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- PSYCHOLOGICAL FACTORS NOT STRENGTH DEFICITS ARE…
PSYCHOLOGICAL FACTORS NOT STRENGTH DEFICITS ARE ASSOCIATED WITH SEVERITY OF GLUTEAL TENDINOPATHY: A CROSS-SECTIONAL STUDY
BACKGROUND & OBJECTIVE
Gluteal tendinopathy is a common condition with a high prevalence among middle-aged females. It can present with severe symptoms and impact valued activities, work and quality of life. A number of physical factors have been studied such as abductor function, body mass index (BMI) and waist girth, but less is known about the influence of psychological factors in gluteal tendinopathy. This study examined physical and psychological factors in participants with gluteal tendinopathy to see how they varied with different levels of pain and disability.
A cross-sectional study design was used. Participants were included if between 35 and 70 years old and had lateral hip pain for at least 3 months with an average intensity of 4 or more out of 10 on a numeric scale. Several tests were used in the diagnosis of gluteal tendinopathy which are worth noting as they may prove useful in clinic. To be included participants needs to report pain on direct palpation of the gluteal tendon insertions on the greater trochanter and test positive (have lateral hip pain) on at least 1 of the following 6 tests:
- FABER (Flexion Abduction External Rotation)
- FADER (Flexion Adduction External Rotation)
- Isometric muscle contraction in FADER test position
- Adduction test
- Isometric muscle contraction in adduction position
- Single leg stance on affected leg for 30 seconds
Those that met these criteria then went on to have an MRI to confirm diagnosis. 204 participants were recruited, 82% of which were female. The mean age was 55 years with a range between 36 and 71. Psychological factors were assessed using a collection of questionnaires including the Pain Catastrophizing Scale, the Pain Self Efficacy Questionnaire and the Patient Health Questionnaire. Quality of life and physical activity were also assessed alongside waist girth and hip abductor strength. VISA-G (reliable and valid disability score for gluteal tendinopathy, see - https://www.researchgate.net/publication/304168478_Visa_G_with_scoring) was used to assess severity and classify participants into 3 subgroups; mild, moderate and severe. A numeric scale was also used to assess average and worst pain ratings over the previous week.
The severe group had significantly higher pain catastrophizing and depression scores and lower pain self-efficacy compared to both the mild and moderate severity groups. Quality of life and activity levels were also significantly lower in the severe group. Waist girth