Load Modification Versus Standard Exercise for Greater Trochanteric Pain Syndrome
Condition: Hip Injuries; Pain; Therapy/Rehabilitation
MeSH terms: Hip Injuries
Study type: Interventional

Summary: 
      Greater trochanteric pain syndrome (GTPS), or lateral hip pain, is associated with muscle
      weakness, altered movement patterns and painful daily activities. The disability associated
      with GTPS is comparable to end stage hip osteoarthritis, primarily affecting young and middle
      aged women. Few non-operative treatments have demonstrated long-term lasting or satisfactory
      results. For those who do improve, recurrence rates of pain and disability can be as high as
      50%.

      Gluteal tendinopathy is the most common condition associated with a GTPS diagnosis. High
      compressive loads of the gluteal tendons during common activities like walking,
      stair-climbing, and running are the theorized mechanism for GTPS. These compressive loads are
      exacerbated with postures and movement patterns that involve the lateral tilting of the
      pelvis or movement of the thigh across the midline of the body. There is recent evidence that
      load modification through education and exercise is superior to a corticosteroid injection
      for reducing pain in these patients. However, it is unknown whether the possible effects of
      the load modification program were due to exercise alone or the reduction in compressive
      loads. As current physical therapy interventions for GTPS commonly incorporate high load
      postures and exercise activities, there is an urgent need to compare outcomes of standard of
      care physical therapy to load modification.

      The goal of this study is to evaluate the short-term effects of load modification education
      on pain and function in individuals with GTPS. Participants will be randomized to receive
      either standard exercise education or load modification education. Both groups will complete
      a series of questionnaires about their pain and function, and undergo a brief 2-dimensional
      assessment of their posture and movement. Between follow-up sessions, participants will be
      asked to respond to brief weekly online surveys to document their home program compliance,
      pain, and function. It is hypothesized that the group of participants receiving load
      modification will have the highest proportion of individuals with significant improvements in
      pain and function, and will demonstrate improved posture and movement.
    


Intervention name(s): Load modification education; Standard exercise education
Intervention type(s): Other; Other
Intervention description(s): Load modification education includes exercises currently prescribed by physical therapists, like stretching and strengthening activities, but will also include education on common daily postures and movement patterns that may increase load and stress on the muscles and tendons around the hip.; Standard exercise education includes exercises currently prescribed by physical therapists, like stretching and strengthening activities.
Other intervention name(s): Load modification; Standard exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment