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Costa E Silva Cabral AL, Marques JDP, Dionisio VC. Scapular dyskinesis and overhead athletes: A systematic review of electromyography studies. J Bodyw Mov Ther 2024; 39:606-614. [PMID: 38876694 DOI: 10.1016/j.jbmt.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE Understanding how the main scapular muscles behave in overhead athletes with scapular dyskinesis (SD). DESIGN Systematic Review. SETTING Electronic searches were performed in Pubmed (MedLine), Embase, CINAHL, and SPORTDiscus databases. PARTICIPANTS Overhead athletes with SD. MAIN OUTCOME MEASURES Electromyographic activity of the upper (UT), middle (MT), and lower (LT) trapezius, and serratus anterior (SA). RESULTS Eight studies were included in this review. The UT activity showed a tended to increase its activity mainly during tasks over 90° compared to 45°. SA activity had similar behavior, mainly during isometric tasks. The MT also increased its activity mainly in tasks with overhead angulations when compared to lower angulations. The LT activation tended to decrease its EMG activity at angulations below 60° in overhead athletes with SD. CONCLUSIONS The EMG behaviour of UT and SA for non-athletes appears to differ from what has already been described in the literature. The MT seems to be the most neglected muscle for scapular stabilization in overhead athletes with SD. The decrease in LT activity suggests that this may have implications for the performance of these athletes.
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Affiliation(s)
- Ana Luiza Costa E Silva Cabral
- Federal University of Uberlândia, Faculty of Physical Education and Physiotherapy (FAEFI), Laboratory of Neuromechanics and Physiotherapy (LANEF), Brazil.
| | - Júlia de Paula Marques
- Federal University of Uberlândia, Faculty of Physical Education and Physiotherapy (FAEFI), Laboratory of Neuromechanics and Physiotherapy (LANEF), Brazil
| | - Valdeci Carlos Dionisio
- Federal University of Uberlândia, Faculty of Physical Education and Physiotherapy (FAEFI), Laboratory of Neuromechanics and Physiotherapy (LANEF), Brazil
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Wadekar S, Gaddis JM, Middleton E, Xi Y, Mulligan E, Bialaszewski R, Laboret B, Wells J. The Morbidity of Greater Trochanteric Pain Syndrome Versus That of Patients Awaiting Total Hip Replacement. Orthopedics 2024:1-6. [PMID: 38810128 DOI: 10.3928/01477447-20240520-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed medical issue, yet there are little data assessing the relative morbidity of GTPS. We sought to characterize the morbidity on presentation of GTPS and compare it to that of patients with end-stage hip osteoarthritis awaiting total hip arthroplasty. We hypothesized that patients with GTPS would have morbidity similar to or worse than that of patients with osteoarthritis. MATERIALS AND METHODS This retrospective case-control study examined patient-reported outcome measures of 156 patients with GTPS (193 hips) and 300 patients with hip osteoarthritis before total hip arthroplasty (326 hips). Patients with secondary hip conditions or previous hip surgeries were excluded from the study. Patient-reported outcome measures were analyzed using an equivalence test and two one-sided t tests. RESULTS Equivalence in mean visual analog scale pain scores between GTPS and osteoarthritis was established with a tolerance margin of ±10. The difference in mean visual analog scale pain scores was 0.35 (95% CI, -0.86 to 0.16; P=.02). The Hip disability and Osteoarthritis Outcome Score Quality of Life was much worse for patients with GTPS, placed well outside of the ±10 tolerance margin, and the difference in mean scores was 1.72 (95% Cl, -2.17 to -1.26; P=.99). Equivalence in mean UCLA Activity scores between GTPS and osteoarthritis was established with a tolerance margin of ±5. The difference in mean UCLA Activity scores was 0.002 (95% CI, -0.45 to 0.43; P<.01). CONCLUSION The morbidity and functional limitations of patients with GTPS were similar to those of patients undergoing total hip arthroplasty. GTPS remains a functional problem for patients, and clinicians and researchers should consider GTPS as seriously as hip osteoarthritis. [Orthopedics. 202x;4x(x):xx-xx.].
