Prescriptive hip exercises improve pain, satisfaction in patients with LBP
Including manual therapy of the hip joints and prescriptive exercise programmes of the gluteal muscles in a low-back pain (LBP) intervention may improve clinical outcomes in individuals with a primary complaint of LBP, a new randomized controlled trial (RCT) shows.
Investigators randomly assigned 90 participants to receive either LBP treatment only (LBP) or both LBP and prescriptive hip treatment (LBP +HIP). Only patients at least 18 years of age who presented a primary complaint of LBP and showed improvements in pain and/or range of motion during the assessment visit were included.
Aside from a pragmatic, guideline-oriented treatment for LBP, participants in the LBP + HIP group received prescriptive hip treatments, which included exercises that targeted both hips and the hip joint. The primary outcome of the study was Modified Oswestry Disability Index (ODI) scores.
Only 84 of the 90 participants (aged 46.1 [16.2] years)completed all follow-up measures and were thus included in the analysis. Of the six lost to follow-up, two belonged to the LBP + HIP group and four to the LBP group.
The average duration of back pain symptoms was 19.7±7.2 and 20.3±6.5 weeks in the LBP and LBP + HIP groups, respectively. Baseline ODI scores were 36.7±2.1 and 36.4±1.5, and baseline numeric pain rating scale (NPRS) scores were 5.4±0.3 and 5.1±0.3, respectively. There were no significant differences in any of the baseline characteristics between the two groups.
At the end of two weeks, there were no significant between-group differences in ODI (mean difference [MD], 2.6; 95 percent CI, 0.67 to 4.43; p=0.01) and NPRS (MD, 0.2; -0.6 to 0.5; p=0.27). The LBP + HIP group had significant improvements in patient satisfaction (p<0.01) and global rating of change (GRoC; p<0.01).
At discharge, the LBP + HIP group had significantly more favourable ODI (p=0.03), NPRS (p=0.02), patient satisfaction (p<0.01) and GRoC (p<0.01).