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Original article
Isometric versus isotonic exercise for greater trochanteric pain syndrome: a randomised controlled pilot study
  1. Christopher Clifford1,2,
  2. Lorna Paul3,
  3. Grant Syme4,
  4. Neal L Millar2
  1. 1Department of Physiotherapy, NHS Greater Glasgow and Clyde, Glasgow, UK
  2. 2Institute of Infection, Immunity and Inflammation, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
  3. 3School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
  4. 4Department of Physiotherapy, NHS Fife, Kirkcaldy, UK
  1. Correspondence to Dr Neal L Millar; neal.millar{at}glasgow.ac.uk

Abstract

Objectives Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. Limited evidence exists for the effectiveness of exercise for GTPS. This study aimed to compare the effectiveness of isometric and isotonic exercise for individuals with GTPS.

Methods This randomised controlled pilot trial recruited 30 participants with GTPS. Both programmes consisted of daily, progressive home exercise for 12 weeks with 8 individual physiotherapy sessions over the trial period. The primary outcome measure was the Victorian Institute of Sport Assessment-Gluteal (VISA-G) and secondary outcome measures included the Numeric Pain Rating Scale (0–10) and an 11-point Global Rating of Change Scale. Outcome measures were assessed at baseline, 4 and 12 weeks.

Results Twenty-three participants completed the trial. After 12 weeks, mean VISA-G scores improved in both groups; 55–65 in the isometric group and 62–72 in the isotonic group. 55% of the isometric group and 58% of the isotonic group achieved a reduction in pain of at least 2 points (minimally clinically important difference (MCID)) on the Numeric Pain Rating Scale. 64% of the isometric group and 75% of the isotonic group had improved by at least 2 points (MCID) on the Global Rating of Change Scale.

Conclusion Isometric and isotonic exercise programmes appear to be effective for individuals with GTPS and should be considered in the loading management of patients with this condition.

  • Tendinopathy
  • Physiotherapy
  • Tendinosis
  • Hip

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjsem-2019-000558

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    Footnotes

    • Contributors All authors were involved in the conception and design of this study and interpretation of the data. CC was responsible for initial writing and drafting of the manuscript, which was reviewed by all authors. All authors approved the final version to be submitted.

    • Funding This work was funded by grants from the Medical Research Council UK (MR/R020515/1) and Versus Arthritis (21346) and Scottish Senior Clinical Fellowship scheme.

    • Competing interests None declared.

    • Patient and public involvement statement Patients enroled were reveiwed back at the end of the study and informed of unblinded results. These patients and other public memebrs are currently informing the design of a new RCT involving pateint edication in GTPS based on these results.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the West of Scotland Research Ethics Service (REC reference: 17/WS/0110).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available on reasonable request.