Trial clinico comparativo sull’efficacia dell’ortesi nel trattamento del dolore laterale di gomito

Abstract

Lateral elbow pain syndrome (epicondylitis or tennis elbow) is a musculotendinous pathology that affects more than 3% of the population, with a maximum impact on people aged between 40 and 50 years and an average duration that goes from six months to two years (Assendelft, 1996). In few cases it can last longer (Hudak P, 1996). It strongly affects daily activities like work and sport. Statistically, tennis elbow chiefly affects both people involved in sports like tennis or golf and people who use professional tools for their working activities. More than 40 types of treatment in the care of epicondylitis or tennis elbow have been described in literature (Ernst, 1992). Among the ones described, the most recurrent are: use of orthoses, topical treatments, and hysiotherapy modalities such us ultrasound, laser, massage, electrotherapy, manual handling, infiltration with corticosteroids and surgery. Moreover, for therapeutic purposes, the use of a bracelet, the so-called epicondylitis clasp, is recommended most of the times. It has to be worn just below the elbow, to minimize the damages caused by the extensor carpi radialis tendons stress. In order to verify the effectiveness of this device, a comparative clinical study with a 2-month follow-up has been set with the goal to clarify if the use of an orthoses – according to a regular schedule and a well-tested rehabilitative protocol – could improve the results of the physiotherapeutic treatment. 38 patients suffering from tennis elbow have been selected. They have been divided into 2 groups (homogeneous for age, sex, duration of symptoms) of 19 patients each: group A (study group) and group B (control group). The two groups have been subjected to an identical therapeutic protocol, but only the study group had to use an orthoses for epicondylitis. They had to wear the bracelet following a fixed scheme, both at work and while playing sports. Finally, the of use of the tutor in association with the therapy has been assessed by comparing the subjective assessment of reactivity, the improvement of function in work and sport activities and the clinical evaluation, observed at three different times: at the beginning of the therapy, at the end of the treatment cycle and after 2 months. The final results, while not reaching significance from a statistical point of view probably because of the limited number of patients tested, show that the use of the tutor for a few hours a day both during work and sport activities, leads to a significant improvement of the results of the manual and physical treatment therapy, by enhancing its effects.