Functional impact of gluteal tendinopathy: A secondary cross-sectional analysis of baseline data from the LEAP randomised clinical trial.

66 Gluteal Tendinopathy – Clinical Diagnosis Vs. Mri Diagnosis?

10 Hip Abductor Strength In Individuals With Gluteal Tendinopathy: A Cross-sectional Study

Treatment of hip microinstability and gluteal tendinopathies involves movement control and exercise

To evaluate the relationship between radiographic measurements of the hip and sonographic evidence of gluteal tendinopathy and bursitis in patients with lateral hip pain. Patients with lateral hip pain referred for ultrasound of the hip in our institution over a 5-year period were identified. Findings of gluteal tendinopathy and subgluteal or trochanteric bursitis on ultrasound were recorded. Radiographs of the hip were also evaluated and femoral offset (FO), global offset (GO), abductor lever arm (ALA) and trochanteric impingement distance (TID) were recorded. The mean of each measurement was compared between patients with gluteal tendinopathy and subgluteal or trochanteric bursitis. 273 patients were included in the study. 107 patients (39.2%) had a THA. In the asymptomatic hip, a range of normal measurements were obtained: FO 22.4-76.5 mm, GO 40.1-116.1 mm, ALA 45.0-98.4 mm and TID 13.8-63.1 mm. In the native hip and post THA, there was no statistically significant relationship between FO, GO, ALA and TID in patients with gluteal tendinopathy or trochanteric or subgluteal bursitis. Lateral hip pain is a common presenting complaint in patients with hip pain and is reported in a small proportion of patients post THA. No statistically significant relationship was found between radiographic measurements and ultrasound findings in our patient cohort. However, we describe the range of measurements obtained from the normal asymptomatic hip in this large cohort of patients, which may aid in the evaluation and management of patients with lateral hip pain.

Background Gluteal tendinopathy (GT) is a degenerative tendon condition characterised by pain over the greater trochanter of the hip. A randomised controlled trial (RCT) in Australia found that 14 sessions of EDucation on load management plus eXercise (EDX) delivered over 8 weeks resulted in greater improvements in global rating of change and pain outcomes at 8 and 52 weeks, compared with corticosteroid injection or ‘wait and see’. Typically, 5-6 physiotherapy sessions are provided in public and private physiotherapy settings in Ireland, therefore, the aim of this study is to examine the feasibility of conducting an RCT to investigate effectiveness of 6 sessions of the EDX programme compared to usual care. Methods We will randomly allocate 64 participants with GT to physiotherapist-administered EDX or usual care. The EDX intervention (EDX-Ireland) will be delivered in 6 sessions over 8 weeks. To determine feasibility of an RCT, we will assess recruitment and retention and outcome measure completion. The health status outcomes to be assessed at baseline, 8 weeks and 3 months include: Global Rating of Change, pain severity, the Victorian Institute of Sport Assessment-Gluteal Questionnaire (VISA-G), the Patient-Specific Functional Scale, the Pain Catastrophizing Scale, Patient Health Questionnaire (PHQ), Pain Self-Efficacy Questionnaire, the EQ-5D-5L, the Central Sensitisation Inventory and hip abductor muscle strength. We will explore acceptability of the EDX-Ireland intervention from the perspective of patients and treatment providers, and the perspective of referrers to the trial. A Study Within A Trial will be also applied to compare recording of exercise adherence using app-based technology to paper-based diary. Discussion There is a need to establish effective treatments for GT that potentially can be implemented into existing health systems. The findings of this feasibility trial will inform development of a future definitive RCT. Registration The trial is registered prospectively on ClinicalTrials.gov (NCT05516563, 27/10/2022).

The melbourne hip MRI score (MHIP score): reliability of a novel scoring system for MRI assessment of severity in gluteal tendinopathy

Physical activity in the prevention and treatment of obesity and its comorbidities: evidence report of independent panel to assess the role of physical activity in the treatment of obesity and its comorbidities.

BackgroundParticipating in physical activity after a diagnosis of cancer is associated with reduced morbidity and improved outcomes. However, declines in, and low levels of, physical activity are well documented in...

