EXERCISE BASED INTERVENTIONS FOR GLUTEAL TENDINOPATHY: SYSTEMATIC REVIEW
Tendon. Tendonitis. Greater trochanter pain syndrome. Trochanteric bursitis. Hip.
Gluteal tendinopathy is a common condition in adults, presenting pain and tenderness to palpation in the greater trochanter. Exercise has been shown to be effective for the treatment of tendinopathies in general, however, the effects of exercise for the treatment of gluteal tendinopathy have not been systematically reviewed. The aim of this review was to evaluate the effect of exercise on pain, function, global perception of change and quality of life in individuals with gluteal tendinopathy. Search strategies were performed in the databases (Cochrane Library, MEDLINE/PubMed, CINAHL, Embase and PEDro). The risk of bias was assessed using the PEDro scale. 1463 were identified and seven studies were included for descriptive analysis. The mean score of the studies using the PEDro scale was 7.57 ± 1.81 points. Exercise plus education was superior to wait and see for treatment success rate, pain, function, quality of life, between 4 and 52 weeks. There were no differences between isometric and isotonic exercise plus education in treatment success rate, pain, function, quality of life, at 4 and 12 weeks. Likewise, isometric and kinetic chain exercise and simulated exercise also did not show differences at 12 and 52 weeks for the same outcomes. Exercise plus education was superior to corticosteroid injection (CI) for treatment success rate at 8, 26, and 52 weeks, pain level only at 8 weeks, however pain frequency was higher at 8, 12, and 52 weeks. Function was higher in the exercise plus education group compared to CI at 8, 12 and 26 weeks and quality of life at 8, 12, 26 and 52. CI compared to exercise was higher at 4 weeks, however at 60 weeks exercise was higher for pain and degree of recovery. Exercise compared to shock wave therapy (ESWT) showed no differences at 4 and 60 weeks for pain and degree of recovery, only at 16 weeks there was an improvement for ESWT. Exercise was superior to platelet-rich plasma (PRP) infiltration for the pain outcome at 12, 24, and 48 weeks. We conclude that exercises are recommended for the treatment of gluteal tendinopathy, as they present better results than approaches such as 'wait and see' and CI or PRP infiltrations.