None listed
Conditions
Brief summary
Background: Lateral Epicondylalgia (LE), also known as tennis elbow, is one of the most prevalent musculoskeletal disorders among the working population. Despite the numerous treatment methods available to manage the symptoms of this common condition, no sound clinical evidence is available to suggest long term relief and functional restoration for injured workers with LE. Workplace-based rehabilitation has been recognised in recent years to provide many benefits in the return to work process for injured workers for other health conditions. However, no studies have investigated this type of intervention for the management of LE. Consideration of the injured workers workplace as part of the rehabilitation program may not only possibly improve long term outcomes for workers with LE, but may also provide further information on preventative strategies to avoid the occurrence of LE. Purpose: The primary purpose of this study is to investigate the impact of adding a workplace-based hand therapy intervention to the usual clinic-based approach on the return to work outcomes of injured workers with LE, compared to the usual clinic-based hand therapy intervention only. Method: Mixed methodologies will be used in this study. A scoping review will be conducted to identify the effectiveness of current common conservative treatment methods for the management of LE and determine the impact of workplace-based interventions for the general management of injured workers in the return to work process. Surveys will be distributed to identify the current practice trends of medical practitioners and hand therapists in the management LE. A randomised controlled trial (RCT) will be conducted to identify (i) any differences in primary outcomes of claims costs and claims duration on the return to work status of injured workers who receive usual care vs. usual care + workplace-based intervention and (ii) any differences in secondary outcomes of pain, grip strength and function of injured workers who receive usual care vs. usual care + workplace based intervention. Finally, focus groups will be used to identify the lived experience of these injured workers with LE within the workers’ compensation system. Expected Results: The results from this study will inform the key stakeholders in the workers’ compensation system (employers, medical practitioners, insurance case managers, vocational rehabilitation providers, and hand therapists), to establish an evidence-based approach for the management of injured workers with LE.
Interventions
The intervention exposure is an additional workplace visit (to the usual clinic based treatment) by the treating hand therapists within the first four weeks of the initial appointment to identify risk factors associated with LE and provide specific education on pathology, activity modification, postures to avoid and recommendations tailored specifically to the patient in their workplace. The duration of this work site visit will be one hour. There is a work site visit form that will be used by a
The intervention exposure is an additional workplace visit (to the usual clinic based treatment) by the treating hand therapists within the first four weeks of the initial appointment to identify risk factors associated with LE and provide specific education on pathology, activity modification, postures to avoid and recommendations tailored specifically to the patient in their workplace. The duration of this work site visit will be one hour. There is a work site visit form that will be used by all hand therapists when completing this work site visit. There are four common steps for all hand therapists to follow: (1) Identify the activities that the patient has difficulty at work (2) Assess the risk factors for LE in the workplace (3) Provide and demonstrate specific work recommendations to reduce the risk factors (4) Educate and inform the appropriate key parties.
Sponsors
Curtin University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: *Male or female *Aged 18 to 65 years of age *Clinically diagnosed with LE characterised by pain reproduced on at least 2/5 of these clinical tests: (1) resisted middle finger test (2) resisted wrist extension (3) resisted supination (4) palpation over LE (5) palpation over CETO *Submitted a claim for worker’s compensation related to LE *Unilateral only *Can be acute or chronic patients (Acute= <3 months of symptoms, Chronic= >3 months)
Exclusion criteria
Patients will be excluded if they have had any of the following in the past 6 months: *Corticosteroid injection *Blood injections (ABI, PRP) *Previous surgeries for the management of LE *Workers’ compensation claim is declined *Has other upper limb injuries *If the patient works FIFO or in rural setting (whereby a worksite visit would not be possible) *Does not speak or understand English *Are unable to return to work duties due to intense LE symptoms *Are unable to return to work on alternative work duties
Outcome results
None listed