BackgroundAs many children do not meet the recommended daily physical activity (PA) levels, more research is needed towards environmental determinants of children’s PA levels. The aims of this longitudinal study were to investigate whether the physical environment and parenting practices have an impact on changes in children’s weekday time spent at various PA levels and whether associations between physical neighbourhood environment and changes in children’s PA are moderated by parenting practices.MethodsWe performed a secondary data analysis of longitudinal data collected at three timepoints (baseline, 6, and 18 months) from 10 control schools of the Active Living study, a quasi-experimental study, which took place in South Limburg, the Netherlands. In total, 240 children aged 8–12 years were included in the analyses. PA levels were measured using accelerometry (ActiGraph GT3X+). The physical environment was assessed at baseline through neighbourhood audits of the school environment, and PA parenting practices were measured at baseline via validated parental questionnaires. Multivariate multilevel regression analyses were conducted to determine the main effects of the physical environment and parenting practices on changes in children’s time spent in sedentary behaviour (SB), light PA and moderate-to-vigorous PA (MVPA) over 18 months. Additionally, moderation of the association between the physical environment and children’s PA levels by parenting practices was examined by adding interacting terms to the regression equations.ResultsWalkability of the physical environmental was associated with a decrease in SB at 18 months (B = -5.45, p < .05). In addition, the parenting practice logistic support was associated with an increase in MVPA (at all time points, B = .68, B = .73 and B = 1.02, respectively, all p < .05) and a decrease in SB (at 18 months, B = -1.71, p < .05). Stratified analyses (based on significant interaction terms) showed that the effect of specific physical environmental features (e.g., sports facilities) on children’s improvements in PA levels were strengthened by favourable parenting practices.DiscussionBesides the main effects of walkability and logistic support, there were indications that several parenting practices moderate the association between the physical environment and changes in children’s time in various PA levels. The current findings are exploratory, and need to be confirmed in further research.

The purpose of this study was to examine the influence of body mass index (BMI), physical activity (PA) level, dietary inflammatory index (DII), and oral contractive (OC) use on C-reactive protein (CRP) levels, and to determine if elevated CRP values reflect systemic inflammation in OC users. Data were obtained from four cycles (1999-2006) of the U.S. National Health and Nutrition Examination Survey (NHANES) study, yielding a sample of 496 current OC users and a comparator group of 1,583 regularly menstruating women. A general linear model was used to test for interaction effects among BMI, PA level, and OC use, after adjusting for age and smoking status, with log-transformed CRP (lnCRP) identified as the outcome variable. Sequential general linear models with no interaction terms were then constructed to examine the impact of BMI, PA level, and OC use on circulating lnCRP after adjusting for age and smoking status. Follow-up analyses used general linear models to assess the relationship between lnCRP and other indices of systemic inflammation among OC users and nonusers, and to examine the predictors of lnCRP within each subgroup. The omnibus model including smoking status, age, PA level, OC use, and BMI did not identify any statistically significant two-way or three-way interaction effects (all p ≥ .259). The adjusted r2 value of the model modestly increased from 0.3789 to 0.3801 when all interaction terms were removed. After adjusting for smoking status and age, a sequentially built model indicated that PA level was inversely related to lnCRP values (p = .0019). When OC use was added to the model, it was positively associated with lnCRP values (p < .0001), with statistically and clinically significant lnCRP differences between OC users and nonusers. BMI was the last variable entered into the model, which was positively associated with lnCRP (p < .0001). Among OC nonusers, PA level (p = .0008) and BMI (p < .0001) were significantly predictive of lnCRP levels after adjusting for smoking status and age. In contrast, PA level was not significantly predictive of lnCRP values (p = .718) among OC users. All alternative indices of inflammation were positively correlated with lnCRP values (all p < .0001), but correlations were significantly stronger among OC users than nonusers (all p < .05). In a subset of OC nonusers with complete nutrition data, PA level (p = .021), BMI (p < .0001), and DII (p = .007) were significantly predictive of lnCRP after adjusting for smoking status and age. In contrast, PA level (p = .709) and DII (p = .690) were not significantly predictive of lnCRP values among OC users. In conclusion, OC-induced elevations in CRP appear to be reflective of a chronic, systemic inflammatory response. PA and low DII are associated with lower CRP among OC nonusers, but do not mitigate CRP elevations among OC users.

Physical activity and health

Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of lateral hip pain. The condition mostly occurs in mid-life both in athletes and in subjects who do not regularly exercise. Females are afflicted more than males. This condition interferes with sleep (side lying) and common weight-bearing tasks, which makes it a debilitating musculoskeletal condition with a significant impact. Mechanical loading drives the biological processes within a tendon and determines its structural form and load-bearing capacity. The combination of excessive compression and high tensile loads within tendons are thought to be most damaging. The available evidence suggests that joint position (particularly excessive hip adduction), together with muscle and bone elements, are key factors in gluteal tendinopathy. These factors provide a basis for a clinical reasoning process in the assessment and management of a patient presenting with localized lateral hip pain from gluteal tendinopathy. Currently, there is a lack of consensus as to which clinical examination tests provide best diagnostic utility. On the basis of the few diagnostic utility studies and the current understanding of the pathomechanics of gluteal tendinopathy, we propose that a battery of clinical tests utilizing a combination of provocative compressive and tensile loads is currently best practice in its assessment. Management of this condition commonly involves corticosteroid injection, exercise or shock wave therapy, with surgery reserved for recalcitrant cases. There is a dearth of evidence for any treatments, so the approach we recommend involves managing the load on the tendons through exercise and education on the underlying pathomechanics.

