Physiotherapy management of greater trochanteric pain syndrome (GTPS)

an international survey of current physiotherapy practice

Helen French, Stephanie Woodley, Angela Fearon, Louise O'Connor, Alison Grimaldi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland. Design: Cross-sectional observational survey of physiotherapists. Methods: An online survey was distributed to registered musculoskeletal physiotherapists in Australia, NZ and Ireland. Ordinal and nominal data were analysed using frequency counts or mean ranks; median and interquartile ranges were calculated for numerical data. Inter-country comparisons were made using Chi-squared analyses for nominal/ordinal data and Kruskal–Wallis tests for numerical data. Statistical significance was set at P < 0.05. Results/findings: Valid responses were received from 361 physiotherapists, 61% were female and 80% worked in private practice. Overall, consistency in treatment of GTPS was observed across the three countries. All physiotherapists used education and exercise (most commonly strengthening and neuromuscular control) primarily targeting the gluteal muscles. Other interventions included massage (90%), stretching (53%), range of motion (40%), thermal modalities (50%), taping (38%) and electrotherapy (25%), whilst 40% commonly recommended up to 2 to 3 corticosteroid injections per patient/per annum. Physiotherapists used pain severity scales as their primary outcome measure (79%). Single leg stance was the most common physical measure used (68%), and global rating scores or standardised physical measures were less commonly used. Conclusion: This international survey established the physiotherapy management of GTPS. Education used in conjunction with exercise is in line with current evidence, but a proportion of clinicians use adjunct treatments without clear rationale or supporting evidence. Results indicate the need to further define optimal management of GTPS using robust methodologies such as randomised controlled trials.

Original languageEnglish
Pages (from-to)1-26
Number of pages26
JournalPhysiotherapy (United Kingdom)
DOIs
Publication statusE-pub ahead of print - 2 Jun 2019

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Physical Therapists
Pain
New Zealand
Ireland
Exercise
Electric Stimulation Therapy
Education
Massage
Private Practice
Articular Range of Motion
Leg
Adrenal Cortex Hormones
Randomized Controlled Trials
Cross-Sectional Studies
Hot Temperature
Outcome Assessment (Health Care)
Surveys and Questionnaires
Muscles
Injections
Therapeutics

Cite this

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title = "Physiotherapy management of greater trochanteric pain syndrome (GTPS): an international survey of current physiotherapy practice",
abstract = "Objectives: This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland. Design: Cross-sectional observational survey of physiotherapists. Methods: An online survey was distributed to registered musculoskeletal physiotherapists in Australia, NZ and Ireland. Ordinal and nominal data were analysed using frequency counts or mean ranks; median and interquartile ranges were calculated for numerical data. Inter-country comparisons were made using Chi-squared analyses for nominal/ordinal data and Kruskal–Wallis tests for numerical data. Statistical significance was set at P < 0.05. Results/findings: Valid responses were received from 361 physiotherapists, 61{\%} were female and 80{\%} worked in private practice. Overall, consistency in treatment of GTPS was observed across the three countries. All physiotherapists used education and exercise (most commonly strengthening and neuromuscular control) primarily targeting the gluteal muscles. Other interventions included massage (90{\%}), stretching (53{\%}), range of motion (40{\%}), thermal modalities (50{\%}), taping (38{\%}) and electrotherapy (25{\%}), whilst 40{\%} commonly recommended up to 2 to 3 corticosteroid injections per patient/per annum. Physiotherapists used pain severity scales as their primary outcome measure (79{\%}). Single leg stance was the most common physical measure used (68{\%}), and global rating scores or standardised physical measures were less commonly used. Conclusion: This international survey established the physiotherapy management of GTPS. Education used in conjunction with exercise is in line with current evidence, but a proportion of clinicians use adjunct treatments without clear rationale or supporting evidence. Results indicate the need to further define optimal management of GTPS using robust methodologies such as randomised controlled trials.",
keywords = "Evidence-based practice, Exercise, Gluteal tendinopathy, Greater trochanteric pain syndrome, Load management, Physiotherapy",
author = "Helen French and Stephanie Woodley and Angela Fearon and Louise O'Connor and Alison Grimaldi",
year = "2019",
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Physiotherapy management of greater trochanteric pain syndrome (GTPS) : an international survey of current physiotherapy practice . / French, Helen; Woodley, Stephanie; Fearon, Angela; O'Connor, Louise; Grimaldi, Alison.

In: Physiotherapy (United Kingdom), 02.06.2019, p. 1-26.

Research output: Contribution to journalArticle

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