Influence of Tendon Neuroplastic Training in Grip Strength of Patient with Lateral Elbow Tendinopathy – A Case Report

Abstract

This case report is about a 38-year-old female IT worker experiencing elbow pain for six months in the lateral aspect of her right elbow 3-4 centimetres distal to the lateral epicondyle of humerus. Patient underwent a four week supervised Tendon Neuroplastic Training TNT program and static stretching exercises for extensor muscle group of wrist joint and isometric training for wrist extensors in both 90 degree elbow flexion and 0 degree elbow extension positions to improve functional integrity. In addition rotator cuff muscles and scapular muscles were strengthened and supinator muscle strengthening exercises were performed. Outcome measures were recorded evaluated at week 0 baseline at week-4 last day of the treatment and at week-12 2 month after the end of treatment. Function and pain were measured in this study where pain-free grip strength was measured with handheld dynamometer to evaluate function and pain was measured by using a visual analogue scale VAS and finally both pain and function were measured by using Patient-Rated Tennis Elbow Evaluation PRTEE. After therapeutic interventions at week-4 the grip strength was 24.3 kg pain score on VAS was 1 and PRTEE questionnaire score was 8. At week-12 pain score on VAS was 0 PRTEE questionnaire score was 5 and grip strength was 31 kgs. There was a marked increase in grip strength with increment of 20.18 kg from baseline marked reduction in pain score VAS with 8 points and marked reduction in PRTEE questionnaire score with 66 points at 12th week follow-up. Based on this case study it can be concluded that TNT exercises can improve grip strength and result in pain reduction in the patients with lateral elbow tendinopathy with multi model exercise approach. Future studies need to be done with high quality trails and long-term follow-up.