Do posted foot orthoses alter hip biomechanics and pain during walking in women with greater trochanteric pain syndrome?

Jayden Hunter; Wayne Spratford; Angie Fearon; Jaquelin A Bousie

doi:10.1016/j.gaitpost.2022.10.014

Do posted foot orthoses alter hip biomechanics and pain during walking in women with greater trochanteric pain syndrome?

Gait Posture. 2023 Jan:99:35-43. doi: 10.1016/j.gaitpost.2022.10.014. Epub 2022 Oct 22.

Authors

Jayden Hunter¹, Wayne Spratford², Angie Fearon², Jaquelin A Bousie³

Affiliations

¹ Discipline of Physiotherapy, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia.
² UCRISE, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia.
³ Discipline of Physiotherapy, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia; UCRISE, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia. Electronic address: jaquelin.bousie@canberra.edu.au.

PMID: 36327536
DOI: 10.1016/j.gaitpost.2022.10.014

Abstract

Background: Greater trochanteric pain syndrome (GTPS), including gluteal tendinopathy and bursitis, is a common, painful and debilitating condition. It is thought to involve overload of the gluteal tendons, which may be amplified through increased hip adduction moment (HAM) seen during gait in these individuals. Reducing the aberrant HAM may improve pain and function in this population. We aimed to determine if medially-posted foot orthoses immediately reduce HAM and pain in females with GTPS during walking gait.

Methods: A double-blind, repeated-measures trial with randomised intervention order compared three conditions in 53 women with GTPS. Participants acted as their own control during baseline (everyday-shoe insole), medially-posted (active) orthosis, or flat insert (sham orthosis) walking. Data were collected via three-dimensional gait analysis for HAM, hip, pelvic, and thorax kinematics; as well as ground reaction force; and pain via the numerical rating scale. Subgroup analysis was performed based on a pronated foot-posture defined by the Foot Posture Index.

Results: A small pain reduction was found between the active orthosis and flat insert (mean difference = -0.444, p = 0.017). No difference was detected for pain between other condition comparisons. Thoracic lateral flexion increased at second-peak HAM between the baseline and active conditions (mean difference = -0.917, p = 0.040). No differences were detected for HAM, remaining kinematic or kinetic variables, or ground reaction force data across the three conditions. No significant differences were detected between any of the three conditions for biomechanical or pain data in the pronated-foot subgroup.

Significance: A medially-posted foot orthosis did not immediately alter gait biomechanics or provide a clinically meaningful pain reduction in women with GTPS. There is uncertainty regarding the clinical benefit of orthoses in the management of GTPS. Longer-term follow-up or the use of customised orthoses may produce different outcomes and should be explored in future research.

Keywords: Foot orthosis; Gait biomechanics; Gluteal tendinopathy; Greater trochanteric pain syndrome; Hip adduction moment.

Publication types

Randomized Controlled Trial

MeSH terms

Biomechanical Phenomena
Bursitis*
Female
Foot Orthoses*
Gait
Humans
Pain
Walking