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Effects of manual therapy and exercise targeting the hips in patients with low‐back pain—A randomized controlled trial
Author(s) -
Bade Michael,
CoboEstevez Manuel,
Neeley Darren,
Pandya Jeevan,
Gunderson Travis,
Cook Chad
Publication year - 2017
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12705
Subject(s) - medicine , physical therapy , oswestry disability index , randomized controlled trial , low back pain , manual therapy , lumbar , rating scale , patient satisfaction , physical medicine and rehabilitation , surgery , alternative medicine , psychology , developmental psychology , pathology
Rationale The benefits of providing manual therapy and exercise targeting the hips in individuals with mechanical low‐back pain (LBP) are not well established. Objectives The objective in this study is to determine whether a formal prescriptive treatment protocol for the hips improves outcomes in patients with a primary complaint of mechanical LBP. Methods Eighty‐four (84) subjects (50 males, 46.1 ± 16.2 years) were randomized to 1 of 2 groups: pragmatic treatment of the lumbar spine only (LBP) (n = 39) or pragmatic treatment of the lumbar spine and prescriptive treatment of bilateral hips (LBP + HIP) (n = 45). Pragmatic treatment of the lumbar spine was based upon published clinical guidelines. Prescriptive treatment of the hips involved the use of 3 hip exercises targeting the gluteal musculature and 3 mobilization techniques targeting the hips. Subjects were assessed at baseline, 2 weeks, and at discharge with the following measures: Modified Oswestry Disability Index, Numeric Pain Rating Scale, a global rating of change (GRoC) score, the patient acceptable symptom state (PASS), and patient satisfaction. Results At 2 weeks, significant differences between groups differences were found in GRoC and patient satisfaction ( P < .05) favoring the LBP + HIP group. At discharge, there were significant differences on the Modified Oswestry Disability Index, numeric pain rating scale, GRoC, and patient satisfaction favoring the LBP + HIP group ( P < .05). Effect sizes were small to medium. Conclusion Our findings suggest that a prescriptive treatment of the hips may be of clinical value to individuals presenting with the primary complaint of mechanical LBP.