Sensorimotor deficits in lateral epicondylalgia—So what?

Abstract

Deficits in sensorimotor measures of upper limb reaction time and speed of movement have been identified in patients with lateral epicondylalgia. It is unknown what part these deficits have to play in the recovery of the condition or their relationship to previously validated outcome measures of pain and function. A 198 participants with a clinical diagnosis of tennis elbow were assessed at baseline, then at 3, 6, 12, 26 and 52 weeks post-randomisation, for the primary outcome measures of pain, global improvement, and grip force as well as upper limb reaction time and speed of movement. Participants were randomised to receive either a corticosteroid injection, a wait and see approach or an elbow manipulation/exercise programme. Baseline sensorimotor measures within the LE cohort were compared to a control group (n = 40) with no previous history of upper limb complaints. Significant deficits in both reaction time and speed of movement in the LE group compared to control group were confirmed at baseline (p ≤ 0.003), with no significant difference between affected and unaffected sides within the LE group or between dominant and nondominant sides in the control group (p > 0.05). Although sensorimotor measures within the LE group improved significantly over time, there was no significant difference between intervention groups. Importantly, the LE group remained significantly worse at 52 weeks compared to the control group (p ≤ 0.008). It appears that upper limb reaction time and speed of movement are affected bilaterally in a unilateral condition and that these measures change over time but this change is independent of treatment and not strongly related to other measures of pain and function. The clinical significance of sensorimotor deficits requires further investigation.