None listed
Conditions
Brief summary
A single-case experimental design with multiple baselines across participants will be conducted to evaluate the effects of self mobilisation exercises on pain-related grip measures in individuals with lateral elbow tendinopathy. In this study, participants will be assigned to a randomised baseline monitoring period (7, 10 or 13 days) before commencing the intervention. Staggering the introduction of the intervention across participants at different timepoints allows the treatment effect to be distinguished from natural symptom fluctuation or spontaneous recovery. The primary and secondary outcome measures will be measured daily throughout the baseline (7-13 days) and intervention (14 days) periods and at a single 2-week follow-up timepoint. In this study, it is hypothesised that the self mobilisation intervention will improve pain-free grip strength and reduce pain ratings at different grip loads across participants when comparing the baseline phase to the intervention and follow-up phases.
Interventions
Intervention: Self mobilisation exercise for lateral elbow tendinopathy
Following enrolment into the study, participants will be randomly allocated using a computer-generated sequence to 1 of 3 baseline periods: 7 days, 10 days or 13 days.
Participants will perform self mobilisation of their elbow as a home exercise following the baseline period - starting Day 8, 11 or 14.
Participants will attend a face-to-face instruction session (~30 minutes) with a registered physiotherapist with postgr
Intervention: Self mobilisation exercise for lateral elbow tendinopathy Following enrolment into the study, participants will be randomly allocated using a computer-generated sequence to 1 of 3 baseline periods: 7 days, 10 days or 13 days. Participants will perform self mobilisation of their elbow as a home exercise following the baseline period - starting Day 8, 11 or 14. Participants will attend a face-to-face instruction session (~30 minutes) with a registered physiotherapist with postgraduate qualifications where they will be provided with verbal and written instruction on how to perform the self mobilisation exercise – either a lateral glide of the humeroulnar joint or posterior-anterior glide of the radius with pain-free gripping. To perform the self-lateral glide of the humeroulnar joint with pain-free gripping, participants will stand next to a wall with the upper arm stabilised against the wall and elbow flexed to 90°. Participants will place their other hand on the medial aspect of the forearm just below the elbow joint and apply a glide laterally. Participants will grip until their first onset of pain while maintaining the glide (~3-5 second hold). The glide is then released. To perform the self-posterior-anterior glide of the radius with pain-free gripping, participants will be positioned in standing or sitting with their elbow fully extended. Participants will place their index and middle finger on the radial head and apply a posterior-anterior glide. Participants will grip until their first onset of pain while maintaining the glide (~3-5 second hold). The glide is then released. Glide selection will be individualised based on which technique produces the greatest immediate improvement in pain-free grip strength during the assessment; if neither technique produces greater improvement, the lateral glide will be used as the default. Participants must demonstrate correct technique before commencing the home program of self mobilisation exercises. Participants will complete the home program of self mobilisation exercises independently and unsupervised. Participants will perform 1 set of 10 repetitions of the self mobilisation exercise daily for 2 weeks. Participants will record their exercise adherence on a paper diary.
Sponsors
The University of Queensland
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: 1) participants aged 18 to 70 years 2) unilateral lateral elbow tendinopathy of at least 6 weeks’ duration 3) average pain severity during the past week greater than or equal to 3 on a 11-point numerical rating scale 4) pain over the lateral epicondyle or common extensor tendon that is aggravated by at least 2 of: palpation, gripping, resisted third finger or wrist extension, or stretching of forearm extensor muscles 5) reduced pain-free grip strength
Exclusion criteria
Exclusion criteria: 1) other sources of elbow pain (e.g., exacerbation of elbow pain with neck movements or manual palpation, pain localized over the radiohumeral joint, abnormal findings on neurological examination) 2) concomitant musculoskeletal pain conditions reported by participants to be their predominant complaint 3) major neurological, inflammatory or systemic conditions 4) a history of elbow dislocation, fracture or tendon rupture in the last year 5) any injections within the previous 6 months 6) any treatment by a healthcare practitioner within the preceding 3 months 7) Participants who don’t have sufficient English language proficiency to understand the study procedures
Outcome results
None listed