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

Fukuda, Thiago Yukio; Aquino, Leticia Moraes de; Pereira, Pedro; Ayres, Isabella; Feio, Ana Francisca; Jesus, Fabio Luciano Arcanjo de; Neto, Mansueto Gomes

doi:10.1016/j.bjpt.2021.10.005

Cited by 10 publications

(33 citation statements)

References 32 publications

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“…The nine original trials were published between 2010 and 2021: two from Europe; four from South America; two from Asia; and one multicenter trial. All trials investigated nontraumatic musculoskeletal health conditions: patellofemoral pain [ 30 , 31 , 32 ] and low back pain [ 33 , 34 , 35 , 36 , 37 , 38 ]. The sample sizes of the included trials ranged from 20 to 90 participants and consisted of participants aged between 22 and 61 years old.…”

Section: Resultsmentioning

confidence: 99%

“…The sample sizes of the included trials ranged from 20 to 90 participants and consisted of participants aged between 22 and 61 years old. Five trials included only females [ 30 , 31 , 32 , 34 , 35 ], two trials included both sexes [ 33 , 38 ], and two trials did not present sex distributions [ 36 , 37 ]. Three trials investigated the efficacy of hip strengthening compared with control (no intervention), and six trials investigated whether hip strengthening combined with other active interventions enhanced the effects of the other active interventions.…”

Section: Resultsmentioning

confidence: 99%

“…Three trials investigated the efficacy of hip strengthening compared with control (no intervention), and six trials investigated whether hip strengthening combined with other active interventions enhanced the effects of the other active interventions. The outcomes included NPRS [ 16 , 17 , 18 , 30 , 33 , 38 ], VAS [ 31 , 32 , 35 , 36 , 37 ], and measured pain intensity [ 32 ]. Self-reported disability was assessed by the Oswestry Disability Index (ODI) [ 33 , 34 , 35 , 36 , 38 ], the Lower Extremity Functional Scale (LEFS), the Anterior Knee Pain Scale (AKPS) [ 30 ], the Roland–Morris questionnaire [ 37 ], and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…The outcomes included NPRS [ 16 , 17 , 18 , 30 , 33 , 38 ], VAS [ 31 , 32 , 35 , 36 , 37 ], and measured pain intensity [ 32 ]. Self-reported disability was assessed by the Oswestry Disability Index (ODI) [ 33 , 34 , 35 , 36 , 38 ], the Lower Extremity Functional Scale (LEFS), the Anterior Knee Pain Scale (AKPS) [ 30 ], the Roland–Morris questionnaire [ 37 ], and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) [ 31 ]. Hip strength was assessed by a handheld isometric dynamometer and a force dynamometer [ 32 , 35 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Control: sham, placebo, no intervention, or waiting list. (a) Downgraded owing to imprecision: less than 400 participants included in the meta-analysis (sample of less than 200 was considered serious imprecision, and the evidence was downgraded by two levels); (b) Downgraded owing to inconsistency: I 2 statistic was higher than 50% or pooling was not possible (poor overlap between the confidence intervals of the effects of the studies included in the meta-analysis was considered serious inconsistency, and the evidence was downgraded by two levels); (c) Downgraded owing to risk of bias: more than 25% of the participants in the meta-analysis were from trials with a high risk of bias (i.e., PEDro score < 6 of 10) [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Section: Figurementioning

confidence: 99%

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Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations

Silva

Maia²,

Mendonça³

et al. 2022

Diagnostics

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To investigate the efficacy of hip strengthening on pain, disability, and hip abductor strength in musculoskeletal conditions of the trunk and lower limbs, we searched eight databases for randomized controlled trials up to 8 March 2022 with no date or language restrictions. Random-effect models estimated mean differences (MDs) with 95% confidence intervals (CIs), and the quality of evidence was assessed using the GRADE approach. Very low quality evidence suggested short-term effects (≤3 months) of hip strengthening on pain intensity (MD of 4.1, 95% CI: 2.1 to 6.2; two trials, n = 48 participants) and on hip strength (MD = 3.9 N, 95% CI: 2.8 to 5.1; two trials, n = 48 participants) in patellofemoral pain when compared with no intervention. Uncertain evidence suggested that hip strengthening enhances the short-term effect of the other active interventions on pain intensity and disability in low back pain (MD = −0.6 points, 95% CI: 0.1 to 1.2; five trials, n = 349 participants; MD = 6.2 points, 95% CI: 2.6 to 9.8; six trials, n = 389 participants, respectively). Scarce evidence does not provide reliable evidence of the efficacy of hip strengthening in musculoskeletal conditions of the trunk and lower limbs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

See 3 more Smart Citations

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations

Silva

Maia²,

Mendonça³

et al. 2022

Diagnostics

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Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults

Verville,

Ogilvie,

Hincapié

et al. 2023

J Occup Rehabil

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Purpose Evaluate benefits and harms of structured exercise programs for chronic primary low back pain (CPLBP) in adults to inform a World Health Organization (WHO) standard clinical guideline. Methods We searched for randomized controlled trials (RCTs) in electronic databases (inception to 17 May 2022). Eligible RCTs targeted structured exercise programs compared to placebo/sham, usual care, or no intervention (including comparison interventions where the attributable effect of exercise could be isolated). We extracted outcomes, appraised risk of bias, conducted meta-analyses where appropriate, and assessed certainty of evidence using GRADE. Results We screened 2503 records (after initial screening through Cochrane RCT Classifier and Cochrane Crowd) and 398 full text RCTs. Thirteen RCTs rated with overall low or unclear risk of bias were synthesized. Assessing individual exercise types (predominantly very low certainty evidence), pain reduction was associated with aerobic exercise and Pilates vs. no intervention, and motor control exercise vs. sham. Improved function was associated with mixed exercise vs. usual care, and Pilates vs. no intervention. Temporary increased minor pain was associated with mixed exercise vs. no intervention, and yoga vs. usual care. Little to no difference was found for other comparisons and outcomes. When pooling exercise types, exercise vs. no intervention probably reduces pain in adults (8 RCTs, SMD = − 0.33, 95% CI − 0.58 to − 0.08) and functional limitations in adults and older adults (8 RCTs, SMD = − 0.31, 95% CI − 0.57 to − 0.05) (moderate certainty evidence). Conclusions With moderate certainty, structured exercise programs probably reduce pain and functional limitations in adults and older people with CPLBP.

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The effectiveness of hip interventions in patients with low-back pain: A systematic review and meta-analysis

Ceballos‐Laita¹,

Estébanez-de-Miguel²,

Jiménez‐Rejano³

et al. 2023

Brazilian Journal of Physical Therapy

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

Cited by 10 publications

References 32 publications

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations

Efficacy of Hip Strengthening on Pain Intensity, Disability, and Strength in Musculoskeletal Conditions of the Trunk and Lower Limbs: A Systematic Review with Meta-Analysis and Grade Recommendations

Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Structured Exercise Programs for Chronic Primary Low Back Pain in Adults

The effectiveness of hip interventions in patients with low-back pain: A systematic review and meta-analysis

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