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Citaker S, Arikan H, Maras G, Ayas IH, Yazgan-Dagli B. Translation, reliability, and validity of the Turkish version of the Victorian Institute of Sports Assessment For Gluteal Tendinopathy (VISA-G) questionnaire in individuals with greater trochanteric pain syndrome. Physiother Theory Pract 2024; 40:617-624. [PMID: 36170045 DOI: 10.1080/09593985.2022.2127139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain. OBJECTIVE The objectives of this study were to translate the Victorian Institute of Sports Assessment for Gluteal Tendinopathy (VISA-G) questionnaire into the Turkish language and to examine its reliability and validity. METHODS 108 individuals (45 female, 63 male) participated in the translation and the reliability and validity analysis. The original VISA-G questionnaire was translated into Turkish language using Beaton guidelines. The Turkish version of the VISA-G, Harris Hip Score (HHS), Oswestry Disability Index (ODI), Oxford Hip Score (OHS), and International Physical Activity Questionnaire (IPAQ) were applied to 108 individuals with GTPS for convergent validity. The VISA-G was retested to investigate its reliability after one week. RESULTS The VISA-G had a good correlation with HHS (r = 0.694, p < .001), ODI (r = -0.659, p < .001), OHS (r = 0.678, p < .001), and IPAQ (r = 0.440, p < .001). The reliability and internal consistency were excellent (ICC (2,1) value = 0.943; Cronbach's α = 0.946, respectively). And no floor and ceiling effects were revealed related VISA-G. CONCLUSION The Turkish version of the VISA-G has good validity and excellent reliability. It can be used in clinical and research practices in the Turkish population with GTPS.
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Affiliation(s)
- Seyit Citaker
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Bişkek Street 06490, Cankaya, Turkey
| | - Halime Arikan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tokat Gaziosmanpasa University, Taşlıçiftlik Campus, 60250, Turkey
| | - Gokhan Maras
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Bişkek Street 06490, Cankaya, Turkey
| | - Inci-Hazal Ayas
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Bişkek Street 06490, Cankaya, Turkey
| | - Beyza Yazgan-Dagli
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Bişkek Street 06490, Cankaya, Turkey
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Nascimento MB, Vilarinho LG, Lobato DFM, Dionisio VC. Role of gluteus maximus and medius activation in the lower limb biomechanical control during functional single-leg Tasks: A systematic review. Knee 2023; 43:163-175. [PMID: 37422984 DOI: 10.1016/j.knee.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/30/2023] [Accepted: 05/12/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES Single-leg (SL) tasks are included as assessment and intervention strategies in several dysfunctions due to the inherent motor control requirement. The recruitment of gluteus maximus (GMAX) and medius (GMED) muscles is essential for proper biomechanical control of the knee and hip joints. The study aims to identify the role of gluteal activation in the biomechanical control of the lower limb during SL tasks. METHODS This is a systematic review with searches performed in Pubmed, CINAHL, MEDLINE, Web of Science, and Sportdiscus databases. Cross-sectional studies carried out with asymptomatic individuals were selected, containing hip and knee kinematic and kinetic outcomes assessed through 3D or 2D movement analysis and EMG activity of GMED and GMAX muscles. Two independent reviewers performed the procedures to select the studies, determine the methodological quality and extract the data. RESULTS The initial search resulted in 391 studies, and after the assessment procedures, 11 studies were included. Lower GMAX activation was associated with greater hip internal rotation (HIR) excursion and greater HIR moment, and lower GMED activation was associated with greater hip adduction (HAD)/knee abduction (KAB) excursions and greater KAB moment during single-leg squat (SLS). CONCLUSIONS The SL tasks showed a relevant association between the gluteal EMG and other biomechanical outcomes, mainly the SLS task. Interpretation must be cautious, as most studies present high and moderate methodological quality, especially on kinetic data.
