Neuromuscular training in hip osteoarthritis is a promising approach to improve quality of life, pain, and functional performance, but few studies use statistical methods to predict clinical evolution of these patients. Simulation Modeling Analysis (SMA) allows the application of time series analysis in small samples, identifying individual patterns of response to treatment. This approach can optimize physical therapy interventions and become a relevant tool in hip osteoarthritis treatment.

To predict values and verify differences in quality of life for a patient with hip osteoarthritis undergoing neuromuscular training, using SMA. Additionally, to evaluate pain intensity, functional performance, and muscle strength before and after neuromuscular training. Method: Case study with a male patient (59 years, BMI: 32.2 kg/m²) diagnosed with advanced hip osteoarthritis. Quality of life was assessed by WOMAC, pain by Numerical Pain Scale (NPS), functional performance by Timed Up & Go (TUG), and 30-Second Chair Stand (30STS) tests, and muscle strength by maximum isometric dynamometry. Treatment followed an adapted neuromuscular training protocol (NEMEX-TJR), with 26 sessions of 50 minutes over three months. Statistical analysis included descriptive analysis of variables (pain, functional performance, and muscle strength) and time series analysis for WOMAC data. Bootstrapping was used to estimate autocorrelation coefficients based on lags. Correlation values and slopes were also calculated. Statistical significance was set at 5 %. Results: SMA analysis demonstrated a significant prediction of continuous improvement in quality of life with neuromuscular training, with an estimated reduction of 1.28 points on WOMAC per week. After neuromuscular training, there was a global improvement of 61.9 % in quality of life and 100 % reduction in pain. In functional tests, TUG improved by 18.7 % and 30STS showed a 64.6 % increase in repetitions. Increased strength was observed in hip abductor muscles (12.7 % in the unaffected lower limb) and adductors (11.9 % in the affected lower limb and 6.3 % in the unaffected). Conclusion: SMA allowed observation of significant difference and prediction of quality of life evolution over time, demonstrating the effectiveness of the NEMEX-TJR protocol for this outcome in this patient pattern. Additionally, there was a clinically relevant reduction in pain, improved functional performance, and increased strength of hip adductors and abductors. These findings reinforce the positive impact of neuromuscular training on hip osteoarthritis treatment. Studies with larger samples are needed to consolidate these findings and validate SMA use as a complementary tool in rehabilitation. Implications: SMA application in physical therapy can contribute to a more individualized approach, week by week, allowing adjustments based on treatment response prediction. This can positively impact clinical management of hip osteoarthritis, optimize decision-making, and improve quality of life, pain, and functional performance outcomes for patients.

SMA analysis demonstrated a significant prediction of continuous improvement in quality of life with neuromuscular training, with an estimated reduction of 1.28 points on WOMAC per week. After neuromuscular training, there was a global improvement of 61.9 % in quality of life and 100 % reduction in pain. In functional tests, TUG improved by 18.7 % and 30STS showed a 64.6 % increase in repetitions. Increased strength was observed in hip abductor muscles (12.7 % in the unaffected lower limb) and adductors (11.9 % in the affected lower limb and 6.3 % in the unaffected).

SMA allowed observation of significant difference and prediction of quality of life evolution over time, demonstrating the effectiveness of the NEMEX-TJR protocol for this outcome in this patient pattern. Additionally, there was a clinically relevant reduction in pain, improved functional performance, and increased strength of hip adductors and abductors. These findings reinforce the positive impact of neuromuscular training on hip osteoarthritis treatment. Studies with larger samples are needed to consolidate these findings and validate SMA use as a complementary tool in rehabilitation.

SMA application in physical therapy can contribute to a more individualized approach, week by week, allowing adjustments based on treatment response prediction. This can positively impact clinical management of hip osteoarthritis, optimize decision-making, and improve quality of life, pain, and functional performance outcomes for patients.