Low back pain after unstable extracapsular hip fractures: Randomized control trial on a specific training

L. Di Lorenzo, A. Forte, R. Formisano, R. Gimigliano, S. Gatto

Research output: Contribution to journalArticlepeer-review


Aim. This study compares the efficacy of a walking recovery rehabilitation program with or without specific back exercises In patients affected by unstable extracapsular hip fractures and secondary back pain. Further, it reports data and images about analysed tomographic changes of the psoas muscle ipsilateral to fractures. Methods. A prospective, randomized, parallel treatment trial was carried out. Patients admitted for rehabilitation after fractures were evaluated for secondary back pain. If clinically Indicated, patients were further scheduled for a computed tomography (CT) scan of the lumbar spine by which we evaluated cross-sectional changes in density and fibroadipose degeneration of the body of the psoas muscle. When back pain matched cross-sectional changes in psoas density, the patient was eligible for our study, enrolled and randomly assigned to 1 of 2 study groups. Both groups were scheduled for hip rehabilitation and walking training plus a back protocol for the study group only. Pain was evaluated subjectively with a visual analog scale to calculate treatment effectiveness and Harris hip score was used to assess the outcome after surgery. Results. Thirty-seven patients out of about hundred were enrolled. In all cases CT scans showed age-related changes commonly seen in the lumbar spine and significant fibroadipose degeneration and altered density in the ipsilateral psoas muscles. With back exercises added to the standard rehabilitation protocol, all study patients recovered significantly better than control group patients (P

Original languageEnglish
Pages (from-to)349-357
Number of pages9
JournalEuropa Medicophysica
Issue number3
Publication statusPublished - Sep 2007


  • Back pain
  • Hip fractures
  • Psoas muscles

ASJC Scopus subject areas

  • Rehabilitation


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