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Affiliation(s)
- Matheus Batista Nascimento
- Federal University of Uberlândia - UFU, Faculty of Physical Education and Physiotherapy- FAEFI, Uberlândia, Minas Gerais, Brazil.
| | - Lucas Gois Vilarinho
- Federal University of Uberlândia - UFU, Faculty of Physical Education and Physiotherapy- FAEFI, Uberlândia, Minas Gerais, Brazil
| | | | - Valdeci Carlos Dionisio
- Federal University of Uberlândia - UFU, Faculty of Physical Education and Physiotherapy- FAEFI, Uberlândia, Minas Gerais, Brazil
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Park YG, Goh TS, Kim DS, Jung SJ, Lee JS. Relationships between Clinical Status and Gait Parameters in Ankylosing Spondylitis. Clin Orthop Surg 2023; 15:249-256. [PMID: 37008970 PMCID: PMC10060776 DOI: 10.4055/cios22112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to identify the relationship between gait parameters and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS). Methods The study group comprised 134 patients with AS and 124 patients were enrolled as controls. All study participants underwent instrumented gait analysis and completed clinical questionnaires. The kinematic parameters of gait were walking speed, step length, cadence, stance phase, single support, double support, phase coordination index (PCI), and gait asymmetry (GA). For each patient, a visual analog scale (VAS; 0-10) score was used to assess back pain, 36-item short form survey (SF-36) questionnaire was administered to evaluate the HRQOL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was calculated. Using kinematic parameters and questionnaires, statistical analyses were done to investigate significant differences between the groups. Relationship of gait kinematic data and questionnaires of clinical outcome was also evaluated. Results Among the 134 patients with AS, 34 were women and 100 were men. In the control group, 26 were women and 98 were men. The patients with AS and control group patients had significant differences in terms of walking speed, step length, single support, PCI, and GA. However, such differences were not observed in cadence, stance phase, and double support (p > 0.05). In correlation analyses, gait kinematic parameters and clinical outcomes were significantly related with each other. In multiple regression analysis performed to identify predictive factors for clinical outcome, walking speed was found to predict VAS, and walking speed and step length were found to predict the BASDAI and SF-36 scores. Conclusions Patients with and without AS had significant differences in the gait parameters. Correlation analysis showed significant correlation between the gait kinematic data and clinical outcomes. In particular, walking speed and step length successfully predicted clinical outcomes in patients with AS.
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Affiliation(s)
- Yong Geon Park
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Tae Sik Goh
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Dong Suk Kim
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Seok Jin Jung
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jung Sub Lee
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
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Andreasen J, Fearon A, Morissey D, Hjørnholm LH, Kristinsson J, Jorgensen JE, Mølgaard CM. "I feel I have been taken seriously" Women's experience of greater trochanteric pain syndrome treatment-A nested qualitative study. PLoS One 2022; 17:e0278197. [PMID: 36441745 PMCID: PMC9704619 DOI: 10.1371/journal.pone.0278197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Women experiencing greater trochanteric pain syndrome (GTPS) report high levels of pain and reduced quality of life. Exploring how they manage GTPS in a daily life context can provide important knowledge about individual coping strategies. Education, extracorporeal shockwave therapy (ESWT) and exercise have good group level evidence for efficacy in clinical trials and are increasingly used in routine care for patients with GTPS. Exploring women's experiences of such treatment may help understand the mechanisms underpinning these positive results and inform treatment strategies. We therefore aimed to explore how women with GTPS experience and manage their daily life, and their experience of the combined treatment of education, ESWT and exercises. METHODS This qualitative study was nested within a cohort study based in a hospital outpatient clinic and a physiotherapy clinic in Denmark assessing the combined treatment of education, ESWT and exercises. Data was collected from eleven women using in-person, individual, semi-structured interviews which were audio recorded. Transcripts were coded and analysed using an inductive thematic analysis approach. FINDINGS Five themes were identified: (1) Daily life was controlled and structured by pain; (2) The condition was acknowledged and taken seriously by treating professionals; (3) The participants´ experiences of the intervention-information is key; (4) Improved capability and autonomy in pain management and (5) The women´s perspectives on improving and expanding the intervention. Learning how to manage pain was experienced as the most important element of the program to the women to be able to minimize pain and manage daily life. CONCLUSION Exploration of how women with greater trochanteric pain syndrome experienced and managed daily hip pain, and how they experienced and adapted to treatment are important novel findings that will inform clinical practice. This new knowledge may be used to inform an individualized patient education, treatment and evaluation strategy for women with the painful and debilitating condition of GTPS.
