guideline","year":"2023","journal-title":"J Am Acad Orthop Surg"},{"issue":"5","key":"ref2","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1002\/art.1780340502","article-title":"The American College of Rheumatology Criteria for the classification and reporting of osteoarthritis of the hip","volume":"34","author":"R. 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Bichsel","year":"2022","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"ref12","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.otsr.2011.08.015","article-title":"Clinical evaluation of hip joint rotation range of motion in adults","volume":"98","author":"P. Kouyoumdjian","year":"2012","journal-title":"Orthop Traumatol Surg Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/1471-2474-11-194","article-title":"Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients","volume":"11","author":"S. Nussbaumer","year":"2010","journal-title":"BMC Musculoskelet. Disord."},{"issue":"3","key":"ref14","doi-asserted-by":"publisher","first-page":"145","DOI":"10.2519\/jospt.1992.16.3.145","article-title":"Reliability of hand-held dynamometry and its relationship with manual muscle testing in patients with osteoarthritis in the knee","volume":"16","author":"K. W. Hayes","year":"1992","journal-title":"J Orthop Sports Phys Ther"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2019.102076","article-title":"Evidence and recommendations for the use of segmental motion testing for patients with LBP \u2013 a systematic review","volume":"45","author":"M. Stolz","year":"2019","journal-title":"Musculoskelet Sci Pract"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.msksp.2022.102529","article-title":"Reliability of the straight leg raise test for suspected lumbar radicular pain: a systematic review with meta-analysis","volume":"59","author":"R. J. Nee","year":"2022","journal-title":"Musculoskelet Sci Pract"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.7860\/jcdr\/2017\/24899.9794","article-title":"Las\u00e8gue's sign","author":"S.U. Kamath","year":"2017","journal-title":"J Clin Diagnost Res"},{"issue":"20","key":"ref18","doi-asserted-by":"publisher","first-page":"2518","DOI":"10.1097\/cm9.0000000000002418","article-title":"Posterior hip capsular tenderness test improved the sensitivity and positive predictive value of FADIR test in diagnosing femoroacetabular impingement","volume":"135","author":"G. Gao","year":"2022","journal-title":"Chin. Med. J."},{"issue":"4","key":"ref19","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/ptj\/79.4.371","article-title":"The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application","volume":"79","author":"J. M. Binkley","year":"1999","journal-title":"Phys Ther"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"851","DOI":"10.2147\/jpr.s158847","article-title":"Test\u2013retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain","volume":"11","author":"A. Alghadir","year":"2018","journal-title":"J Pain Res"},{"issue":"12","key":"ref21","doi-asserted-by":"publisher","DOI":"10.3390\/biology10121251","article-title":"Efficacy of exercise-based rehabilitation programs for improving muscle function and size in people with hip osteoarthritis: a systematic review with meta-analysis","volume":"10","author":"Z. P. J. Rostron","year":"2021","journal-title":"Biology"},{"issue":"2","key":"ref22","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1002\/acr.24131","article-title":"2019 American College of Rheumatology\/Arthritis Foundation Guideline for the management of osteoarthritis of the hand, hip, and knee","volume":"72","author":"S. L. Kolasinski","year":"2020","journal-title":"Arthritis Care Res"},{"issue":"11","key":"ref23","doi-asserted-by":"publisher","first-page":"3007","DOI":"10.1111\/os.70161","article-title":"Pain phenotype in knee osteoarthritis: implications for mechanism-based therapy","volume":"17","author":"C. He","year":"2025","journal-title":"Orthop Surg"},{"issue":"2","key":"ref24","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.joca.2023.11.015","article-title":"Osteoarthritis year in review 2023: biomechanics","volume":"32","author":"L. E. 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Diamond","year":"2022","journal-title":"Osteoarthritis Cartilage Open"},{"issue":"8","key":"ref28","doi-asserted-by":"publisher","DOI":"10.3390\/biology9080194","article-title":"Pathogenesis of osteoarthritis: risk factors, regulatory pathways in chondrocytes, and experimental models","volume":"9","author":"Y. He","year":"2020","journal-title":"Biology"},{"issue":"1","key":"ref29","doi-asserted-by":"publisher","DOI":"10.47206\/ijsc.v3i1.182","article-title":"Partial vs full range of motion resistance training: a systematic review and meta-analysis","volume":"3","author":"M. Wolf","year":"2023","journal-title":"Int J Strength Condit"},{"issue":"2","key":"ref30","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/j.rdc.2020.12.002","article-title":"Basic mechanisms of pain in osteoarthritis","volume":"47","author":"A. M. 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