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NCT04009837: MASH

Manual Therapy and Strengthening for the Hip in Older Adults With Chronic Low Back Pain

Completed NA Results posted Last updated 11 April 2024
What this trial tests

NA trial testing Hip-focused rehabilitation intervention in Chronic Low-back Pain in 184 participants. Completed in 3 October 2022.

Timeline
1 November 2019
Primary endpoint
3 October 2022
3 October 2022

Quick facts

Lead sponsorUniversity of Delaware
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposetreatment
Enrollment184
Start date1 November 2019
Primary completion3 October 2022
Estimated completion3 October 2022
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of Delaware

Who can join

Adults 60 to 85, any sex, with Chronic Low-back Pain or Hip Impairments. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Quebec Back Pain Disability Scale Primary · Baseline to 8-week assessment (i.e. post-intervention)

A 20-item questionnaire that assesses limitations in daily activities due to back pain. Scores can range from 0-100% with higher scores indicating greater back pain-related disability.

Baseline
GroupValue95% CI
Hip-focused27.9± 15.8
Spine-focused27.9± 15.5
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused16.7± 11.7
Spine-focused20.3± 14.3
10-Meter Walk Test at Self-Selected Speed (10MWT) Primary · Baseline to 8-week assessment (i.e. post-intervention)

A performance test where participants walk along a 10-meter linear pathway at their 'usual pace' for three trials. Average self-selected gait speed is determined over the central 6 meters of the course in meters/second. Faster walking speeds indicate better mobility.

Baseline
GroupValue95% CI
Hip-focused1.12± 0.25
Spine-focused1.12± 0.24
8-week (post-intervention) assessment
GroupValue95% CI
Hip-focused1.2± 0.24
Spine-focused1.21± 0.23
Quebec Back Pain Disability Scale Secondary · Baseline to the 6-month assessment

A 20-item questionnaire that assesses limitations in daily activities due to back pain. Scores can range from 0-100% with higher scores indicating greater back pain-related disability.

Baseline
GroupValue95% CI
Hip-focused27.9± 15.8
Spine-focused27.9± 15.5
6-months (final assessment)
GroupValue95% CI
Hip-focused15.8± 12.5
Spine-focused17.3± 14.1
10 Meter Walk Test -- Self-Selected Gait Speed at 6 Months (Final Assessment) Secondary · Baseline to 6-months

A performance test where participants walk along a 10-meter linear pathway at their 'usual pace' for three trials. Average self-selected gait speed is determined over the central 6 meters of the course in meters/second. Faster walking speeds indicate better mobility.

Baseline
GroupValue95% CI
Hip-focused1.12± 0.25
Spine-focused1.12± 0.24
6-months
GroupValue95% CI
Hip-focused1.21± 0.25
Spine-focused1.24± 0.22
10-Meter Walk Test at Fast Speed (10MWT) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A performance test where participants walk along a 10-meter linear pathway 'as quickly as possible', for three trials. Average fast gait speed is determined over the central 6 meters of the course in meters/second. Faster walking speeds indicate better mobility.

Baseline
GroupValue95% CI
Hip-focused1.57± 0.34
Spine-focused1.59± 0.38
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused1.65± 0.31
Spine-focused1.67± 0.32
6-months (final assessment)
GroupValue95% CI
Hip-focused1.63± 0.31
Spine-focused1.66± 0.34
Timed Up-and-Go (TUG) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A performance test where participants rise from a chair, walk 3 meters at their regular pace, and return to a seated position in the same chair. One practice trial is performed followed by three timed trials; performance times are averaged. Greater times indicate worse physical function.

Baseline
GroupValue95% CI
Hip-focused9.73± 2.68
Spine-focused9.46± 2.07
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused8.92± 1.89
Spine-focused9.12± 1.93
6-months (final assessment)
GroupValue95% CI
Hip-focused8.99± 1.93
Spine-focused8.82± 2.03
Six-Minute Walk Test (6MWT) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A performance test where participants are asked to walk as far as they can in six minutes around a continuous track. Greater distances (in meters) indicate better mobility and exercise tolerance.

