Manual Therapy and Strengthening for the Hip in Older Adults With Chronic Low Back Pain

Summary

Older adults with chronic low back pain (LBP) are at a greater risk for disability, loss of independence, and lower quality of life. Experts agree that LBP is not a homogeneous condition, and treatments should differ based upon clinical presentation. Our past work indicates that all of these hip and lumbar spine impairments may contribute to worse physical function and greater disability, but the relative importance of each impairment is unclear. Thus, clinicians have limited evidence to draw on for treatment decisions for this patient population. We have identified a vulnerable subgroup of older adults with hip and low back pain. The purpose of this study is to randomize participants into one of two treatment arms and analyze the outcomes.

Conditions

• Chronic Low-back Pain
• Hip Impairments
• Hip-spine Syndrome
• Osteoarthritis

Interventions

BEHAVIORAL

Hip-focused rehabilitation intervention

The hip-focused intervention includes a blend of hip-focused rehabilitative techniques and some basic lumbar spine-directed techniques. The hip-focused arm includes tailored manual therapy, progressive strengthening exercises, and flexibility exercises for the hip, as well as spinal flexibility and trunk muscle training exercises. The intervention will be delivered by licensed physical therapists in one-hour sessions, twice per week, for 8 weeks.

BEHAVIORAL

Spine-focused rehabilitation intervention

The spine-focused rehabilitation intervention is a direct and comprehensive lumbar spine rehabilitative program, but it does not include hip treatment. The spine-focused arm includes spinal manual therapy, spinal flexibility exercises, and trunk muscle training exercises. The intervention will be delivered by licensed physical therapists in one-hour sessions, twice per week, for 8 weeks.

Sponsors & Collaborators

• University of Pittsburgh

  collaborator OTHER

• Duke University

  collaborator OTHER

• National Institute on Aging (NIA)

  collaborator NIH

• University of Delaware

  lead OTHER

Principal Investigators

• Gregory E Hicks, PhD · University of Delaware

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Max Age

85 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-11-01

Primary Completion

2022-10-03

Completion

2022-10-03

Countries

• United States

Study Locations