Physiotherapy management of greater trochanteric pain syndrome (GTPS): an international survey of current physiotherapy practice

H P French; S J Woodley; A Fearon; L O'Connor; A Grimaldi

doi:10.1016/j.physio.2019.05.002

Physiotherapy management of greater trochanteric pain syndrome (GTPS): an international survey of current physiotherapy practice

Physiotherapy. 2020 Dec:109:111-120. doi: 10.1016/j.physio.2019.05.002. Epub 2019 Jun 2.

Authors

H P French¹, S J Woodley², A Fearon³, L O'Connor⁴, A Grimaldi⁵

Affiliations

¹ School of Physiotherapy, RCSI, Ireland. Electronic address: hfrench@rcsi.ie.
² Department of Anatomy, School of Biomedical Sciences, University of Otago, New Zealand. Electronic address: stephanie.woodley@otago.ac.nz.
³ UCRISE, Faculty of Health, University of Canberra, Australia. Electronic address: Angie.Fearon@canberra.edu.au.
⁴ School of Physiotherapy, RCSI, Ireland. Electronic address: louisemoconnor@rcsi.ie.
⁵ Physiotec Physiotherapy, Brisbane, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia. Electronic address: info@dralisongrimaldi.com.

PMID: 31493863
DOI: 10.1016/j.physio.2019.05.002

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.

Publication types

Comparative Study
Multicenter Study
Observational Study

MeSH terms

Adult
Australia
Bursitis / therapy*
Cross-Sectional Studies
Female
Femur*
Humans
Ireland
Male
Middle Aged
New Zealand
Pain Management / methods*
Pain Measurement
Physical Therapy Modalities*
Surveys and Questionnaires
Tendinopathy / therapy*