Lateral Epicondylitis
Conditions
Brief summary
No consensus has yet been built on the treatment of lateral epicondylitis (LE) due to the lack of evidence. Although conflicting results are present, radial extracorporeal shock wave therapy (rESWT) has increasingly been used in the treatment of tendinopathy
Detailed description
ESWT and exercise have beneficial effects on the management of tendinopathies owing to their various mechanisms that showed therapeutic efficacy. Owing to its positive outcomes, extracorporeal shock wave therapy (ESWT) has recently been used in the treatment of musculoskeletal system diseases such as plantar fasciitis, Achilles tendinopathy, calcific rotator cuff tendinopathies, and patellar tendinopathy
Interventions
DEVICErESWT
rESWT was administered once per week for 3 weeks using a ShockMaster 500 device with 1.8 bar pneumatic pressure, 10 Hz frequency, with 2000 pulses.
OTHERSupervised exercises
A program including post-isometric relaxation, and progressive resistance exercise (eccentric wrist extension) on the wrist extensors
Sponsors
Istanbul University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The diagnosis of LE was made in the clinical examination, and the diagnosis was confirmed with the Southampton Diagnostic Criteria of the presence of epicondyle pain, and epicondyle pain and tenderness on resisted extension of the wrist. * Patients with symptoms lasting longer than 3 months * with average pain in the previous week detected as 3 or above on a 10-cm visual analogue scale (VAS) * who were aged over 18 years
Exclusion criteria
* pain in the proximal part of the affected extremity (e.g. shoulder pain, neck pain) * abnormal neurogenic symptoms (e.g. radicular pain, numbness) on the affected extremity * presence of posterior interosseous nerve entrapment * congenital or acquired upper extremity deformities that might affect grip strength * systemic musculoskeletal system or neurologic disorders * systemic rheumatologic disease or systemic infection * presence of malignancy, coagulation disorders, and anticoagulant use * inserted cardiac pacemaker * history of surgical treatment on the elbow of the affected extremity * pregnancy. * patients who were administered other treatments such as physical therapy or steroid injections in the last 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change Patient-rated Tennis Elbow Evaluation score | Change from Baseline at 1 month and 3 months after treatment. | The Patient-rated Tennis Elbow Evaluation is a specific questionnaire designed for the evaluation of the disease-specific pain and function/disability in LE. The scores were calculated separately and as the total PRTEE score, where 0 represented the best score, and 100 represented the worst score. The PRTEE consists of a pain scale with 5 items questioning pain during rest and specific activities (0 represents 'no pain' and 10 represents 'the highest pain'), and a function/disability scale with 10 items evaluating difficulties experienced during specific and daily activities (0 represents 'no difficulty' and 10 represents 'the highest difficulty) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change Visual Analogue Scale score | Change from Baseline at 1 month and 3 months after treatment. | The self-evaluation of pain severity during rest and activity in the previous week was calculated using a 10-cm VAS scale |
| Change Roles and Maudsley Score | Change from Baseline at 1 month and 3 months after treatment. | The Roles and Maudsley score was used to evaluate pain and activity limitation as classified in four categories: 1 point = excellent, no pain, complete movement, and complete activity; 2 points = good, discomfort from time to time, complete movement, and complete activity; 3 points = fair, discomfort after long-duration activity; and 4 points = poor, pain that restricts activity. |
| Change Grip Strength score | Change from Baseline at 1 month and 3 months after treatment. | Grip strength of the affected upper extremity was calculated using a Hydraulic Hand Dynamometer |
Outcome results
None listed