Ganderton
et al.99 Ganderton C, Semciw A, Cook J, Moreira E, Pizzari T. Gluteal loading versus sham exercises to improve pain and dysfunction in postmenopausal women with greater trochanteric pain syndrome: a randomized controlled trial. J Womens Health. 2018;27(6):815-29.
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Characteristics of the sample:
Postmenopausal women with lateral hip pain. (n = 94)
Intervention:
G1: Globe intervention group (n=46)
(Gluteal La Trobe University exercise program)
Globe Group (GLOBE Protocol) Therapy with isometric exercises of gluteus medius and minimus, quadriceps, and triceps sural being performed in 4 stages
G2: Placebo - Group of simulated exercises (n=48)
Performed seated exercises not directed to the therapeutic loading of the gluteal tendons or the strengthening of the kinetic chain. Exercises aimed at gluteal activation, extension of the knee joint, and elevation of the calf (sitting). |
Initial duration: 12 weeks
Reassessed after: 52 weeks |
Conservative |
There was improvement in pain and functional capacity in both groups, being more effective in the Globe intervention group, with respect to pain and functionality. |
Ganderton
et al.66 Ganderton C, Semciw A, Cook J, Pizzari T. Does menopausal hormone therapy (MHT), exercise or a combination of both, improve pain and function in post-menopausal women with greater trochanteric pain syndrome (GTPS)? A randomised controlled trial. BMC Womens Health. 2016;16:32.
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Characteristics of the sample:
116 participants were recruited, considering possible dropouts. Postmenopausal women with GTPS randomly allocated to the exercise group and the transdermal cream/hormone therapy group (n=100)
Intervention:
All participants received guidance on their condition, necessary care, and procedures to be performed at home when performing their duties.
(I) Globe exercises and placebo cream (n=25)
(II) Simulated exercise and MHT transdermal cream (menopause hormone therapy) - (n=25)
(III) Simulated exercise and placebo cream - (n=25)
(IV) Globe exercises and MHT transdermal cream - (n=25)
Exercise group with intervention *:
Globe Protocol (Gluteal La Trobe Protocol). It consists of isometric exercises of the gluteus medius and minimus, quadriceps, triceps sural,
Group of simulated exercises *:
A simulated exercise program not intended for the rehabilitation of gluteal tendons and transdermal cream. It consists of exercises for the kinetic chain without load, in the sitting position.
*Received transdermal cream and placebo cream. |
12 weeks
Gradual progression
of
exercises
over 4, 8, 12
weeks
Results
evaluated
in these periods |
Conservative |
A study identified whether an exercise program aimed at loading gluteal tendons, in addition to strengthening the kinetic chain, has superior effects than a simulated exercise program for low-load lower limbs. |
Mellor
et al.1111 Mellor R, Grimaldi A, Wajswelner H, Hodges P, Abbott JH, Bennell K, et al. Exercise and load modification versus corticosteroid injection versus 'wait and See' for persistent gluteus medius/minimus tendinopathy (the LEAP trial): a protocol for a randomized clinical trial. BMC Musculoskelet Disord. 2016;17:196.
|
Characteristics of the sample:
Females with GTPS (n=201)
Intervention:
G1: Exercise group and load management with functional training exercises, strengthening of the hip and thigh muscles, with an emphasis on the adductors hip muscles; self-management of the dynamic control of adduction during function and educational guidelines related to the care of tendons in the affected area, through printed leaflets, verbal explanations and audiovisual resources (n=67).
G2: Local corticosteroid injection group (n=67)
G3: Control group with spontaneous improvement (n=67) |
12 months
Results evaluated
in:
4, 8, 12, 26,
26, 52 weeks |
Combined |
The corticosteroid injection is effective in improving pain in the short term when compared to the control group. However, in the short or long term, it has better results and a lower recurrence rate when an exercise and load management program is established.
(Ongoing study) |
Morton
et al.2828 Morton S, Chan O, Price J, Pritchard M, Crisp T, Perry JD, Morrissey D. High volume image-guided injections and structured rehabilitation improve greater trochanter pain syndrome in the short and medium term: a combined retrospective and prospective case series. Muscles Ligaments Tendons J. 2015;5(2):73-87.
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Characteristics of the sample:
Participants diagnosed with GTPS aged 18 to 80 years (n=31). Retrospective group (Age range: 46 to 55) and Prospective group (Age range: 56 to 65)
Intervention:
- Injection of marcaine and hydrocortisone;
- Educational exercises program with postural guidelines to avoid positions compressing the gluteal tendons (recommendations regarding lateral posture and excessive adduction in the sitting position);
- Exercises with isometric and concentric-eccentric resistance for hip extensors, endurance with central body control exercises and emphasis on lateral trunk control;
The established protocol was directed to 8 prospective individuals (attended by a radiofrequency specialist in the medical clinic for 5 months, evaluated after 6 weeks) and 23 retrospective ones (extracted from a database of 2 years before) of the short and medium-term treatment with the high-volume image-guided injections with structured rehabilitation. |
5 months
(both groups) |
Combined |
Both retrospective and prospective groups showed improvement in pain after the injection of corticosteroids, followed by structured rehabilitation. The combination of injection and structured rehabilitation provides short, medium, and long-term benefits, although further studies are necessary to confirm the long-term effects. The sample is considered insufficient to reach decisive conclusions, and the established protocol requires more information. |
Source: Research data, 2019.