Hip Hinge Instruction for Lower Back Pain

Overseen By William J. Hanney, PHD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Central Florida

Disqualifiers: Low back pain, Pelvic pain, Hip pain, Musculoskeletal injuries, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

30 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Founder Exercise for lower back pain?

Research shows that hip strengthening exercises can help reduce pain and disability in people with low back pain, suggesting that exercises like the Founder Exercise, which targets similar areas, might also be beneficial. ^{1 2 3 4 5}

Is the hip hinge exercise safe for humans?

There is no specific safety data available for the hip hinge exercise or its variations like the Founder Exercise in the provided research articles. ^{1 6 7 8 9}

How is the Founder Exercise treatment different from other treatments for lower back pain?

The Founder Exercise treatment is unique because it focuses on teaching proper hip hinge movements, which can help reduce strain on the lower back by improving hip flexibility and strength. This approach is different from other treatments that may not specifically target the hip's role in managing lower back pain. ^{1 10 11 12 13}

What is the purpose of this trial?

To evaluate if the Founder exercise will significantly change participants kinematics when performing hip hinge movement. Secondary purpose is to evaluate if completing the Founder Exercise intervention will improve confidence in performing a hip hinge.

Eligibility Criteria

This trial is for individuals experiencing lower back pain or arthritis who are interested in improving their hip hinge movement, which is important for activities like lifting. Specific eligibility criteria have not been provided, so it's best to contact the study organizers for more details.

Inclusion Criteria

Ability to understand verbal and tactile cues

Ability to perform physical exercises, including bending at the waist

Exclusion Criteria

I have had low back, pelvic, or hip pain.

I experience pain with the treatment.

Pregnant individuals or those planning pregnancy during the study duration

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

Pre-intervention assessment

Baseline data collection including demographic information, confidence scale, and placement of reflective markers

15 minutes

1 visit (in-person)

Intervention

Participants receive 8 minutes of instruction on the Founder Exercise and perform 10 practice repetitions

15 minutes

1 visit (in-person)

Post-intervention assessment

Reassessment of hip hinge movement and grip strength, completion of confidence scale

15 minutes

1 visit (in-person)

Follow-up

Participants are monitored for any adverse effects and can request their individual results

1 week

Treatment Details

Interventions

• Founder Exercise

Trial Overview The trial focuses on teaching a specific exercise called the Founder and assessing its impact on how participants perform a hip hinge movement. It also looks at whether this exercise boosts confidence in doing the movement correctly.

Participant Groups

Group I: Hip Hinge Experimental Treatment 1 Intervention

* Each participant will receive 8 minutes of instruction from Assessor 2 on performing the Founder Exercise according to the standardized training strategies documented in the attached file labeled "Founder Exercise Instruction". * The participant will then be allowed 10 practice repetitions with cueing from Assessor 2. Guidelines for cuing can be found in the "Founder Exercise Instruction" document.

Who Is Running the Clinical Trial?

University of Central Florida

Lead Sponsor

Trials

101

Recruited

1,191,000+

Findings from Research

Hip strengthening exercises significantly reduce pain and disability in individuals with low back pain, based on a review of five studies involving 309 patients.

The evidence suggests that incorporating hip strengthening into rehabilitation therapy can enhance outcomes, although the quality of evidence for disability improvement was rated as low.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Addition of specific hip strengthening exercises to conventional rehabilitation therapy for low back pain: a systematic review and meta-analysis. de Jesus, FLA., Fukuda, TY., Souza, C., et al.[2022]

In a randomized controlled trial involving 76 participants with low back pain (LBP) and hip impairment, adding hip treatments to standard care did not significantly improve disability or pain outcomes compared to treatment focused solely on the lumbar spine.

At both discharge and 12 months, there were no significant differences in disability or pain levels between the two treatment groups, suggesting that hip treatments may not be necessary for effective management of LBP in patients with concurrent hip issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

When Treating Coexisting Low Back Pain and Hip Impairments, Focus on the Back: Adding Specific Hip Treatment Does Not Yield Additional Benefits-A Randomized Controlled Trial. Burns, SA., Cleland, JA., Rivett, DA., et al.[2022]

A systematic review and meta-analysis of six randomized controlled trials involving 387 participants found that hip-targeted physical therapy interventions did not lead to significant reductions in pain or disability for patients with low back pain.

The studies showed a trivial effect size for pain outcomes and a small effect size for disability, indicating that these interventions may not be effective, and all studies had a high risk of bias.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of hip-targeted physical therapy interventions on low back pain: A systematic review and meta-analysis. Bernet, BA., Peskura, ET., Meyer, ST., et al.[2019]

A systematic review of 159 randomized controlled trials on exercise for low back pain revealed that most studies had a stronger focus on efficacy rather than effectiveness, indicating that many trials may not fully reflect real-world clinical settings.

A significant portion of the trials (42.1%) exhibited a high risk of bias, suggesting that future research should adopt more pragmatic designs to enhance the applicability of findings in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trials investigating exercise for low back pain lack pragmatic application: a systematic review. Tracy, BA., Soncrant, J., Rhon, DI., et al.[2023]

A systematic review of 582 clinical trials on exercise interventions for low back pain revealed that the reporting quality was generally poor, with a median completeness of only 59.2% for the TIDieR checklist and 33.3% for the CERT checklist.

