Angela Fearon1, Teresa Neeman2, Paul Smith3, Jennie Scarvell4, Jill Cook5. 1. University of Canberra, Discipline of Physiotherapy, Locked bag 1, University of Canberra, Bruce, ACT, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia. Electronic address: Angie.Fearon@canberra.edu.au. 2. Australian National University, Statistical Consulting Unit, Building 27, ANU Campus, ACTON, ACT, 2600, Australia. Electronic address: Teresa.Neeman@anu.edu.au. 3. Australian National University, Fenner School, Building 141, Linnaeus Way, ANU Campus, ACTON, ACT, 2600, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia. Electronic address: psmith@orthoact.com.au. 4. University of Canberra, Discipline of Physiotherapy, Locked bag 1, University of Canberra, Bruce, ACT, 2601, Australia; Trauma and Orthopaedic Research Unit, Canberra Hospital, Canberra, ACT, Australia. Electronic address: Jennie.Scarvell@canberra.edu.au. 5. Latrobe University, La Trobe Sport and Exercise Medicine Research Centre, Bundoora, Vic, Australia. Electronic address: j.cook@latrobe.edu.au.
Abstract
QUESTION: What are the functional differences between people with greater trochanteric pain syndrome (GT), hip osteoarthritis (OA) or an asymptomatic population as measured by walking, Time Up and Go, single leg standing and strength? DESIGN: Cross sectional study with blinded measurers. PARTICIPANTS: 38 participants with GT, 20 with end stage hip OA and 21 asymptomatic healthy control (AS) participants. All participants were women. OUTCOME MEASURES: Pain (numeric rating scale), Walking speed (m/s), cadence (steps/min) and step length (m) measured via the 10m walk test and the Timed Up and Go; balance via single leg stance (s) duration; and hip abduction, adduction, medial and lateral rotation strength, standardized to body mass (BM) via the body mass average index (BMavg), measured via a wall mounted dynamometer. RESULTS: The two symptomatic groups reported similar pain levels (p=0.226), more pain then the AS group (p<0.000). Compared to the AS participants, participants with GT or hip OA demonstrated lower walking speed (10mwt and TUG, p<0.001), lower cadence and shorter duration single leg stance on the affected leg (p<0.05). Participants with GT or hip OA also demonstrated bilaterally weaker hip abduction than the AS group (p≤0.005). Compared to AS and GT participants, participants with hip OA demonstrated adduction weakness on the affected side (p=0.008 and p=0.002 respectively). CONCLUSION: There is a significant level of dysfunction and impairments associated with GT and hip OA. As activity limitations do not appear to be differentiated by structural impairments, we suggest that pain, rather than the underlying pathology may be the driving impairment that leads to walking and single leg standing dysfunction.
QUESTION: What are the functional differences between people with greater trochanteric pain syndrome (GT), hip osteoarthritis (OA) or an asymptomatic population as measured by walking, Time Up and Go, single leg standing and strength? DESIGN: Cross sectional study with blinded measurers. PARTICIPANTS: 38 participants with GT, 20 with end stage hip OA and 21 asymptomatic healthy control (AS) participants. All participants were women. OUTCOME MEASURES: Pain (numeric rating scale), Walking speed (m/s), cadence (steps/min) and step length (m) measured via the 10m walk test and the Timed Up and Go; balance via single leg stance (s) duration; and hip abduction, adduction, medial and lateral rotation strength, standardized to body mass (BM) via the body mass average index (BMavg), measured via a wall mounted dynamometer. RESULTS: The two symptomatic groups reported similar pain levels (p=0.226), more pain then the AS group (p<0.000). Compared to the ASparticipants, participants with GT or hip OA demonstrated lower walking speed (10mwt and TUG, p<0.001), lower cadence and shorter duration single leg stance on the affected leg (p<0.05). Participants with GT or hip OA also demonstrated bilaterally weaker hip abduction than the AS group (p≤0.005). Compared to AS and GTparticipants, participants with hip OA demonstrated adduction weakness on the affected side (p=0.008 and p=0.002 respectively). CONCLUSION: There is a significant level of dysfunction and impairments associated with GT and hip OA. As activity limitations do not appear to be differentiated by structural impairments, we suggest that pain, rather than the underlying pathology may be the driving impairment that leads to walking and single leg standing dysfunction.
Authors: Luke McCarney; Alexander Andrews; Phoebe Henry; Azharuddin Fazalbhoy; Isaac Selva Raj; Noel Lythgo; Julie C Kendall Journal: Chiropr Man Therap Date: 2020-10-19
Authors: André Strahl; Murteza Ali Kazim; Nils Kattwinkel; Wiebke Hauskeller; Steffen Moritz; Sönke Arlt; Andreas Niemeier Journal: Bone Joint J Date: 2022-03 Impact factor: 5.385