Ceballos-Laita L, Estébanez-de-Miguel E, Jiménez-Rejano JJ, Bueno-Gracia E, Jiménez-Del-Barrio S. The effectiveness of hip interventions in patients with low-back pain: A systematic review and meta-analysis.
Braz J Phys Ther 2023;
27:100502. [PMID:
37037144 PMCID:
PMC10120300 DOI:
10.1016/j.bjpt.2023.100502]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND
Low-back pain (LBP) may be directly or indirectly related to impairments from the hip joint.
OBJECTIVE
To evaluate the effectiveness of hip interventions on pain and disability in patients with LBP in the short-, medium-, and long-term.
METHODS
PubMed, Cochrane Library, PEDro, Web of Science, and SCOPUS databases were searched in November 2022. Randomized controlled trials involving hip-targeted interventions compared to specific low back interventions in patients with LBP were selected. The outcomes were pain intensity and disability. The quality of the studies was assessed with the risk of bias tool. GRADE was used to rate the certainty of evidence. Meta-analyses were conducted using random effects models.
RESULTS
A total of 2581 studies were screened. Eight were included in the meta-analysis involving 508 patients with LBP. The results provided very low certainty that both hip strengthening and hip stretching improved pain (MD = -0.66; 95% CI -0.86, -0.48; I2:0%) (MD = -0.55; 95% CI -1.02, -0.08) and disability (SMD = -0.81; 95% CI -1.53, -0.10; I2: 80%) (SMD = -1.03; 95% CI -1.82, -0.25) in the short-term, respectively. No benefits were found in the medium- or long-term. The risk of bias, heterogeneity, and imprecision of the results downgraded the level of evidence.
CONCLUSIONS
Very low certainty evidence suggest a positive effect of hip strengthening in isolation or combined with specific low back exercise and hip stretching combined with specific low back exercise for decreasing pain intensity and disability in the short-term, in patients with LBP.
SYSTEMATIC REVIEW REGISTRATION NUMBER
PROSPERO CRD42022303173.
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