The effect of the addition of hip strengthening exercises to a lumbopelvic exercise programme for the treatment of non-specific low back pain: A randomized controlled trial

Abstract

Objectives: To compare the efficacy of two exercise programmes in reducing pain and disability for individuals with non-specific low back pain and to examine the underlying mechanical factors related to pain and disability for individuals with NSLBP.

Design: A single-blind, randomized controlled trial.

Methods: Eighty participants were recruited from eleven community-based general medical practices and randomized into two groups completing either a lumbopelvic motor control or a combined lumbopelvic motor control and progressive hip strengthening exercise therapy programme. All participants received an education session, 6 rehabilitation sessions including real time ultrasound training, and a home based exercise programme manual and log book. The primary outcomes were pain (0-100 mm visual analogue scale), and disability (Oswestry Disability Index V2). The secondary outcomes were hip strength (N/kg) and two-dimensional frontal plane biomechanics (°) measure during the static Trendelenburg test and while walking. All outcomes were measured at baseline and at 6-week follow up.

Results: There was no statistical difference in the change in pain (x¯ = -4.0 mm, t = -1.07, p = 0.29, 95%CI -11.5, 3.5) or disability (x¯ = -0.3%, t = -0.19, p = 0.85, 95%CI -3.5, 2.8) between groups. Within group comparisons revealed clinically meaningful reductions in pain for both Group One (x¯ = -20.9 mm, 95%CI -25.7, -16.1) and Group Two (x¯ = -24.9, 95%CI -30.8, -19.0).

Conclusions: Both exercise programmes had similar efficacy in reducing pain. The addition of hip strengthening exercises to a motor control exercise programme does not appear to result in improved clinical outcome for pain for individuals with non-specific low back pain.

Keywords: Chronic disease; Exercise therapy; Kinematics; Rehabilitation.