PHYSIOTHERAPY INTERVENTIONS FOR CHRONIC LATERAL EPICONDYLAGIA
Introduction
Lateral epicondylagia is a musculoskeletal disorder characterised by pain and tenderness at the lateral epicondyle.1 Whilst relatively little is known about its exact aetiology and associated risk factors, it is generally attributed to repeated forearm use and damage to the forearm muscles and tendons.1, 2 Over 40 different treatment methods have been described in literature, including rest, ice, braces, injections, and strengthening and stretching exercises. Research has found these methods to be inconsistently effective. 1, 3
Discussion
Newcomer, Martinez-Silvestrini, Schaefer, Gay, and Arendt4 conducted a randomised controlled trial to evaluate the effectiveness of eccentric strengthening in treating lateral epicondylagia. Subjects experiencing over 3 months of elbow pain were randomised into three groups to ensure internal validity: eccentric training and stretching, concentric training and stretching and stretching only. Researchers justified using stretching as a control as it remains a common intervention for treating lateral epicondylagia.1, 3-5 Outcomes were measured initially and then remeasured at 2 weeks by using visual analog pain scale (VAS)6, Pain Free Grip (PFG)7, Patient-rated Forearm Evaluation Questionnaire (PRFEQ)8 and Disabilities of the Arm, …show more content…
No gold standard exists to measure outcomes of lateral epicondylagia4, however PRFEQ’s reliability, sensitivity and reproducibility have been justified in previous studies8 and VAS is used extensively in clinical practice, including in the evaluation of lateral epicondylagia.4, 11 Furthermore, as a region-specific assessment tool, DASH successfully measures the functional status of patients which was an important outcome factor for this study by Martinez-Silvestrini et al.4, 9 Before measuring PFG, an electronic dynamometer was calibrated to optimise measurement accuracy, hence increasing the study’s reliability and validity.4,
Introduction
Lateral epicondylagia is a musculoskeletal disorder characterised by pain and tenderness at the lateral epicondyle.1 Whilst relatively little is known about its exact aetiology and associated risk factors, it is generally attributed to repeated forearm use and damage to the forearm muscles and tendons.1, 2 Over 40 different treatment methods have been described in literature, including rest, ice, braces, injections, and strengthening and stretching exercises. Research has found these methods to be inconsistently effective. 1, 3
Discussion
Newcomer, Martinez-Silvestrini, Schaefer, Gay, and Arendt4 conducted a randomised controlled trial to evaluate the effectiveness of eccentric strengthening in treating lateral epicondylagia. Subjects experiencing over 3 months of elbow pain were randomised into three groups to ensure internal validity: eccentric training and stretching, concentric training and stretching and stretching only. Researchers justified using stretching as a control as it remains a common intervention for treating lateral epicondylagia.1, 3-5 Outcomes were measured initially and then remeasured at 2 weeks by using visual analog pain scale (VAS)6, Pain Free Grip (PFG)7, Patient-rated Forearm Evaluation Questionnaire (PRFEQ)8 and Disabilities of the Arm, …show more content…
No gold standard exists to measure outcomes of lateral epicondylagia4, however PRFEQ’s reliability, sensitivity and reproducibility have been justified in previous studies8 and VAS is used extensively in clinical practice, including in the evaluation of lateral epicondylagia.4, 11 Furthermore, as a region-specific assessment tool, DASH successfully measures the functional status of patients which was an important outcome factor for this study by Martinez-Silvestrini et al.4, 9 Before measuring PFG, an electronic dynamometer was calibrated to optimise measurement accuracy, hence increasing the study’s reliability and validity.4,