None listed
Conditions
Brief summary
The aim of the project is to evaluate changes in ultrasound and clinical parameters in patients with lateral epicondylar enthesopathy following percutaneous electrolysis. It was hypothesized that percutaneous electrolysis would have a beneficial effect on both objective and subjective parameters assessed in patients with lateral epicondylar enthesopathy.. Eligible patients with lateral epicondylar enthesopathy will be randomly assigned to one of two groups: Group A, which will receive percutaneous electrolysis, or Group B, which will receive quasi-percutaneous electrolysis (placebo). Before treatment, and at 1, 6, and 12 weeks, as well as 6 and 12 months after treatment, all patients will have their tendon thickness and stiffness measured, their pain levels at rest, at night, and during activity assessed, their pressure sensitivity levels measured, their function assessed (PRTEE and DASH questionnaires), and their grip strength, pincer grip strength, wrist and finger extensor muscle strength, and wrist and finger flexor muscle strength measured on both the affected and unaffected limbs.
Interventions
The aim of the study is to evaluate changes in ultrasound and clinical parameters in patients with enthesopathy of the lateral epicondyle of the humerus after the use of percutaneous electrolysis.
Patients diagnosed with enthesopathy of the lateral epicondyle of the humerus will be randomly allocated to one of two experimental groups: Group A or Group B.
Group A – Percutaneous electrolysis + isometric training
Percutaneous electrolysis treatments will be performed using the PHYSIO INVASIVA 2.0 d
The aim of the study is to evaluate changes in ultrasound and clinical parameters in patients with enthesopathy of the lateral epicondyle of the humerus after the use of percutaneous electrolysis. Patients diagnosed with enthesopathy of the lateral epicondyle of the humerus will be randomly allocated to one of two experimental groups: Group A or Group B. Group A – Percutaneous electrolysis + isometric training Percutaneous electrolysis treatments will be performed using the PHYSIO INVASIVA 2.0 device from EASYTECH. During each treatment, the patient will be in a sitting position. A needle connected to the negative pole of the power source will be inserted under ultrasound guidance into the common extensor tendon of the wrist and fingers, near the lateral epicondyle of the humerus, at the site of the lesion. A self-adhesive plate electrode made of conductive carbon rubber, completing the circuit, will be attached to the lateral aspect of the forearm, 15 cm above the lateral epicondyle of the humerus. Each treatment will last 90 seconds, with a current intensity of 400 microamperes. Treatments will be performed once a week for a total of five sessions. All procedures will be delivered by the same experienced physiotherapist, trained and licensed to perform percutaneous electrolysis. Fidelity monitoring for percutaneous electrolysis: To ensure fidelity to the intervention, all treatment parameters (current intensity, treatment duration, needle placement, patient positioning) will be documented in the medical notes after each session. Medical records will be reviewed weekly by the study coordinator to confirm adherence to the protocol. Isometric training: Throughout the therapy period, all patients in Group A will also perform isometric training. During the training, the patient will perform isometric contractions of the wrist and finger extensors of the affected limb with maximum force. If pain occurs during contraction, The contraction force will be reduced to a level no higher than 4 on a numerical rating scale (NRS) from 0 to 10, where 0 indicates no pain and 10 indicates the worst pain imaginable. Each contraction will last 30 seconds and will be repeated four times per session, with a two-minute rest between repetitions. No external devices are used during the exercises; resistance is applied manually using the participant’s unaffected hand placed on the dorsal aspect of the affected hand. The exercises will be self-administered at home three times per day, every day, for five consecutive weeks. Adherence monitoring for isometric training: Participants will complete a daily exercise diary documenting the number of sessions performed and the pain intensity reported during each session. Diaries will be reviewed weekly by the study coordinator to assess adherence. The parameters of the treatment in Group A are based on clinical experience, literature review, and established principles for the application of physical modalities.
Sponsors
Academy of Physical Education in Katowice, Mikolowska Street 72A, 40-065 Katowice
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• pain at the attachment of the common extensor tendon of the wrist and fingers to the lateral epicondyle of the humerus, lasting for at least 3 months, • pain on palpation at the attachment of the common extensor tendon of the wrist and fingers to the lateral epicondyle of the humerus, • positive Thomson's test, • positive Mill's test, • positive Moudsley's test.
Exclusion criteria
• pregnancy, • cancer, • implanted pacemaker, • insulin pump, • cardiac arrhythmia, • circulatory system failure, • anticoagulant therapy, • physical therapy within the last 6 weeks, • corticosteroid injections within the last 6 weeks, • diabetes, • rheumatoid arthritis, • ankylosing spondylitis and other rheumatoid diseases, • post-traumatic changes to the shoulder joint, • diseases of both the cervical and thoracic spine, • arthropathy of the humeral-radial joint, • degenerative changes to the elbow joints, • degenerative changes to the hand joints, • carpal tunnel syndrome, • cubital tunnel syndrome, • radial nerve entrapment, • neuropathy of the posterior interosseous nerve, • local infections of the upper limb, • dermatitis involving the limb upper, • elbow instability, • medial epicondyle enthesopathy, • bilateral lateral epicondyle enthesopathy.
Outcome results
None listed