LEAP-Ireland Feasibility Trial of Exercise and Education for Gluteal Tendinopathy
Gluteal Tendinopathy, Trochanteric Bursitis, Greater Trochanteric Pain Syndrome
About this trial
This is an interventional treatment trial for Gluteal Tendinopathy
Eligibility Criteria
Inclusion Criteria:
- Aged between 35-70 years
- Lateral hip pain for at least 3 months, of ≥ 4/10 on an 11-point numeric rating scale on most days of the last 3 months
- Tenderness on palpation of the greater trochanter
- Reproduction of pain on at least one of following diagnostic clinical tests: (FADER test, FADER with Static muscle test (internal rotation) at end of range (FADER-R), FABER test, passive hip Adduction in side lying (ADD) test, adduction with resisted isometric abduction (ADD-R), and single leg stand (SLS) for 30 seconds
- Demonstrated tendon pathology on MRI
- Access to a computer, smartphone or tablet with internet connection
Exclusion Criteria:
- Previous cortisone injection in the region of the lateral hip in the last 12 months
- Physiotherapy (including regular appropriate Pilates) for lateral hip pain in the last 3 months
- Lumbar spine or lower limb surgery in the last 6 months
- Any known advanced hip joint pathology where groin pain is the primary complaint and/or where groin pain is experienced at an average intensity of ≥2 on most days of the week, or Kellgren-Lawrence score of >2 (mild) on X-Ray
If the following clinical criteria for the diagnosis of hip osteoarthritis (American College Rheumatology) are fulfilled:
- Self-reported hip pain with either hip internal rotation <15° and hip flexion ≤115° or ≥15° hip internal rotation and pain on hip internal rotation
- Μorning stiffness ≤ 60 minutes
- Αge ≥ 50 years
- Hip joint flexion is <90°, bilaterally
- Lumbar radiculopathy or pain in another body location that is greater than the hip pain (NRS)
- Known advanced knee pathology or restricted knee range of motion (must have minimum 90° flexion and full extension, bilaterally)
- Any systemic diseases affecting the muscular or nervous system, and uncontrolled diabetes
- Fibromyalgia
- Use of cane or walking aid
- Malignant tumour (current or in the past 6 months)
- Systemic inflammatory disease
- Any factors that would preclude the participant from having an MRI (e.g. pacemaker, metal implants, pregnancy, or trying to become pregnant, claustrophobia)
- If the participant is involved in any injury claim
- If the participant is unable to commit to an 8-week programme of up to 6 sessions of exercise
- If the participant is unable to write, read or comprehend English
- Unable or unwilling to use technology for exercise prescription and adherence
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
No Intervention
EDucation and eXercise intervention (EDX)
Usual Care
EDX-Ireland will involve 6 face-to-face education and exercise sessions on a individualised basis with a physiotherapist, delivered over eight weeks. This will be supplemented by a home based exercise programme.
Participants will continue to follow what they have done so far for their hip pain, or what their doctor has suggested/prescribed. If a participant is referred to physiotherapy as part of the usual care treatment, waiting time will be recorded. Participants will receive a written information leaflet on the pathology of gluteal tendinopathy and general advice on symptom management.