Effects of Modified Clamshell Exercises in Patients With Hip Osteoarthritis Grade II.

NCT07401719 | Recruiting DMC

• 1 other identifier: LCPT/DPT/ERB/44
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Osteo Arthritis of Hip

Keywords

Modified Clamshell Exercises; Hip Osteoarthritis Grade II; Hip Osteoarthritis; Clamshell Exercises; Hip Disability and Osteoarthritis Outcome Score (HOOS-12) scale; Hip Arthritis

Outcome Measures

Primary Outcomes (2)

• 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

  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.

  12 weeks

Secondary Outcomes (1)

• Functional Outcomes

  12 weeks

Study Arms (3)

Modified Clamshell Exercise

EXPERIMENTAL

This group will receive modified clamshell exercises along with conventional exercises.

Other: Modified clamshell exercise; Other: Conventional exercises

Clamshell exercise

EXPERIMENTAL

Participants in this group will receive clamshell exercises along with conventional exercises.

Other: Clamshell Exercises; Other: Conventional exercises

Conventional Exercises

ACTIVE COMPARATOR

This group will only receive conventional exercises including TENS, hot pack, bridging, sideways hip lifts, standing hip extension, and double hip rotation exercises.

Other: Conventional exercises

Interventions

Modified clamshell exercise OTHER

This 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.

Modified Clamshell Exercise

Clamshell Exercises OTHER

This 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.

Clamshell exercise

Conventional exercises OTHER

This 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.

Clamshell exercise; Conventional Exercises; Modified Clamshell Exercise

Eligibility Criteria

• Age: 45 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• \- (1) Patients between 45 to 60 years. (2) Both male and female patients with hip osteoarthritis grade II were selected for this study.
• (3) Patients with Hip Osteoarthritis grade II. (4) Patients with pain more than 6 months.

You may not qualify if:

• (1) Patients with Cardiac disorders. (2) Patient with other current lower extremity pathologies (e.g., peripheral vascular disease, septic arthritis) (3) Patients with low back surgery.

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

Ghurki Trust and Teaching Hospital

Lahore, Punjab Province, 54600, Pakistan

RECRUITING

Related Publications (4)

• Exercise Therapy Program in Rehabilitation of Patients with Primary Hip Osteoarthritis

  BACKGROUND

• Exercise in patients with hip osteoarthritis-effects on muscle and functional performance

  BACKGROUND

• Kaleem S, Noor R, Bashir MS, Ikram M. Effects of clamshell exercises in terminal extension lag after ACL reconstruction.

  BACKGROUND

• Effect of modified clamshell exercise on gluteus medius, quadratus lumborum and anterior hip flexor in participants with gluteus medius weakness

  BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Hip

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Study Officials

• Principal investigator

  Ghurki Trust and Teaching Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Zile Amna

CONTACT

+923201012563; zileamna@gmail.com

Salwa Atta

CONTACT

03084579229; salwa.atta@ubas.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: This study uses a double-blinded design. Participants and outcome assessors will be blinded to group allocation to minimize performance and selection bias. Group assignment will be concealed using sealed, opaque, sequentially numbered envelopes. All outcome assessments, including pain intensity, hip function, and range of motion, will be performed by an independent outcome assessor who will remain blinded to group allocation throughout the study. Due to the nature of exercise-based interventions, the treating therapists will not be blinded
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study follows a randomized controlled trial (RCT) design to compare the effectiveness of modified clamshell exercises and clamshell exercises, each combined with conventional hip osteoarthritis exercises, in patients with Grade II hip osteoarthritis. Eligible participants will be randomly allocated into three parallel groups using a computer-generated randomization sequence to ensure balanced group assignment. The first group will receive modified clamshell exercises in combination with conventional exercises, the second group will receive clamshell exercises with conventional exercises, and the third group will receive conventional exercises only. A double-blinded approach will be used, in which both the participants and outcome assessors will be blinded to group allocation. Outcomes will be assessed at baseline and at 3, 6, and 12 weeks to evaluate changes in pain intensity, hip function, and range of motion. This study design allows for a controlled comparison of exercise-based

Study Record Dates

• First Submitted: February 3, 2026
• First Posted: February 10, 2026
• Study Start: August 7, 2025
• Primary Completion: February 10, 2026
• Study Completion: February 10, 2026
• Last Updated: February 10, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)