Original research| Volume 101, ISSUE 3, P457-463, March 2020

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Relationship Between Gliding and Lateral Femoral Pain in Patients With Trochanteric Fracture

  • Kengo Kawanishi
    Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

    Department of Rehabilitation, Kano General Hospital, Osaka, Japan
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  • Shintarou Kudo
    Corresponding author Shintarou Kudo, PT, PhD, Graduate School of Health Science, Morinomiya University of Medical Science, 1-26-16 Nankoukita Suminoe Ward, Osaka, Osaka Prefecture 559-8611, Japan.
    Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

    Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
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  • Katsushi Yokoi
    Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

    Department of Occupational Therapy, Morinomiya University of Medical Sciences, Osaka, Japan
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Published:October 21, 2019DOI:


      • Better tissue gliding results in less postoperative pain after trochanteric fracture.
      • Severe pain decreased significantly with increased gliding at 3 weeks post operation.
      • Gliding is an important factor with trochanteric fracture for lateral femoral pain.



      To investigate the association between gliding and lateral femoral pain with trochanteric fracture (TF).


      Prospective cohort study.


      The survey was conducted at approximately 3 weeks and 11 weeks post operation.


      Patients (N=23) with TF after surgery.


      Not applicable.

      Main Outcome Measure

      Pain was assessed using a numeric rating scale for the following 5 conditions: rest pain, tenderness pain, stretch pain (SP), contraction pain, and weight-loading pain. Based on weight-loading pain, the subjects were divided into 2 groups: severe and moderate. Gliding of both the vastus lateralis (VL) muscle and subcutaneous (SC) tissue were recorded during knee motion using B-mode ultrasonography with a 12-MHz linear transducer fixed on the lateral thigh using an original fixation device. Particle image velocimetry analysis software was adapted to create the flow velocity of both VL muscle and SC tissue from echo imaging, and 2 regions of interest were selected on the VL muscle and SC tissue. Gliding was calculated using a coefficient of correlation from each time series data set.


      Gliding and pain (stretch/contraction) were significantly different between the 2 groups at 3 weeks post operation. Changes in both weight-loading pain (r=0.49) and SP (r=0.42) correlated significantly with improvements in gliding.


      Patients with weight-loading pain after surgery for TF showed decreased gliding during recovery, and an improvement in gliding was associated with improvements in both weight-loading pain and SP.

      Graphical abstract


      List of abbreviations:

      NRS (numeric rating scale), SC (subcutaneous), SP (stretch pain), TF (trochanteric fracture), VL (vastus lateralis)
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