RecruitingNot ApplicableNCT06456099

Feasibility of a Home Exercise Program With the Addition of a Corticosteroid Injection in Patients With Lateral Hip Pain

Feasibility of a Home Exercise Program With the Addition of a Corticosteroid Injection in Patients With Greater Trochanteric Pain Syndrome in General Practice


Sponsor

Aalborg University

Enrollment

20 participants

Start Date

Jun 7, 2024

Study Type

INTERVENTIONAL

Summary

We have developed an exercise protocol that we plan to evaluate in a future randomized controlled trial in combination with a corticosteroid injection. In accordance with the MRC Framework of Complex Interventions, which reccomends stepwise development of interventions and testing of feasibility before applying them to a trial, we aim to evaluate the feasibility of our intervention before initiating further trials. The purpose of this non-randomized feasibility study is to test the feasibility and acceptability of this exercise protocol with addition of a corticosteroid injection with no aim of evaluating effects. All participants in this study will receive the following interventions: * An ultrasound-guided corticosteroid injection superficial to the insertion of the gluteus medius and minimus tendons on the greater trochanter of the hip. * A home exercise program including 3 exercises, scalable to 3 different difficulty levels. * A patient information leaflet containing relevant information on managing lateral hip pain.


Eligibility

Min Age: 35 Years

Inclusion Criteria7

  • years of age
  • Self-reported pain on the outside of the hip for at least 12 weeks with an average intensity of present pain over the last week of at least 4/10 on a numeric rating scale 0-10 (0 being no hip pain and 10 being worst hip pain imaginable)
  • Access to a computer, smartphone or tablet with internet connection
  • Tenderness on palpation of the greater trochanter
  • Reproduction of lateral hip pain with 30 sec single leg stance test
  • Ability to speak and understand Danish (written and oral)
  • In case of bilateral hip pain, the study hip will be the most painful at inclusion

Exclusion Criteria8

  • Corticosteroid injection in the affected hip or other new treatment by a health professional within the last 3 months
  • History of systemic inflammatory diseases, e.g. rheumatoid arthritis, spondyloarthritis
  • Weekly intake of oral glucocorticoids
  • History of other hip conditions, e.g. clinically significant hip osteoarthritis, hip dysplasia, prior hip surgery
  • History of prior lumbar back surgery
  • Current low back pain or episodes of low back pain within the last 3 months that have caused sick leave and/or treatment by a health professional
  • Physical or mental disabilities that make it impossible to understand and/or perform exercises and complete questionnaires
  • Current or planned pregnancy or breastfeeding

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Interventions

DRUGUltrasound-guided corticosteroid injection

Participants will receive one ultrasound-guided injection with 1 ml Kenalog 40mg/ml and 1 ml Lidocaine 10mg/ml superficial to the insertion of the gluteus medius and minimus tendons on the greater trochanter of the hip at baseline, Prior to the beginning of exercises.

BEHAVIORALHome exercise program

Our exercise protocol is based on previous literature and expert opinions that has been synthesized in a Delphi study conducted by our research group. The exercise program consists of three body weighted strength exercises, that are to be performed every second day for a period of eight weeks (see appendix 6, "Træningsvejledning"). Exercise instructions will be available as a handout and online with video instructions. The corticosteroid injection usually causes a flare-up in pain with a duration of up to 48 hours. Participants will be instructed to begin the exercises as soon as possible after this flare-up has settled. Compliance to exercises are measured using a training diary that the participants must fill out during the study period (see appendix 7, "Træningsdagbog").

BEHAVIORALPatient information leaflet

In order to support self-management and modification of tendon load, participants will receive a handout at baseline that contains information about GTPS and advice on load management (see appendix 8, "Folder - Smerter på ydersiden af hoften"). The participants will be encouraged to read the leaflet regularly and follow the advice.


Locations(1)

Center For General Practice in Aalborg

Gistrup, Denmark

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NCT06456099