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Affiliation(s)
- Jane Andreasen
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark,The Faculty of Medicine, Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, Aalborg, Denmark,* E-mail:
| | - Angela Fearon
- UCRISE, Faculty of Health, University of Canberra Hospital, University of Canberra, Bruce ACT, Australia
| | - Dylan Morissey
- Sport and Exercise Medicine, Queen Mary University of London, London, United Kingdom,Physiotherapy Department, Barts Health NHS Trust, London, United Kingdom
| | - Laura H. Hjørnholm
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark
| | - Jens Kristinsson
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | | | - Carsten M. Mølgaard
- Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark,Sport and Exercise Medicine, Queen Mary University of London, London, United Kingdom,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Migliorini F, Kader N, Eschweiler J, Tingart M, Maffulli N. Platelet-rich plasma versus steroids injections for greater trochanter pain syndrome: a systematic review and meta-analysis. Br Med Bull 2021; 139:86-99. [PMID: 34405857 DOI: 10.1093/bmb/ldab018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 07/17/2021] [Accepted: 07/20/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Greater trochanter pain syndrome (GTPS) is characterized by a persistent and debilitating pain around the greater trochanter. GTPS can be caused by a combination of gluteus medius or minimus tendinopathy, snapping hip or trochanteric bursitis. SOURCE OF DATA Recent published literatures identified from PubMed, EMBASE, Google Scholar, Scopus. AREAS OF AGREEMENT Platelet rich plasma (PRP) and corticosteroids (CCS) injections are useful options to manage symptoms of GTPS. AREAS OF CONTROVERSY Whether PRP leads to superior outcomes compared to CCS injections is unclear. GROWING POINTS A systematic review and meta-analysis comparing PRP versus CCS in the management of GTPS was conducted. AREAS TIMELY FOR DEVELOPING RESEARCH PRP injections are more effective than CCS at approximately 2 years follow-up.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopedic, Trauma, and Reconstructive Surgery, RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Nardeen Kader
- Department of Orthopedics, South West London Elective Orthopaedic Centre (SWLEOC), Dorking Rd, Epsom KT18 7EG, UK
| | - Jörg Eschweiler
- Department of Orthopedic, Trauma, and Reconstructive Surgery, RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Markus Tingart
- Department of Orthopedic, Trauma, and Reconstructive Surgery, RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi (SA), Italy.,School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, 01782 Stoke on Trent, UK.,Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK
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Pathogenesis and contemporary diagnoses for lateral hip pain: a scoping review. Knee Surg Sports Traumatol Arthrosc 2021; 29:2408-2416. [PMID: 33341914 PMCID: PMC8298339 DOI: 10.1007/s00167-020-06354-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/26/2020] [Indexed: 01/14/2023]
Abstract
PURPOSE Recent advances in diagnostic imaging techniques and soft tissue endoscopy now allow for precise diagnosis and management of extra-articular hip pathology. The aim of this scoping review is to present an evidence-based update of the relevant literature focussing only on the pathoanatomy, clinical assessment and the diagnosis of pathology in the peritrochanteric space. METHODS A literature search was performed on PubMed to include articles which reported on the anatomy and diagnosis of greater trochanteric pain syndrome, trochanteric bursitis, gluteus medius tears and external snapping hip syndrome. RESULTS A total of 542 studies were identified, of which 49 articles were included for full text analysis for the scoping review. Peritrochanteric space pathology can be broadly classified into (1) greater trochanteric pain syndrome (GTPS), (2) abductor tears and (3) external snapping hip syndrome. Anatomically, gluteus medius, gluteus minimus and tensor fascia lata work in conjunction to abduct and internally rotate the hip. The anterolateral part of the gluteus medius tendon is more prone to tears due to a thin tendinous portion. Increased acetabular anteversion has also been shown to be associated with gluteal and trochanteric bursitis. In terms of clinical examination, tests which were found to be most useful for assisting in the diagnoses of lateral hip pain were the single-leg stance, resisted external derotation of the hip, hip lag sign and the Trendelenburg's test. Dynamic ultrasound along with guided injections and MRI scan do assist in differentiating the pathology and confirming the diagnosis in patients presenting with lateral hip pain. Finally, the assessment of baseline psychological impairment is essential in this group of patients to ensure outcomes are optimised. CONCLUSION Lateral hip pain used to be a poorly defined entity, but advances in imaging and interest in sports medicine have led to a better understanding of the pathology, presentation and management of this cohort of patients. A thorough appreciation of the anatomy of the abductor musculature, specific clinical signs and imaging findings will lead to an appropriate diagnosis being made and management plan instituted. LEVEL OF EVIDENCE IV.
