None listed
Conditions
Brief summary
The primary aim of the study is to assess the effects of combined radial shockwave therapy and local vibration on motor function in patients with tennis elbow. Patients will be randomly assigned to one of two study groups: Group A, in which combined therapy consisting of local vibration and radial shockwave therapy will be used, and Group B, in which radial shockwave therapy will be used as monotherapy. To objectively evaluate the effects of the therapy in patients with tennis elbow, the following assessments are planned: isokinetic evaluation of wrist flexor and extensor muscle strength; measurement of wrist flexor and extensor muscle strength using a dynamometer; pain threshold testing using a dolorimeter; evaluation of resting pain, pain during physical activity, and night pain using the Numerical Rating Scale; and assessment of upper limb disability using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire and the modified Laitinen questionnaire. All measurements will be conducted before the therapy begins and again at 1 and 6 weeks following its completion.
Interventions
In the experimental group, patients receiving combined therapy will undergo both local vibration treatment and radial shockwave therapy. Local vibration therapy will be administered first, followed by the application of radial shockwave therapy. The intervention will be performed by a qualified physiotherapist.
Local Vibration Therapy
Local vibration treatments will be performed using the Storz Medical Duolith SD1 device with the V25 vibration transmitter (Ø 25 mm). For patients with significa
In the experimental group, patients receiving combined therapy will undergo both local vibration treatment and radial shockwave therapy. Local vibration therapy will be administered first, followed by the application of radial shockwave therapy. The intervention will be performed by a qualified physiotherapist. Local Vibration Therapy Local vibration treatments will be performed using the Storz Medical Duolith SD1 device with the V25 vibration transmitter (Ø 25 mm). For patients with significant body hair, the skin area to be treated will be covered with gel prior to the procedure. The patient will be seated with the arm abducted and the elbow flexed to approximately 60°. The forearm will be positioned in pronation and supported, along with the hand, on the therapy table. During the procedure, the supinator muscle, tendons, and muscle bellies of the wrist and finger extensor muscles will be dynamically treated. The following parameter values will be applied: Vibration frequency: 30 Hz Pressure: 3 bars Number of vibrations: 2000 (Hyo Jeong 2023) Number of sessions: 3 (with a 7-day interval between sessions) Radial Shockwave Therapy Radial shockwave treatments will be performed without anesthesia. Before the procedure, the skin surface to be treated will be covered with gel. The patient will be seated with the arm abducted and the elbow flexed to approximately 60°. The forearm will be positioned in pronation and supported, along with the hand, on the therapy table. The shockwave pulses will be applied to the most painful point in the area of the lateral epicondyle. The following parameter values will be used: Pressure: 2.5 bars Number of pulses: 2000 Frequency: 8 Hz Number of sessions: 3 (with a 7-day interval between sessions) The entire therapeutic session, including local vibration treatment and radial shockwave therapy, will last approximately 15 minutes. To ensure fidelity and adherence to the intended procedures, a standardized intervention protocol will be implemented. The physiotherapist involved in the study will undergo training prior to the intervention to ensure consistency in the delivery of treatment. The intervention sessions will take place at the Department of Physical Medicine at the Jerzy Kukuczka Academy of Physical Education in Katowice.
Sponsors
Jerzy Kukuczka Academy of Physical Education in Katowice
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
Informed consent to participate in the study Age between 18 and 45 years Lateral epicondyle pain of the humerus persisting for at least 3 months Pain during palpation of the lateral epicondyle of the humerus Tendon abnormalities visible on ultrasound (presence of focal hypoechoic areas, vascular changes, focal swelling) Positive Thomson test (pain during resisted extension of the radiocarpal joint with the elbow extended, forearm in pronation, wrist slightly extended, and fingers clenched in a fist) Positive Mill’s test (pain during resisted supination of the forearm with the elbow slightly flexed, forearm in pronation, wrist slightly extended, and fingers clenched in a fist) Pain during resisted extension of the middle finger
Exclusion criteria
Age under 18 Thrombophlebitis Atherosclerosis Renal failure Local infection in the upper limb Cancer Implanted pacemaker Cardiac arrhythmia Cardiovascular failure Anticoagulant therapy Physiotherapy conducted within the last 6 weeks Corticosteroid injections administered within the last 6 weeks Diabetes Rheumatoid arthritis and other rheumatic diseases Cancer Pregnancy Post-traumatic changes in the shoulder joint Cervical and thoracic spine disorders Degenerative changes in the elbow and hand joints Neurological disorders (carpal tunnel syndrome, cubital tunnel syndrome, radial nerve entrapment) Local infections in the upper limb Dermatitis in the upper limb Elbow joint instability Bilateral tennis elbow Golfer’s elbow Acute post-traumatic condition Hypersensitivity to shockwave therapy Cemented prosthesis Tumor Vascular fragility Osteoporosis Epilepsy
Outcome results
None listed