Kim L. Bennell, Christine Rini, Francis Keefe, Simon French, Rachel Nelligan, Jessica Kasza, Andrew Forbes, Fiona Dobson, J. Haxby Abbott, Andrew Dalwood, Bill Vicenzino, Anthony Harris, Rana S. Hinman

Persistent hip pain in older people is usually due to hip osteoarthritis (OA), a major cause of pain, disability and psychological dysfunction. To evaluate whether adding an internet-based pain coping skills training (PCST) protocol to a standardized intervention of education followed by physical therapist-instructed home exercise leads to greater improvements in pain and function. Assessor-, therapist- and participant-blinded randomized controlled trial SETTING: Community PARTICIPANTS: 142 people over 50 years of age with self-reported hip pain consistent with hip OA INTERVENTION: Participants will be randomly allocated to: i) control - a 24 week standardized intervention comprising an 8-week internet-based education package followed by 5 individual physical therapy exercise sessions plus home exercises (3 times weekly) or ii) PCST - adding an 8-week internet-based PCST protocol to the control intervention. Outcomes will be measured at baseline, 8, 24 and 52 weeks with the primary time point at 24 weeks. Primary outcomes are hip pain on walking and self-reported physical function. Secondary outcomes include health-related quality-of-life, participant perceived treatment response, self-efficacy for pain management and function, pain coping attempts, pain catastrophizing and physical activity. Measures of adherence, adverse events, use of health services, and process measures will be collected at 24 and 52 weeks. Cost effectiveness will be assessed at 52 weeks. A self-reported diagnosis of persistent hip pain will be used. The findings will help determine whether adding an internet-based PCST protocol to standardized education and physical therapist-instructed home exercise is more effective than education and exercise alone for persistent hip pain. This study has the potential to guide clinical practice towards innovative modes of psychosocial healthcare provision.