Fearon Angela M, Grimaldi Alison, Mellor Rebecca, Nasser Anthony Michael, Fitzpatrick Jane, Ladurner Andreas, Vicenzino Bill
Faculty of Health, University of Canberra Research Institute for Sport and Exercise, Bruce, Australian Capital Territory, Australia
Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
Br J Sports Med. 2024 Mar 8;58(5):245-254. doi: 10.1136/bjsports-2023-107150.
Gluteal tendinopathy (GT) is common and can be debilitating and challenging to manage. A lack of condition specific and appropriate outcome measures compromise evidence synthesis for treatment and limits clinical guideline development. Our objective was to develop a core outcome measurement set for GT (COS-GT). Participants were patients with GT and expert health professionals (HPs). A scoping review identified measures used in GT research, which were mapped to the nine International Scientific Tendinopathy Symposium Consensus core domains, and included in two surveys of HPs. The first survey identified the feasible and true measures for each domain. The second survey refined the list which a patient focus group then considered. Meeting online, HPs reached consensus (agreement ≥70%) on the most appropriate COS-GT measures. 34 HPs and seven patients were recruited. 57 measures were mapped to the nine core domains. Six measures did not proceed past survey one. Of those that progressed, none had adequate clinimetric properties for a COS-GT. Thus, participants decided on interim measures: the global rating of change, pain at night, time to pain onset with single limb stance, pain with stair walking, pain self-efficacy and hip abduction strength. HP participants additionally recommended that pain over the last week, the European Quality of Life-5 dimensions-5 levels and the Victorian Institute of Sport Assessment-Gluteal be considered in clinical trials, as they currently provide best easures of the relevant tendinopathy domains. In conclusion this interim COS-GT should guide outcome measure selection in clinical practice and future research trials in patients with GT.
臀肌肌腱病（GT）很常见，可能会使人虚弱，且治疗起来颇具挑战性。缺乏针对该病症的特定且合适的结局指标会影响治疗证据的综合分析，并限制临床指南的制定。我们的目标是制定一套GT的核心结局测量指标集（COS - GT）。参与者包括GT患者和专业健康专家（HP）。一项范围综述确定了GT研究中使用的指标，这些指标被映射到九个国际肌腱病科学研讨会共识核心领域，并纳入了两项针对HP的调查。第一次调查确定了每个领域可行且真实的指标。第二次调查对指标列表进行了完善，随后患者焦点小组对其进行了审议。HP们通过在线会议就最合适的COS - GT指标达成了共识（≥70%的一致率）。招募了34名HP和7名患者。57项指标被映射到九个核心领域。六项指标在第一次调查后未继续推进。在推进的指标中，没有一项具有适用于COS - GT的足够临床测量特性。因此，参与者决定采用临时指标：整体变化评分、夜间疼痛、单腿站立时疼痛发作时间、上下楼梯时疼痛、疼痛自我效能感和髋关节外展力量。HP参与者还建议在临床试验中考虑过去一周的疼痛、欧洲五维健康量表 - 5级和维多利亚运动评估 - 臀肌量表，因为它们目前能最好地测量相关肌腱病领域。总之，这个临时的COS - GT应指导GT患者临床实践和未来研究试验中的结局指标选择。