Despite the introduction of standardized reporting checklists, there has been no significant improvement in the quality of reporting over time, indicating a need for more focused efforts to enhance the clarity and completeness of exercise intervention descriptions in clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise interventions for low back pain are poorly reported: a systematic review. Davidson, SRE., Kamper, SJ., Haskins, R., et al.[2021]

In a 12-month study involving 229 participants with chronic back pain, those in a pedometer-based walking intervention reported a higher number of adverse events (350) compared to the usual care group (250), with musculoskeletal injuries being the most common.

Despite the increased reporting of musculoskeletal events, the study concludes that individuals with chronic back pain can safely participate in walking programs, suggesting the need for counseling on injury prevention and gradual increases in activity levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events experienced by participants in a back pain walking intervention: A descriptive study. Krein, SL., Abdul-Wahab, Y., Kadri, R., et al.[2016]

The systematic review of 24 studies found very low-quality evidence suggesting that limited hip internal rotation (IR) range of motion (ROM) may be associated with nonspecific low back pain (NSLBP), but this finding should be interpreted cautiously due to the overall low quality of the studies.

Among various hip movements assessed, only hip IR was consistently reported as significantly reduced in individuals with NSLBP compared to healthy controls, indicating a potential area for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is there an association between hip range of motion and nonspecific low back pain? A systematic review. Avman, MA., Osmotherly, PG., Snodgrass, S., et al.[2020]

The Spineangel device demonstrated excellent reliability in measuring trunk motion, with intraclass correlation coefficients (ICC) greater than 0.9, indicating it can provide accurate real-time biofeedback for trunk flexion.

This study suggests that the Spineangel device could be a useful tool for facilitating recovery from lower back injuries, but further research is needed to confirm its effectiveness in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Spineangel: Examining the validity and reliability of a novel clinical device for monitoring trunk motion. Intolo, P., Carman, AB., Milosavljevic, S., et al.[2019]

In a study of 70 patients with chronic nonspecific low back pain, adding hip strengthening exercises to manual therapy and lumbar stabilization did not lead to significant improvements in pain or disability compared to manual therapy alone.

Both groups showed improvements in pain and disability over time, but there were no meaningful differences between the two treatment approaches at any follow-up point, suggesting that hip strengthening may not be necessary for better outcomes in this patient population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial. Fukuda, TY., Aquino, LM., Pereira, P., et al.[2023]

A new sit-up exercise has been developed to specifically target abdominal muscles while minimizing the involvement of hip flexors, which could be beneficial for individuals with low back pain.

The exercise was demonstrated in an L1 paraplegic man, and measurements of intra-abdominal pressure during the exercise were taken, suggesting a focus on safety and effectiveness in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A new method of abdominal exercise. Ash, CJ., Burnett, TH.[2004]

A study involving 84 participants with mechanical low-back pain showed that adding hip-specific exercises and mobilization techniques to standard lumbar spine treatment significantly improved patient satisfaction and perceived recovery at both 2 weeks and discharge.

The group receiving hip treatment (LBP + HIP) demonstrated better outcomes on disability and pain scales compared to those treated for the lumbar spine only, suggesting that targeting the hips may enhance recovery in individuals with low-back pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of manual therapy and exercise targeting the hips in patients with low-back pain-A randomized controlled trial. Bade, M., Cobo-Estevez, M., Neeley, D., et al.[2018]

Patients with low-back pain (LBP) and limited hip flexion showed significantly lower hip flexion angles during seated active hip flexion compared to healthy individuals, indicating a potential movement restriction.

The study found that these patients exhibited greater lumbar flexion and posterior pelvic tilting, suggesting that limited hip flexion may lead to compensatory movements that could exacerbate their back pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion. Kim, SH., Kwon, OY., Yi, CH., et al.[2021]

A systematic review of 7 studies involving hip strengthening exercises showed significant improvements in pain and disability for individuals with low back pain (LBP).

The studies included in the review were assessed as having 'good' methodological quality, supporting the efficacy of hip strengthening exercises as a beneficial treatment for LBP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain-A Systematic Review. Santamaría, G., Rodríguez, I., Rodríguez-Pérez, V., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Addition of specific hip strengthening exercises to conventional rehabilitation therapy for low back pain: a systematic review and meta-analysis. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

When Treating Coexisting Low Back Pain and Hip Impairments, Focus on the Back: Adding Specific Hip Treatment Does Not Yield Additional Benefits-A Randomized Controlled Trial. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

The effects of hip-targeted physical therapy interventions on low back pain: A systematic review and meta-analysis. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Trials investigating exercise for low back pain lack pragmatic application: a systematic review. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Exercise interventions for low back pain are poorly reported: a systematic review. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Adverse events experienced by participants in a back pain walking intervention: A descriptive study. [2016]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Is there an association between hip range of motion and nonspecific low back pain? A systematic review. [2020]

8. Scotland pubmed.ncbi.nlm.nih.gov

The Spineangel: Examining the validity and reliability of a novel clinical device for monitoring trunk motion. [2019]

9. Brazil pubmed.ncbi.nlm.nih.gov

Does adding hip strengthening exercises to manual therapy and segmental stabilization improve outcomes in patients with nonspecific low back pain? A randomized controlled trial. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

A new method of abdominal exercise. [2004]

11. England pubmed.ncbi.nlm.nih.gov

Effects of manual therapy and exercise targeting the hips in patients with low-back pain-A randomized controlled trial. [2018]

12. Germany pubmed.ncbi.nlm.nih.gov

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion. [2021]

13. Switzerland pubmed.ncbi.nlm.nih.gov

Effect of Hip Muscle Strengthening Exercises on Pain and Disability in Patients with Non-Specific Low Back Pain-A Systematic Review. [2023]