Hip Range of Motion Reduced in Subjects with Chronic Low Back Pain

Physical Therapy Pediatric Continuing Education Courses
April 17, 2015
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Evidence-Based Practice – Issue 4-2015

Passive Hip Range of Motion (ROM) is Reduced in Active Subjects with Chronic Low Back Pain Compared to Control

Article:  Roach SM, et al.  Passive hip ROM is reduced in active subjects with chronic low back

pain compared to control.  International Journal of Sports Physical Therapy. 2015 Feb; 10(1): 13-20

Purpose.  The purpose of this study was to compare passive range of motion (ROM) of the hip joint in active patients with chronic low-back pain.

Study Design.  Two group, Case-controlled Trial

Methods

  • Participants
    • 30 Healthy Controls
    • 13 males; 17 females
    • Age:  34 years, Height:  171.5 cm; Weight:  71.9 kg
    • No radicular pain
    • No pain complaints of low back pain
    • 30 with NSCLBP
    • 14 males; 16 females
    • Age: 45 years, Height:  170.5 cm; Weight:  71.1 kg
    • No radicular pain
    • May or may not have radicular pain
    • Low Back Pain for > 3 months
  • Exclusion Criteria:
    • Previous Surgery or Acute Pain (<2 weeks) to the:
      • Hip
      • Knee
      • Spine
      • History of neurologic insult
  • Testing:
    • A digital inclinometer measured passive Hip ROM:
    • Extension
    • Internal Rotation
    • External Rotation
    • Total Hip Rotation
    • Testing repeated at 3 months
  • Statistical Analysis:
    • Two-way ANOVA

Results.

  • Statistically significant different (p<0.001) in passive hip extension ROM between groups
  • NSCLBP group had -4.28 of hip extension (did not attain neutral hip flexion/extension)
  • Healthy Control group had 6.88 hip extension
  • No statistical difference in hip external rotation, internal rotation, and total rotation (internal + external rotation)

Clinical Relevance.  Patients with chronic low back pain may present with restrictions in hip ROM, specifically in hip extension.  According to this study, hip rotation ROM did not have an association to low back pain.  Physical therapists should consider evaluating hip extension mobility and implement appropriate treatment interventions to improve passive hip extension ROM for patients presenting with chronic low back pain.

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