Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial

Abstract

Background: The literature is unclear on the need for hip strengthening in persons with low backpain (LBP).Objectives: To investigate the effectiveness of hip strengthening exercises when added to man ual therapy and lumbar segmental stabilization in patients with chronic nonspecific LBP.Methods: Seventy patients with chronic nonspecific LBP were randomly assigned to either the ,manual therapy and lumbar segmental stabilization group or the manual therapy and lumbar seg mental stabilization plus specific hip strengthening group. A 10 cm visual analogue scale and theRolland-Morris Questionnaire were the primary clinical outcome measures at baseline, at the end of treatment (posttreatment), and 6- and 12-months posttreatment. Hip strength and kine matics were measured as secondary outcomes .Results: While within-group improvements in pain, disability, and hip extensors strength occurred in both groups, there were no significant between-group differences at posttreatmentor follow-ups. Mean difference in changes in pain level between groups at posttreatment and at 6- and 12-month follow-up were 0.5 points (95% confidence interval [CI]: -0.5, 1.5), 0.3 points(95% CI: -0.9, 1.5), and 0.0 points (95% CI: -1.1, 1.1), respectively. The mean differences in changes in disability were 0.8 points (95% CI: -1.3, 2.7), 0.0 points (95% CI: -2.4, 2.4), and 0.4.