Baseline
GroupValue95% CI
Hip-focused451.0± 116.7
Spine-focused451.9± 101.6
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused489.0± 100.4
Spine-focused468.2± 108.8
6-months (final assessment)
GroupValue95% CI
Hip-focused487.8± 100.1
Spine-focused477.9± 105.9
30 Second Chair Stand Test Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A performance test where participants perform as many sit-to-stands as possible in 30 seconds while their arms are folded across their chest. The number of stands are counted. Higher numbers correlate with better scores.

Baseline
GroupValue95% CI
Hip-focused10± 3.7
Spine-focused10± 3.2
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused11± 3.1
Spine-focused11± 3.3
6-months (final assessment)
GroupValue95% CI
Hip-focused12± 3.4
Spine-focused11± 3.8
Movement-evoked Pain From the 6MWT and the 30 Second Chair Stand Test Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

Post-test pain intensities, i.e., 0-10, for both the Six-Minute Walk Test and the 30 Second Chair Stand Test were used in the calculation of aggregate movement-evoked pain. Scores for this measure were the sum of both post-test pain intensities, resulting in a score range of 0-20, where higher numbers indicate worse pain.

Baseline
GroupValue95% CI
Hip-focused6.4± 4.3
Spine-focused6.7± 4.7
8-weeks (post-intervention)
GroupValue95% CI
Hip-focused3.6± 3.6
Spine-focused5.2± 4.5
6-months (final assessment)
GroupValue95% CI
Hip-focused3.8± 4.1
Spine-focused4.1± 4.1
Patient Health Questionnaire-9 (PHQ-9) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A 9-item questionnaire that assesses the presence/absence of depressive symptoms. Scores above 5 indicate likeliness of depressive symptoms. Scores range from 0-27.

Baseline
GroupValue95% CI
Hip-focused3.3± 4.1
Spine-focused2.9± 3.6
8 week (post-intervention)
GroupValue95% CI
Hip-focused2.5± 2.7
Spine-focused2.6± 3.6
6 months (final assessment)
GroupValue95% CI
Hip-focused2.4± 2.8
Spine-focused2.5± 3.5
Low Back Activity Confidence Scale (LOBACS) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A 15-item questionnaire that measures a person's confidence in their ability to perform different activities, including carrying, pushing, sitting, walking, and exercising, which may be directly affected by low back pain. There is an overall score, as well as three Self-Efficacy Subscales: Functional, Self-Regulatory, and Exercise. Overall, as well as subscales, range from 0-100%, where higher numbers indicate higher confidence.

Baseline: Overall
GroupValue95% CI
Hip-focused70.1± 16.4
Spine-focused68.9± 18.8
8-week: Overall
GroupValue95% CI
Hip-focused78.4± 14.9
Spine-focused74.3± 19.9
6-month: Overall
GroupValue95% CI
Hip-focused76.2± 18.8
Spine-focused73.0± 20.3
Baseline: Functional Subscale
GroupValue95% CI
Hip-focused56.2± 23.9
Spine-focused54.3± 23.4
8-week: Functional Subscale
GroupValue95% CI
Hip-focused68.2± 21.1
Spine-focused63.1± 26.0
6-month: Functional Subscale
GroupValue95% CI
Hip-focused70.0± 23.9
Spine-focused65.2± 25.6
Baseline: Self-Regulatory Subscale
GroupValue95% CI
Hip-focused78.4± 19.1
Spine-focused77.9± 23.6
8-week: Self-Regulatory Subscale
GroupValue95% CI
Hip-focused86.3± 17.7
Spine-focused82.5± 21.6
Hip Disability and Osteoarthritis Outcome Score (HOOS) Secondary · Baseline, 8-weeks (i.e. post-intervention), and 6-months

A 40-item questionnaire that contains five domains (symptoms, pain, activity of daily living (ADL), sport and recreation, and quality of life). Each scale ranges from 0-100, where higher scores are better, indicating lower hip-related disability.