Physical activity is known to enhance functional recovery and quality of life (QoL) in individuals with musculoskeletal disorders; however, the extent to which varying levels of physical activity influence rehabilitation outcomes—and how demographic and clinical factors moderate these effects—remains inadequately understood. This cross-sectional study investigated the associations between physical activity levels and functional recovery, QoL, and psychological well-being among 286 adults undergoing physiotherapy at a tertiary care hospital in Abha, Saudi Arabia. Participants were classified into low, moderate, or high physical activity groups based on metabolic equivalent of task (MET) hours per week, using the culturally adapted Arabic version of the International Physical Activity Questionnaire – Short Form (IPAQ-SF). Outcome measures included the Patient-Specific Functional Scale (PSFS), the 36-Item Short Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Multiple linear regression analyses, adjusted for age, gender, socioeconomic status, and comorbidities, revealed that higher physical activity levels were significantly associated with greater functional recovery (β = 0.36, 95% CI: 0.06 to 0.66, p = 0.021), higher QoL (β = 0.42, 95% CI: 0.10 to 0.74, p = 0.011), and lower anxiety (r = –0.41, p = 0.013) and depression scores (r = –0.38, p = 0.022). Moderation analysis indicated that age and comorbidities negatively influenced the relationship between physical activity and recovery outcomes. The full model explained 68% of the variance in functional recovery (R² = 0.68, ΔR² = 0.16 with moderators, p = 0.023). These findings indicate that higher physical activity levels are associated with more favorable rehabilitation outcomes among individuals undergoing physiotherapy for musculoskeletal disorders; however, due to the cross-sectional design, causality cannot be inferred, and the generalizability of these associations requires further investigation.

Physical activity is known to enhance functional recovery and quality of life (QoL) in individuals with musculoskeletal disorders; however, the extent to which varying levels of physical activity influence rehabilitation outcomes-and how demographic and clinical factors moderate these effects-remains inadequately understood. This cross-sectional study investigated the associations between physical activity levels and functional recovery, QoL, and psychological well-being among 286 adults undergoing physiotherapy at a tertiary care hospital in Abha, Saudi Arabia. Participants were classified into low, moderate, or high physical activity groups based on metabolic equivalent of task (MET) hours per week, using the culturally adapted Arabic version of the International Physical Activity Questionnaire - Short Form (IPAQ-SF). Outcome measures included the Patient-Specific Functional Scale (PSFS), the 36-Item Short Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Multiple linear regression analyses, adjusted for age, gender, socioeconomic status, and comorbidities, revealed that higher physical activity levels were significantly associated with greater functional recovery (β = 0.36, 95% CI: 0.06 to 0.66, p = 0.021), higher QoL (β = 0.42, 95% CI: 0.10 to 0.74, p = 0.011), and lower anxiety (r = -0.41, p = 0.013) and depression scores (r = -0.38, p = 0.022). Moderation analysis indicated that age and comorbidities negatively influenced the relationship between physical activity and recovery outcomes. The full model explained 68% of the variance in functional recovery (R² = 0.68, ΔR² = 0.16 with moderators, p = 0.023). These findings indicate that higher physical activity levels are associated with more favorable rehabilitation outcomes among individuals undergoing physiotherapy for musculoskeletal disorders; however, due to the cross-sectional design, causality cannot be inferred, and the generalizability of these associations requires further investigation.

BackgroundWith increasing age, physical capacity decreases, while the need and time for recovery increases. At the same time, the demands of work usually do not change with age. In the near future, an aging and physically changing workforce risks reduced work ability. Therefore, the impact of different factors, such as physical activity, on work ability is of interest. Thus, the aim of this study was to evaluate the association between physical activity and work ability using both cross sectional and prospective analyses.MethodsThis study was based on an extensive questionnaire survey. The number of participants included in the analysis at baseline in 2004 was 2.783, of whom 2.597 were also included in the follow-up in 2006. The primary outcome measure was the Work Ability Index (WAI), and the level of physical activity was measured using a single-item question. In the cross-sectional analysis we calculated the level of physical activity and the prevalence of poor or moderate work ability as reported by the participants. In the prospective analysis we calculated different levels of physical activity and the prevalence of positive changes in WAI-category from baseline to follow-up. In both the cross sectional and the prospective analyses the prevalence ratio was calculated using Generalized Linear Models.ResultsThe cross-sectional analysis showed that with an increased level of physical activity, the reporting of poor or moderate work ability decreased. In the prospective analysis, participants reporting a higher level of physical activity were more likely to have made an improvement in WAI from 2004 to 2006.ConclusionsThe level of physical activity seems to be related to work ability. Assessment of physical activity may also be useful as a predictive tool, potentially making it possible to prevent poor work ability and improve future work ability. For employers, the main implications of this study are the importance of promoting and facilitating the employees’ engagement in physical activity, and the importance of the employees’ maintaining a physically active lifestyle.