Abstract
BackgroundIn the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear.Patients and methodsPatients suffering from a LE longer than 3 months were multicentrically and prospectively randomized into a physiotherapeutic group (PT group) and in a physiotherapy group plus wrist orthosis (PT + O group). Physiotherapy consisted of daily eccentric strengthening exercises under initial professional supervision. Inclusion criteria were a Placzek score greater than 4. Exclusion criteria were previous surgery, rheumatic arthritis, elbow instability, radicular symptoms, higher-grade extensor tendon rupture, or cervical osteoarthritis. The clinical evaluation was performed after 12 weeks and 12 months. The Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, Placzek Score, the pain rating (VAS), range of motion and the Subjective Elbow Score were evaluated.ResultsOf the initially 61 patients, 31 were followed up after 12 weeks and 22 after 12 months. Twenty-nine patients (43%) were male, the mean age was 46, and 44 patients (66%) had the right elbow involved. At 12 weeks, there was a pain reduction on the VAS in both groups (PT + O: 6.5–3.7 [p = .001]; PT: 4.7–4.1 [p = .468]), albeit it was only significant for the PT + O group. At 12 months, reduction was significant in both groups (PT + O: 1.1 [p = .000]; PT: 1.3 [p = .000]). The painless maximum hand strength in kg improved in both groups significant after 3 and 12 months. The Placzek score was reduced from 8.25 to 3.5 [p = .001] after 12 weeks for the PT + O group and from 8.1 to 3.8 [p = .000] in the PT group, as well as after 12 months in the PT + O group to 0 [p = .000] and in the PT group to 2.0 [p = .000]. The PRTEE improved in both groups after 12 weeks (PT + O: 52.8––31.3 [p = .002]; PT: 48.6–37.6 [p = .185]) and 12 months (PT + O: 16.15 [p = .000]; PT: 16.6 [p = .000]), although the reduction at 12 weeks was not significant for the PT group.ConclusionThe elbow orthosis appears to accelerate the healing process with respect to the PRTEE and pain on the VAS (12 weeks follow-up), although there is an adjustment after 12 months in both groups and a significant improvement of symptoms is achieved in all endpoints.
Highlights
In the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear
The elbow orthosis appears to accelerate the healing process with respect to the Patient-Rated Tennis Elbow Evaluation (PRTEE) and pain on the visual analog scale (VAS) (12 weeks follow-up), there is an adjustment after 12 months in both groups and a significant improve‐ ment of symptoms is achieved in all endpoints
The aim of the current study is, the prospective randomized evaluation of a new dynamic wrist orthoses in the treatment of LE as compared to physiotherapy alone
Summary
In the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear. The lateral epicondylitis (LE) is a very common disease and is defined as a painful inflammation and/or degeneration of the extensor carpi radialis brevis (ECRB) and the extensor communis digitorum (ECD) at the lateral epicondyle. The first description of this disease was by Runge in 1873. The LE usually occurs due to a cumulative mechanical overload which results in. The disease is often observed in tennis players (10–15%), in which amateur players are much more affected than professional tennis players, and is more commonly known as tennis elbow. There are various classifications of the disease, the Nirschl et al classification is the most common [5].
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