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

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.