Effects of Physiotherapy Approaches on Pain and Strength in Lateral Epicondylitis

Abstract

Lateral epicondylitis is suffered from substantial pain and loss of function of the affected limb. There is a variety of clinical setting to treat lateral epicondylitis. PURPOSE: The purpose of this study was to compare the short-term effects of different physiotherapy approaches on pain and maximum grip strength at two different positions including wrist extension and at 900 flexion in the rehabilitation of patients with lateral epicondylitis. METHODS: Forty-five voluntary patients (mean age 49.5 yrs) were randomly divided into three groups. First group received coldpack-Transcutaneous Electrical Nerve Stimulation(TENS) and the second group kinesio taping in addition to same program, five times per week, total 15 sessions. The third group was received coldpack- Extracorporeal Shock Wave Therapy(ESWT), two times per week, total five sessions. Home exercise program including eccentric and stretching exercises was prescribed for all groups three times per day. Patients were assessed by Visual Analog Scale(VAS) for pain intensity, at rest, night and during activity maximum grip strength with manual hand grip dynamometer, at baseline and the end of the treatment and changes were recorded. Statistical analysis was used for comparing values before and after treatment by Wilcoxon tests and differences between groups at the end of treatments by Mann-Whitney U tests. When differences observed, Tukey test had used to find out the group that caused the differences. RESULTS: There were no significant differences in demographic data of the three groups. Intra-group analysis showed that pain intensity was decreased whereas maximum grip strength was improved for all groups (p<0.05). Inter-group analysis showed kinesio taping group was more effective than the other groups in decreasing pain intensity (p=0.001) and increasing maximum grip strength (p=0.007). CONCLUSION: This study showed that the application of kinesio taping was found to be effective in decreasing pain intensity, recovering grip strength and increasing capacity of functional activity without pain in the treatment of patients with lateral epicondylitis. We conclude that kinesio taping in addition to physiotherapy approaches may be considered as an alternative effective method to control pain and improve grip strength in patients with lateral epicondylitis KEY WORDS: tennis elbow, pain, grip strength shock wave therapy, kinesio taping