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Vol. 23. Issue 5.
Pages 419-427 (01 September 2019)
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Vol. 23. Issue 5.
Pages 419-427 (01 September 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.09.007
Examination procedures and interventions for the hip in the management of low back pain: a survey of physical therapists
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Scott A. Burnsa,
Corresponding author
Scott.burns@temple.edu

Corresponding author at: 1301 Cecil B. Moore, Ritter Annex, 6th floor, Philadelphia, PA 19122, United States.
, Joshua A. Clelandb, Darren A. Rivettc, Suzanne J. Snodgrassc
a Department of Physical Therapy, Temple University, Philadelphia, PA, United States
b Physical Therapy Department, Franklin-Pierce University, Manchester, NH, United States
c Discipline of Physiotherapy, The University of Newcastle, Callaghan, Australia
Highlights

  • Physical therapists routinely examine strength, range of motion and muscle flexibility of the hip(s) for individuals with low back pain.

  • Physical therapists often provide strengthening and flexibility interventions targeting the hips for individuals with low back pain.

  • Post-professional fellowship training as a physical therapist changed intervention selection to include more joint manual therapy and less muscle flexibility and modality usage.

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Figures (1)
Tables (4)
Table 1. Characteristics of respondents.a
Table 2. Number (%) of respondents reporting various factors from the patient history that contribute to their decision to examine of one or both hip joints in individuals with a primary complaint of low back pain.a
Table 3. Number (%) of respondents that use specific hip examination tests for individuals with a primary complaint of low back pain.a
Table 4. Number (%) of respondents that use specific hip interventions for individuals with a primary complaint of low back pain.a
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Abstract
Objectives

The main research aims were to investigate whether physical therapists are examining the hip(s) in individuals with a primary complaint of low back pain (LBP) and if so, the interventions being provided that target the hip(s).

Methods

An anonymous electronic survey was distributed to the membership of the American Physical Therapy Association Orthopaedic and Sports Sections, as well as that of the American Academy of Orthopaedic Manual Physical Therapists. Participant demographics and survey responses were analyzed using descriptive statistics. Associations between variables were examined using chi-square analysis.

Results

The estimated response rate was 18.4% (n=1163, mean age 40.5±11.4 years). The majority of respondents (91%, n=1059) reported they always or most of the time examined the hip(s) in individuals with LBP. The most common examination items utilized were hip strength testing (94%, n=948), passive range of motion (91%, n=921) and muscle flexibility testing (90%, n=906). The most common interventions included hip strengthening (94%, n=866) and hip flexibility exercises (90%, n=814). Respondents enrolled in or having completed a post-professional fellowship were more likely to utilize hip joint manual therapy techniques (x2=25.3, p=<0.001) and less likely to prescribe hip flexibility exercises (x2=7.9, p=0.005) or use electrophysical modalities (x2=4.3, p=0.039).

Conclusions

Physical therapists commonly examine and provide interventions directed at the hip(s) for individuals with LBP. Post-professional fellowship training appears to influence the intervention selection of the physical therapist, with an increase in usage of hip joint manual therapy and a decrease in hip muscle flexibility and modality usage.

Keywords:
Hip
Low back
Practice pattern
Survey

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