JANUARY 24, 2024
Among older adults with chronic low back pain, administering hip-focused physical therapy may relieve pain and disability, according to recent findings.
Researchers performed a multicenter, single-masked, randomized controlled trial at three research-based sites in the United States (Lancet Rheumatol 2023;6[1]:E10-E20). They included 184 adults (60-85 years of age; mean age, 70.7 years; 66% women) with hip pain and weakness who reported moderate low back at least half the days in a six-month
Among older adults with chronic low back pain, administering hip-focused physical therapy may relieve pain and disability, according to recent findings.
Researchers performed a multicenter, single-masked, randomized controlled trial at three research-based sites in the United States (Lancet Rheumatol 2023;6[1]:E10-E20). They included 184 adults (60-85 years of age; mean age, 70.7 years; 66% women) with hip pain and weakness who reported moderate low back at least half the days in a six-month time frame preceding enrollment into the study.
Patients were randomized to receive hip-focused (n=91) or spine-focused physical therapy (n=93) interventions using permuted blocks with random block size, stratified by site and sex.
After eight weeks of therapy, disability and pain were measured using the Quebec Back Pain Disability Scale (QBPDS) and performance-based 10-meter walk test (10MWT). There was a substantial improvement in disability scores (improvement of >50%) in both groups of patients: 46% in the hip-focused group versus 33% of in the spine-focused group. Patients in the hip therapy group had a mean improvement on the QBPDS that was 4.0 points higher than those who received spine-focused physical therapy.
Both groups had similar, clinically meaningful gait speed improvements in the 10MWT (mean difference in improvement between groups, 0.004 m/second; 95% CI, –0.044 to 0.052 m/second). No serious adverse events were related to participants’ physical therapy.
“Tailored hip-focused physical therapy demonstrated greater improvements in low back pain-related disability at 8 weeks,” the researchers reported.
Although there were no statistically significant data to support one form of therapy over another after six months of treatment, the investigators concluded that “both hip-focused physical therapy and spine-focused physical therapy produced clinically meaningful improvements in disability and function for this high-risk population at 6 months.” Further investigation into both therapies and how they serve patients in the long term is warranted.
—Myles Starr
