Kinematics and kinetics during stair ascent in individuals with Gluteal Tendinopathy

Abstract

Background: Individuals with gluteal tendinopathy commonly report lateral hip pain and disability during stair ascent. This study aimed to compare kinematics and kinetics between individuals with and without gluteal tendinopathy during a step up task.Methods: 35 individuals with unilateral gluteal tendinopathy and 35 pain-free controls underwent three-dimensional motion analysis of stance phase during stair ascent. An analysis of covariance was performed to compare hip, pelvis and trunk kinematic and kinetic variables between groups. A K-means cluster analysis was performed to identify subgroups from the entire group (n=70) based on the characteristics of the external hip adduction moment.Finally, a Newcombe-Wilson test was performed to evaluate the relationship between group and cluster codes and a 3x2 ANOVA to investigate the differences in kinematics between groups and cluster codes.Findings: Individuals with gluteal tendinopathy exhibited a greater hip adduction moment impulse during stair ascent (ES=0.83), greater internal rotation impulse during the first 50% stance phase (ES=0.63) and greater contralateral trunk lean throughout stance than controls (ranging from ES=0.67-0.93). Three subgroups based on hip adduction moment characteristics were identified. Individuals with GT were 4.5 times more likely to have a hip adduction moment characteristic of a large impulse and greater lateral pelvic translation at heel strike than the subgroup most likely to contain controls.Interpretation: Individuals with GT exhibit greater hip adduction moment impulse and alterations in trunk and pelvic kinematics during stair ascent. Findings provide a basis to consider frontal plane trunk and pelvic control in the management of gluteal tendinopathy.

Psychological factors not strength deficits are associated with severity of gluteal tendinopathy: A cross‐sectional study

“…Although physical impairments and increased body mass index (BMI) have been identified in individuals with gluteal tendinopathy compared to healthy controls, little is known about differences between subgroups based on the severity of pain and disability. Compared to healthy controls, large deficits in bilateral hip abductor muscle strength are reported in gluteal tendinopathy (Allison et al., ; Fearon et al., ; Ganderton et al., ), alongside differences in muscle activity (Allison et al., ; Ganderton et al., ), kinetics and kinematics (Allison et al., ,,). The association between gluteal tendinopathy and anthropometric features such as BMI, waist girth and hip girth shows somewhat contradictory evidence (Fearon et al., ; Flack et al., ; Allison et al., ; Ganderton et al., ).…”

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“…arm elevation in recurrent LBP. 3,33,97 As a result, rehabilitation to target movement dysfunction is a treatment for musculoskeletal pain. However, treatment success with this approach is limited 1,71 and there is debate regarding the type, quantity, and timing of interventions needed to effectively target movement dysfunction in chronic musculoskeletal pain or indeed whether such an approach is warranted.…”

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