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Heavy slow resistance training combined with patient education in patients with gluteal tendinopathy: A feasibility
Jan Moritz Grigat1, Troels Kjeldsen2, Stian Langgård Jørgensen3
1Exercise Biology, Department of Public Health, Bartholins Allé 2, 8000, Aarhus, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.
Aim:
To investigate the feasibility of heavy slow resistance training (HSR) and patient education (EDU) in patients with gluteal tendinopathy (GT). A secondary aim was to evaluate changes in lateral hip pain, patient-reported outcomes, functional performance and hip muscle strength following the intervention.
Methods:
Nineteen participants (52 ± 7 years, 79 % females) with clinically diagnosed GT, commenced 12 weeks of supervised HSR (2.5 sessions/week) and received written and oral EDU. Different feasibility measures were collected including the percentage of planned HSR sessions attended (session adherence), the percentage of prescribed HSR sets performed (content adherence), drop-outs, adverse events, and pain tolerability. Secondary outcomes included Global Rating of Change, Pain intensity, Victorian Institute of Sport Assessment-Gluteal, Pain Self-Efficacy Questionnaire, EuroQol Group 5-Dimension 5-Level, 9-step timed stair climb test, 30-s chair stand test and maximal isometric hip muscle strength (abduction, flexion and extension).
Results:
Median (IQR) session adherence was 100 % (98-100 %) and content adherence was 99 % (96-100 %). Eighteen participants (95 %) had high (≥80 %) session adherence and 17 (89 %) had high content adherence. One participant (5 %) dropped out. No serious adverse events were reported. Median (IQR) pain tolerability (i.e. no or tolerable pain) was 100 % (100-100 %) before sessions, during HSR, and 24 h after sessions. Paired analyses revealed significant improvements (p ≤ 0.05) with moderate (Cohen's d ≥ 0.5) to large (Cohen's d ≥ 0.8) effect sizes for all secondary outcomes.
Conclusion:
HSR combined with EDU is safe and feasible in patients with GT, in terms of adherence, drop-outs, adverse events and lateral hip pain tolerability.
