School of Physiotherapy, RCSI, Ireland.
Department of Anatomy, School of Biomedical Sciences, University of Otago, New Zealand.
Physiotherapy. 2020 Dec;109:111-120. doi: 10.1016/j.physio.2019.05.002. Epub 2019 Jun 2.
This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland.
Cross-sectional observational survey of physiotherapists.
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.
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.
本研究旨在建立并比较澳大利亚、新西兰（NZ）和爱尔兰目前对 GTPS 的物理治疗管理。
对物理治疗师进行横断面观察性调查。
向澳大利亚、NZ 和爱尔兰的注册肌肉骨骼物理治疗师分发在线调查。使用频率计数或平均等级对顺序和名义数据进行分析；对数值数据计算中位数和四分位距。使用卡方分析进行名义/顺序数据的国家间比较，使用 Kruskal-Wallis 检验进行数值数据的国家间比较。统计显著性设为 P<0.05。
结果/发现：收到了 361 名物理治疗师的有效回复，其中 61%为女性，80%在私人诊所工作。总体而言，三个国家对 GTPS 的治疗一致性。所有物理治疗师主要针对臀肌使用教育和运动（最常见的是强化和神经肌肉控制）。其他干预措施包括按摩（90%）、伸展（53%）、活动范围（40%）、热疗（50%）、贴扎（38%）和电疗（25%），而 40%的人通常建议每个患者/每年最多接受 2 至 3 次皮质类固醇注射。物理治疗师主要使用疼痛严重程度量表作为他们的主要结果测量（79%）。单腿站立是最常用的物理测量方法（68%），较少使用全球评分或标准化物理测量。
这项国际调查确立了 GTPS 的物理治疗管理。结合运动使用的教育与当前证据一致，但一部分临床医生使用辅助治疗，没有明确的理由或支持证据。结果表明，需要使用随机对照试验等强有力的方法进一步定义 GTPS 的最佳管理。
