None listed
Conditions
Brief summary
Lateral epicondylalgia (tendinopathy of the wrist extensors at the lateral epicondyle) is a common condition seen in middle aged people, and despite this, best management is poorly understood. Isometric exercises have been shown as effective in treating tendinopathies in the lower limb, however no-one has investigated the impact of different exercise protocols on immediate pain in the upper limb, and thus for lateral epicondylalgia. A two part cross-over study will examine whether different isometric protocols have better results on pain in this condition, and whether the superior isometric exercise is better than isotonic exercise for immediate impact on lateral epicondylalgia.
Interventions
Participants will complete only one phase of the trial, and will be randomised as to whether they receive 1a or 1b, or 2a or 2b first. Each intervention involves a single session, taking approximately 90 minutes. Each session will be conducted by a physiotherpist (chief investigator). There will be a 1 week washout period between interventions.
Phase 1: Intervention (1a): Isometric wrist extension exercise 5 x 45 secs with 2 minute rest between repetitions.
Phase 2: Intervention (2a): Super
Participants will complete only one phase of the trial, and will be randomised as to whether they receive 1a or 1b, or 2a or 2b first. Each intervention involves a single session, taking approximately 90 minutes. Each session will be conducted by a physiotherpist (chief investigator). There will be a 1 week washout period between interventions. Phase 1: Intervention (1a): Isometric wrist extension exercise 5 x 45 secs with 2 minute rest between repetitions. Phase 2: Intervention (2a): Superior isometric exercise protocol as determined after phase 1 performed 5 x 45 secs with 2 minute rest between repetitions. If after phase 1 no difference is shown between isometric protocols, the cheif investigator will make an a priori decision as to which exercise will be selected as for intervention 2a in phase 2)
Sponsors
La Trobe University
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Participants will be screened by researchers, and included if a diagnosis of current lateral epicondylalgia is confirmed, defined as - self reported localised pain over the common extensor origin at the lateral epicondyle with a loading task such as resisted 3rd digit extension. The loading task must be related to high intensity loading, as opposed to low load repetitive task (such as using a mouse/keyboard).
Exclusion criteria
General Exclusions: Any neurological symptoms including numbness, pins and needles or weakness Past history of elbow surgery Past history of cervical spine surgery Psychiatric illness Inability to speak, read or write English TMS Exclusions: Brain injury or any surgery to the brain (ie. metal implants in head/brain, outside the mouth) Any metallic particles in the eye Aneurysm clips Cochlear implants Noise induced hearing loss Pace makers / spinal cord stimulators Epilepsy of history of seizure activity (or family history in first degree relatives)
Outcome results
None listed