Baseline Symptoms
GroupValue95% CI
Hip-focused67.8± 18.3
Spine-focused68.6± 15.0
8-weeks Symptoms
GroupValue95% CI
Hip-focused80.6± 12.8
Spine-focused77.4± 15.6
6-months Symptoms
GroupValue95% CI
Hip-focused80.4± 13.6
Spine-focused81.6± 15.5
Baseline Pain
GroupValue95% CI
Hip-focused56.1± 12.4
Spine-focused57.7± 11.4
8-weeks Pain
GroupValue95% CI
Hip-focused73.8± 13.7
Spine-focused71.9± 17.2
6-months Pain
GroupValue95% CI
Hip-focused74.1± 15.6
Spine-focused76.5± 17.1
Baseline ADL
GroupValue95% CI
Hip-focused64.9± 16.7
Spine-focused66.0± 16.6
8-weeks ADL
GroupValue95% CI
Hip-focused81.1± 13.9
Spine-focused78.1± 16.2

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse event data were collected from baseline to the 6-month post-baseline final assessment.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Hip-focused
Serious: 9/91 (10%)
Deaths: 0/91
Spine-focused
Serious: 4/93 (4%)
Deaths: 0/93

Serious adverse events (10 terms)

ReactionSystemHip-focusedSpine-focused
Surgical and Medical Procedures-other, specifySurgical and medical procedures
Chest PainCardiac disorders
Myocardial InfarctionCardiac disorders
Atrial FibrillationCardiac disorders
Cardiac Disorders-others, specifyCardiac disorders
CoughRespiratory, thoracic and mediastinal disorders
Heart FailureCardiac disorders
Respiratory, Thoracic and Mediastinal Disorders-other, specifyRespiratory, thoracic and mediastinal disorders
Skin InfectionSkin and subcutaneous tissue disorders
TremorNervous system disorders
Other adverse events (5 terms — click to expand)

ReactionSystemHip-focusedSpine-focused
Pain in extremityMusculoskeletal and connective tissue disorders
Back painMusculoskeletal and connective tissue disorders
MyalgiaMusculoskeletal and connective tissue disorders
FallInjury, poisoning and procedural complications
Surgical and medical procedures-other, specifySurgical and medical procedures

Most-reported serious reactions: Surgical and Medical Procedures-other, specify, Chest Pain, Myocardial Infarction, Atrial Fibrillation, Cardiac Disorders-others, specify, Cough, Heart Failure, Respiratory, Thoracic and Mediastinal Disorders-other, specify.

Data from ClinicalTrials.gov NCT04009837 adverse events section.

Sponsor's own description

Older adults with chronic low back pain (LBP) are at a greater risk for disability, loss of independence, and lower quality of life. Experts agree that LBP is not a homogeneous condition, and treatments should differ based upon clinical presentation. Our past work indicates that all of these hip and lumbar spine impairments may contribute to worse physical function and greater disability, but the relative importance of each impairment is unclear. Thus, clinicians have limited evidence to draw on for treatment decisions for this patient population. We have identified a vulnerable subgroup of older adults with hip and low back pain. The purpose of this study is to randomize participants into one of two treatment arms and analyze the outcomes.

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Hip-focused physical therapy versus spine-focused physical therapy for older adults with chronic low back pain at risk for mobility decline (MASH): a multicentre, single-masked, randomised controlled trial.
    Hicks GE, George SZ, Pugliese JM, Coyle PC, et al · · 2024 · cited 10× · PMID 38258673 · DOI 10.1016/s2665-9913(23)00267-9
  2. The Manual Therapy and Strengthening for the Hip (MASH) Trial: Protocol for a Multisite Randomized Trial of a Subgroup of Older Adults With Chronic Back and Hip Pain.
    Pugliese JM, Coyle PC, Knox PJ, Sions JM, et al · · 2022 · cited 7× · PMID 34751784 · DOI 10.1093/ptj/pzab255

Verify or expand the search:

Other recruiting trials for Chronic Low-back Pain

Currently open trials in the same condition.

Other University of Delaware trials

Trials by the same sponsor.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT04009837.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing