by Hip-focused physical therapy has been found to be effective in reducing chronic low back pain in older adults, according to a clinical trial conducted by researchers from the University of Delaware, Duke University, and the University of Pittsburgh. The study, called the Manual Therapy and Strengthening the Hip (MASH) Trial, is believed to be the first of its kind to assess the efficacy of a tailored physical therapy intervention for older adults with chronic low back pain and coexisting hip pain and muscle weakness.
The trial, which took place over an eight-week period between November 2019 and April 2022, involved 184 participants aged 60 to 85 years old. The participants were randomly assigned to receive either hip-focused or spine-focused therapies delivered at the researchers’ locations. The outcomes measured included pain-related disability, walking performance, and the ability to rise from a seated position.
The findings of the study, published in The Lancet Rheumatology, showed that both therapies improved walking speed similarly. However, the hip-focused therapy resulted in a greater reduction in disability from low back pain immediately following the eight-week intervention. While there was no significant difference in disability reduction at the six-month mark, further analysis revealed that a higher percentage of participants in the hip-focused group experienced a substantial improvement in disability scores. Additionally, the hip-focused treatment was associated with greater improvements in chair-rise performance at six months and walking endurance at eight weeks and six months.
The MASH Trial builds on previous research conducted by lead researcher Gregory Hicks, who has been studying chronic low back pain in older adults for over two decades. Hicks believes that there are often disparities in the level of care given to older adults with musculoskeletal problems, and this study aims to challenge that belief. Hicks emphasized the importance of tailored treatments for different sub-groups of low back pain patients, as it can lead to better outcomes.
The study used artificial intelligence and modeling tools to identify distinct sub-groups of chronic low back pain patients. One sub-group had significant issues with hip weakness and hip pain, another had significant hip weakness without hip pain, and a third sub-group had no issues with the hip. The results highlight the potential for precision medicine and precision rehabilitation in the treatment of chronic low back pain.
Hicks plans to further refine the hip-focused physical therapy intervention and develop treatment approaches for the other sub-groups in future clinical trials. He hopes that this research will bring attention to the importance of studying and treating low back pain in the older adult population, as it is a leading cause of disability globally.
With the incidence of low back pain increasing worldwide, this study provides valuable insights into effective treatment options for older adults. By focusing on the hip as a potential source of pain, physical therapy interventions can help improve function and reduce disability in this population.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
