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

Completed · Not applicable

Conditions studied: Chronic Low-back Pain, Hip Impairments, Hip-spine Syndrome, Osteoarthritis

In brief

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.

Key facts

Study ID

NCT04009837

Run by

University of Delaware

People needed

184

Starts

2019-11-01

Expected to finish

2022-10-03

Last updated by the study team

2024-04-11

Who can join

Age: 60 and older, up to 85. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• LBP duration ≥ 3 months
• LBP an ongoing problem for at least half days in past 6 months
• LBP intensity > 3 on scale of 0 (no pain) to 10 (worst pain imaginable)
• Classified into the "weak+painful" hip-spine subgroup based on two criterion. Participants must have: 1) hip internal rotation strength (normalized to body weight) in at least one hip that is < 0.26; and, 2) from the Hip Disability and Osteoarthritis Outcome Score (HOOS) Pain items P4-P8, a raw score sum of >5 (0-20 range, where higher scores indicate more pain interference with daily activities).

You may not qualify if…

• Previous hip fracture with surgical repair
• Previous hip fracture without surgical repair within the past 15 years
• Total hip replacement
• Known spinal pathology other than osteoarthritis (e.g. recent back surgery, vertebral fractures in the past year, rheumatoid arthritis, metastases)
• Non-ambulatory or severely impairment mobility (i.e. requires wheelchair)
• Folstein Mini-Mental State Examination score of < 24, indicating cognitive impairment
• Severe visual or hearing impairment
• Unable to read or speak English
• Red flags indicative of serious disorder underlying LBP (e.g. fever associated with LBP, significant unintentional weight loss > 10 pounds, pain that awakes or keeps one awake at night)
• Significant pain the legs greater than the back
• Acute illness (e.g. hospitalization within the past 3 months or current infection)
• Inability to participate in study for the full six months for any known reason
• Received physical therapy for low back or hip within the last 3 months

Where it is running

• University of Delaware — Newark, Delaware, United States
• Duke University — Durham, North Carolina, United States
• University of Pittsburgh — Pittsburgh, Pennsylvania, United States

Full record on ClinicalTrials.gov

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