1 School of Allied Health, College of Science, Health and Engineering, La Trobe University , Bundoora, Australia .
2 School of Health and Rehabilitation Sciences, University of Queensland , Queensland, Australia .
J Womens Health (Larchmt). 2018 Jun;27(6):815-829. doi: 10.1089/jwh.2017.6729. Epub 2018 May 1.
The aim of the current study was to determine the effects of education with targeted or sham exercise on pain and function in postmenopausal women with greater trochanteric pain syndrome (GTPS).
Conservative management of GTPS is poorly described, and to date, there have been no studies on education with exercise as an intervention for GTPS. Ninety-four postmenopausal women with GTPS were recruited to participate in this study.
Participants were randomized to receive one of two 12-week exercise programs (GLoBE vs. sham). Participants received education on avoiding tendon compression with appropriate activity modification. The Victorian Institute of Sport Assessment-Gluteal tendon (VISA-G) was examined at baseline, 12, and 52 weeks. Secondary outcomes included hip pain and function questionnaires (Hip dysfunction and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), and Lateral Hip Pain questionnaire), a global rating of change in symptom questionnaire, and a quality of life measure (Assessment of Quality of Life [AQoL]-8D). Differences between groups were analyzed using intention to treat with analysis of covariance, per-protocol analysis, and responder analysis.
Responders to the GLoBE intervention had significantly better VISA-G, HOOS, OHS, and lateral hip pain questionnaire scores compared to responders in the sham group. However, intention to treat analyses showed no between-group differences for the GLoBE intervention and sham exercise groups. Significant improvement in VISA-G score was found for both programs at 12- and 52-weeks time points (p < 0.001).
Lack of treatment effect was found with the addition of an exercise program to a comprehensive education on GTPS management. The improved outcomes of the responders in the GLoBE group indicate that there may be a subgroup of patients with a GTPS diagnosis that benefit from a GLoBE intervention program.
本研究旨在探讨针对或模拟运动的教育对患有转子间疼痛综合征（GTPS）的绝经后女性疼痛和功能的影响。
GTPS 的保守治疗方法描述不足，迄今为止，尚无针对 GTPS 的运动干预教育研究。本研究招募了 94 名患有 GTPS 的绝经后女性。
参与者被随机分配接受两种为期 12 周的运动方案（GLoBE 与模拟）之一。参与者接受了避免肌腱受压和适当活动调整的教育。在基线、12 周和 52 周时评估维多利亚州运动评估-臀肌腱（VISA-G）。次要结局包括髋关节疼痛和功能问卷（髋关节功能和骨关节炎结局评分（HOOS）、Oxford 髋关节评分（OHS）和外侧髋关节疼痛问卷）、症状整体改善评分和生活质量量表（生活质量评估 [AQoL]-8D）。采用意向治疗分析协方差、方案分析和应答者分析比较组间差异。
与模拟组相比，GLoBE 干预的应答者 VISA-G、HOOS、OHS 和外侧髋关节疼痛问卷评分显著更好。然而，意向治疗分析显示，GLoBE 干预与模拟运动组之间无组间差异。两种方案在 12 周和 52 周时 VISA-G 评分均显著改善（p<0.001）。
在 GTPS 管理的综合教育中加入运动方案并未发现治疗效果。GLoBE 组应答者的结果改善表明，GTPS 诊断的患者可能存在一个亚组受益于 GLoBE 干预方案。