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Minetto MA, Busso C, Giannini A, Meiburger K, Massazza G, Maffulli N. Cross-cultural adaptation and validation of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire in Italian and investigation of the association between tendinopathy-related disability and pain. Eur J Phys Rehabil Med 2020; 56:764-770. [PMID: 32638573 DOI: 10.23736/s1973-9087.20.06209-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Victorian Institute of Sports Assessment for gluteal tendinopathy (VISA-G) questionnaire has recently been proposed as a condition-specific patient reported outcome measurement tool to assess the tendinopathy-related disability. AIM The aim was to evaluate the reliability of the Italian version of the VISA-G questionnaire and its construct validity and to investigate the association between tendinopathy-related disability and pain. DESIGN It consists in a cross-sectional study. SETTING The location of the study was a university laboratory. POPULATION We evaluated patients with gluteal tendinopathy (N.=38) and healthy controls (N.=38). METHODS Subjects were asked to fill the VISA-G questionnaire twice to evaluate its reliability. The construct validity was evaluated by comparing the VISA score with the Oswestry Disability Index score. Moreover, pain intensity, extent and location were also investigated. RESULTS The VISA-G scores showed non-significant changes in the median values and the values of intraclass correlation coefficient showed very high correlation between the first and second administration (ICC>0.90 in both populations). No significant correlations were found between VISA-G score and either pain extent (R=-0.05, P=0.76), or resting pain intensity (R=-0.13, P=0.45), or palpation pain intensity (R= 0.01, P=0.97). Conversely, a high (and significant) negative correlation was obtained between VISA-G score and Oswestry Disability Index score (R=-0.80, P<0.0001). CONCLUSIONS These results indicated that the VISA-G Italian version presents excellent test-retest reliability. CLINICAL REHABILITATION IMPACT The evaluation of gluteal tendinopathy-related disability through VISA-G can be useful for the prognostic assessment and/or follow-up of tendinopathy patients in combination with the pain drawing assessment of pain extent.
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Affiliation(s)
- Marco A Minetto
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy -
| | - Chiara Busso
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessandro Giannini
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Kristen Meiburger
- BioLab, Department of Electronics and Telecommunications, Polytechnic of Turin, Turin, Italy
| | - Giuseppe Massazza
- Division of Physical Medicine and Rehabilitation, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.,Center for Sports and Exercise Medicine, Bart's and London School of Medicine and Dentistry, Queen Mary University, London, UK.,School of Pharmacy and Bioengineering, School of Medicine, Keele University, Stoke on Trent, UK
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Common Musculoskeletal Disorders in the Elderly: The Star Triad. J Clin Med 2020; 9:jcm9041216. [PMID: 32340331 PMCID: PMC7231138 DOI: 10.3390/jcm9041216] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/09/2020] [Accepted: 04/22/2020] [Indexed: 12/15/2022] Open
Abstract
Musculoskeletal disorders are debilitating conditions that significantly impair the state of health, especially in elderly subjects. A pathological triad of inter-related disorders that are highly prevalent in the elderly consists of the following main “components”: sarcopenia, tendinopathies, and arthritis. The aim of this review is to critically appraise the literature relative to the different disorders of this triad, in order to highlight the pathophysiological common denominator and propose strategies for personalized clinical management of patients presenting with this combination of musculoskeletal disorders. Their pathophysiological common denominator is represented by progressive loss of (focal or generalized) neuromuscular performance with a risk of adverse outcomes such as pain, mobility disorders, increased risk of falls and fractures, and impaired ability or disability to perform activities of daily living. The precise management of these disorders requires not only the use of available tools and recently proposed operational definitions, but also the development of new tools and approaches for prediction, diagnosis, monitoring, and prognosis of the three disorders and their combination.
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