Greater Trochanteric Pain Syndrome: a comparison of exercise programmes and identification of subgroups

Clifford, Christopher (2023) Greater Trochanteric Pain Syndrome: a comparison of exercise programmes and identification of subgroups. PhD thesis, University of Glasgow.

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Greater trochanteric pain syndrome (GTPS) is a musculoskeletal condition for which exercise programmes are considered an essential part of management. Isometric exercise has been directly compared to isotonic exercise for other tendinopathies but the effectiveness of isometric exercise programmes for GTPS is currently unknown. A number of individuals with GTPS fail to experience clinical improvements following exercise programmes, which could be related to the presence of certain clinical characteristics, including health co-morbidities, co-existing physical symptoms and psychological factors. The prevalence of these clinical characteristics in GTPS populations is largely unknown. Subgroups based on such characteristics have yet to be defined. It is plausible that subgroups exist within GTPS populations who do not respond to current loading programmes.

Three studies were undertaken for this thesis. Firstly, a randomised controlled pilot study investigated whether there was any difference in clinical outcomes when 12 weeks of isometric exercise and isotonic exercise were compared. No difference was observed between both groups at 4 and 12-week follow-up. Secondly, a systematic review of 10 randomised controlled trials evaluated whether isometric exercise was superior to isotonic exercise or any other treatment in the management of tendinopathy. Isometric exercise did not appear to be superior in terms of immediate or short-term pain relief for any tendinopathy. Finally, an on line survey of 261 individuals with GTPS was completed. Subgroups were defined for younger individuals (< 40 years) and older individuals (> 40 years) and sedentary and active individuals. The clinical characteristics identified in younger and older individuals were similar. Subgrouping based on physical activity level revealed that sedentary individuals had a greater number of health co-morbidities, co-existing physical symptoms and higher prevalence of psychological factors.

This thesis reports a number of important findings in relation to the effectiveness of isometric exercise in the management of GTPS and tendinopathy. For the first time subgroups of individuals with GTPS have been defined based on clinical characteristics which may guide future research.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Subjects: R Medicine > RA Public aspects of medicine
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Supervisor's Name: Paul, Professor Lorna, Millar, Professor Neal and Syme, Dr. Grant
Date of Award: 2023
Depositing User: Theses Team
Unique ID: glathesis:2023-83407
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 07 Feb 2023 11:49
Last Modified: 07 Feb 2023 13:01
Thesis DOI: 10.5525/gla.thesis.83407
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