Abstract
As a first-line treatment for lateral elbow tendinopathy (LET), eccentric exercise has been suggested as a conservative treatment method. This study aimed to investigate the impact of eccentric exercise on LET with regard to pain reduction, and strength and functional improvement. The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched, and studies up to May 2021 were included if (1) randomization was used for patient allocation, (2) the study comprised patients with LET, (3) the intervention was eccentric exercise, and (4) the primary outcomes included improvement in pain intensity, muscle strength, or function. The meta-analysis comprised of six studies, totaling 429 participants. Additional eccentric exercise with underlying adjuvant therapy significantly improved the visual analog scale (VAS) scores (standardized mean difference [SMD], −0.63; 95% confidence interval [CI], −0.90–−0.36) and muscle strength (SMD, 1.05; 95% CI, 0.78–1.33) compared with adjuvant therapy alone. Compared with the concentric or isotonic exercise group, the eccentric exercise group showed significantly improved VAS scores (SMD, −0.30; 95% CI, −0.58–−0.02). However, no differences in muscle strength and function were observed between the two groups. Eccentric exercise can improve pain and muscle strength in patients with LET. The limited number of included studies and heterogeneous exercise parameters are important when interpreting these findings.
Highlights
Lateral elbow tendinopathy (LET) is one of the most frequently observed lesions causing work- or sports-related pain disorders [1]
There were no reports of adverse events during the study period in four studies [36,38,39,41]. This is the first meta-analysis to evaluate the effectiveness of eccentric exercise on pain reduction, and muscle strength and functional improvement in patients with LET
We reviewed six studies that included a total of 429 participants with LET, and the meta-analysis revealed that eccentric exercise might improve outcomes regarding pain and muscle strength in these patients
Summary
Lateral elbow tendinopathy (LET) is one of the most frequently observed lesions causing work- or sports-related pain disorders [1]. LET most commonly affects the structure of the extensor carpi radialis brevis [4]. The prevalence of LET peaks between the ages of 30 and 60 years and LET primarily affects the dominant arm [2], with symptoms appearing for a longer duration and with greater severity in women [3,5]. Given the variety of symptoms experienced (i.e., pain and loss of function), patients often withdraw from many daily activities, including work and sports. The costs due to loss of work and reduced daily activities, are often considerable, owing to the long recovery period [6]
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