Hip pain and mobility deficits--hip osteoarthritis: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association.

Pathoanatomical Features: Clinicians should assess for impairments in mobility of the hip joint and the strength of the surrounding muscles, especially the hip abductor muscles, when a patient presents with hip pain. (Recommendation based on weak evidence.) Risk Factors: Clinicians should consider age, hip developmental disorders, and previous hip joint injury as risk factors for hip osteoarthritis. (Recommendation based on strong evidence.) Diagnosis/Classification: Moderate lateral or anterior hip pain during weight bearing, in adults over the age of 50 years, with morning stiffness less than 1 hour, with limited hip internal rotation and hip flexion by more than 15° when comparing the painful to the non painful side are useful clinical findings to classify a patient with hip pain into the International Statistical Classification of Diseases and Related Health Problems (ICD) category of unilateral coxarthrosis and the associated International Classification of Functioning, Disability, and Health (ICF) impairment-based category of hip pain (b2816 Pain in joints) and mobility deficits (b7100 Mobility of a single joint). (Recommendation based on strong evidence.) Differential Diagnosis: Clinicians should consider diagnostic classifications other than osteoarthritis of the hip when the patient's history, reported activity limitations, or impairments of body function and structure are not consistent with those presented in the diagnosis/classification section of this guideline-or-when the patient's symptoms are not diminishing with interventions aimed at normalization of the patient's impairments of body function. (Recommendation based on expert opinion.) Examination – Outcome Measures: Clinicians should use validated functional outcome measures, such as the Western Ontario and McMaster Universities Osteoarthritis Index, Lower Extremity Functional Scale, and the Harris Hip Score before and after interventions intended to alleviate the impairments of body function and structure, activity limitations, and participation restrictions associated with hip osteoarthritis. (Recommendation based on strong evidence.) Examination – Activity Limitation and Participation Restriction Measures: Clinicians should utilize easily reproducible physical performance measures, such as the 6 Minute Walk, Self-Paced Walk, Stair Measure, and Timed Up and Go to assess activity limitation and participation restrictions associated with their patient's hip pain and to assess the changes in the patient's level of function over the episode of care. (Recommendation based on strong evidence.) Interventions-Patient Education: Clinicians should consider the use of patient education to teach activity modification, exercise, weight reduction when overweight, and methods of unloading the arthritic joints. (Recommendation based on moderate evidence.) training, including the use of assistive devices such as canes, crutches, and walkers, can …