Effect of Hip Exercise Program on pain intensity, balance and disability among low back pain patients – a systematic review.

To determine the effectiveness of including hip exercise programs with back exercises in improving pain intensity, balance, and disability among patients with low back pain.

This systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. A computer-assisted database search was conducted for articles in Medline, Central, Embase, PEDro, CINAHL, SPORTDiscus, and Web of Science databases searched from August 2010 to April 2024. Randomized clinical trials that compared hip exercise programs with back exercise to manage low back pain were included.

Totally seven seven studies met the inclusion/exclusion criteria. Six of the seven studies included in the review measured changes in pain with a total of 240 patients. Five studies used the VAS scale to measure pain and one used the NPRS scale. In all of them, an improvement or even pain relief was observed after the intervention in the IG, but the difference between groups was only statistically significant (p 0.05) in three, one found non-significant improvements (p > 0.05), and two did not find any difference. Only 2 studies reported the balance using the stability index and found significant improvement in both IG and CG. The difference between groups was also statistically significant (p 0.05). All seven studies included the level of disability. Roland–Morris questionnaire was used in three whereas the other four used the original or modified Oswestry Disability Index (ODI). Like the pain intensity, all seven trials showed improvements in the IG, however, the difference between the groups was statistically (p 0.05) in the IG when compared to the CG only in four studies.

The review indicates hip exercise programs with back exercises showed significant improvement in the outcomes of pain, balance, and function (disability). Therefore, clinicians should consider the use of these exercises in patients with LBP, without causing injury.

Evidence supports the use of hip exercises for hip and knee injuries, but it is unclear if adding hip exercises reduces pain and disability and improves balance in people with LBP. In our practice, we Physiotherapists believe exercise therapy is the best, though it gives small to moderate benefits and there is no clear evidence to support a specific exercise, thus a need for more evidence.