Exercise compared to a control condition or other conservative treatment options in patients with Greater Trochanteric Pain Syndrome: a systematic review and meta-analysis of randomized controlled trials

Troels Kjeldsen*, Katrine Jessen Hvidt, Marie Bagger Bohn, Bjarne Mygind-Klavsen, Martin Lind, Adam Ivan Semciw, Inger Mechlenburg

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Abstract

OBJECTIVES: To estimate the effectiveness of exercise at end of treatment and long-term follow-up compared to a control condition or other conservative treatments in patients with Greater Trochanteric Pain Syndrome (GTPS).

METHODS: Databases were searched September 2021 and updated September 2023. Randomized controlled trials (RCT) comparing exercise interventions for patients with GTPS, to a control condition; corticosteroid injection; shock wave therapy; or other types of exercise programs were included. Risk of bias was assessed using the ROB2 tool. Meta-analyses were performed using a random-effects model. The certainty of the evidence was rated by the GRADE approach.

RESULTS: Six RCTs including a total of 733 patients with GTPS were included. Three trials compared exercise to sham exercise or wait-and-see control groups, two trials compared exercise to corticosteroid injection, two trials compared exercise to shockwave therapy, and one trial compared exercise to another type of exercise. Meta-analyses showed that in the long term, exercise slightly reduces hip pain and disease severity, while slightly improving patient-reported physical function and global rating of change compared to a control condition. No serious adverse events were reported. Compared to corticosteroid injection, exercise improves long-term global rating of change.

CONCLUSION: The current evidence supports a strong recommendation for exercise as first line treatment in patients clinically diagnosed with GTPS. Compared to corticosteroid injection, exercise is superior in increasing the likelihood that a patient experiences a meaningful global improvement. These results are based on few trials and a moderate number of patients.

REGISTRATION: This review was prospectively registered in the PROSPERO database of systematic reviews (ID: CRD42021261380). CONTRIBUTION OF PAPER.

OriginalsprogEngelsk
Sider (fra-til)69-80
Antal sider12
TidsskriftPhysiotherapy
Vol/bind123
DOI
StatusUdgivet, E-publikation før trykning - 5 jan. 2024

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Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

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