This study focuses on patients diagnosed with Grade II hip osteoarthritis, a degenerative joint condition characterized by pain, reduced range of motion, muscle weakness, and functional limitations. Hip osteoarthritis is commonly assessed using the Kellgren-Lawrence (KL) classification system, with Grade II representing definite osteophyte formation with possible joint space narrowing, where conservative management is strongly recommended. Exercise therapy, particularly strengthening of the hip abductor muscles, plays a key role in improving pelvic stability, reducing pain, and enhancing functional outcomes. Clamshell exercises are widely used to activate the gluteus medius and minimus muscles, while modified clamshell exercises are designed to optimize muscle recruitment and reduce compensatory movements.
A total of 54 participants with Grade II hip osteoarthritis will be included in the study and allocated into three groups. Group A will receive clamshell exercises along with conventional exercise therapy, Group B will receive modified clamshell exercises in addition to conventional exercise therapy, and Group C will receive a conventional exercise program alone. Pain intensity will be assessed using the Visual Analog Scale (VAS), which ranges from 0 to 10. Hip joint range of motion will be measured using a goniometer, and functional outcomes will be evaluated using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The aim of this study is to compare the effects of clamshell exercises, modified clamshell exercises, and conventional exercise programs to determine the most effective intervention for reducing pain, improving hip joint range of motion, and enhancing functional outcomes in patients with Grade II hip osteoarthritis.
Patients between 45 to 60 years
Both male and female patients with hip osteoarthritis grade II were selected for this study
Patients with Hip Osteoarthritis grade II
Patients with pain more than 6 months
Patients with Cardiac disorders
Patient with other current lower extremity pathologies (e.g., peripheral vascular disease, septic arthritis)
Patients with low back surgery.
Parallel
Modified clamshell exercise
Other interventionThis group will receive modified clamshell exercises along with conventional exercises. Time for each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
Clamshell Exercises
Other interventionThis group will receive Clamshell exercises along with conventional exercises. Each session will last for 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
Conventional exercises
Other interventionThis group will only receive conventional exercises including TENS, hot pack bridging, sideways hip lifts, standing hip extension and double hip rotation. time of each session will be 40 minutes. Patient will receive 3 sessions a weeks for 12 weeks.
Pain Intensity
Pain intensity will be assessed using the Visual Analog Scale (VAS). The VAS is a widely used, valid, and reliable subjective measure of pain intensity, where participants rate pain on a scale from 0 to 10 . A score of 0 means no pain, while 10 represent worst imaginable pain. Participants. The VAS is sensitive to changes over time and is commonly used in clinical and research settings to evaluate treatment effectiveness. Pain intensity will be assessed at baseline, 3 weeks, 6 weeks, and 12 weeks
ROM
Range of motion (ROM) of the hip joint will be assessed using a universal goniometer. Goniometric measurement is a standard and objective clinical method used to evaluate joint mobility and functional movement in individuals with hip osteoarthritis. Hip abduction, and external rotation will be measured following standardized positioning and measurement procedures to ensure consistency and reliability. Goniometric ROM measurements provide quantitative data to identify movement limitations, monitor functional improvements, and assess the effectiveness of therapeutic exercise interventions. ROM assessments will be performed at baseline, 3 weeks, 6 weeks, and 12 weeks.
Functional Outcomes
Functional outcome will be assessed using the Hip Disability and Osteoarthritis Outcome Score-12 (HOOS-12). The HOOS-12 is a validated, patient-reported outcome measure designed to evaluate hip-related symptoms, pain, and functional limitations in individuals with hip osteoarthritis. It consists of 12 items covering key domains of hip function and quality of life. Each item is scored on a Likert scale, and scores are transformed to a 0-100 scale, with higher scores indicating better hip function and fewer symptoms. The HOOS-12 is sensitive to clinical changes and suitable for both short-term and long-term assessment of functional improvement. Functional outcomes will be measured at baseline, 3 weeks, 6 weeks, and 12 weeks
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