Patient-Rated Tennis Elbow Evaluation Questionnaire Research Articles

Effects of extracorporeal shockwave therapy versus ultrasonic therapy and deep friction massage in the management of lateral epicondylitis: a randomized clinical trial

The study's goal was to compare and evaluate the benefits of deep friction massage and ultrasonic therapy (US) vs extracorporeal shockwave therapy (ESWT) for people with lateral epicondylitis. This double-blind, parallel-arm randomized clinical trial was conducted after ethical approval on a sample of 80 subjects with lateral epicondylitis. Participants were enrolled based on predefined eligibility criteria. They were randomly allocated to groups A and B. Group A received ESWT, while Group B received the US combined with deep friction massage. Data was collected using the Numeric Pain Rating Score (NPRS) and Patient-rated tennis elbow evaluation questionnaire (PRTEE) at baseline, at 3rd, and at 7th week of treatment. On the basis of the normality of the data, a non-parametric test was applied to evaluate between-group and within-group differences. P value ≤ 0.05 was considered significant. There was a significant difference between groups (p < 0.001). Comparisons of PRTEE scores at 3rd week and 7th week of intervention were found significant for both groups (p < 0.001). While considering between-group comparisons based on percentile scores of PRTEE at baseline, 3rd and 7th week of intervention, in group A Median (IQR) at the baseline was 24.00 (5.00), at 3rd week, 10.00 (5.00) and 7th week was 1.50 (2.50) and in group B Median (IQR) at the baseline was 25.00 (4.00), at 3rd week 19.50 (4.50) and at 7th week was 11.50 (2.50). The results were significant in both groups (p = 0.000), but between-group analysis revealed that ESWT is more effective in patients with lateral epicondylitis.

Bracing or kinesio taping in the management of lateral elbow tendinopathy: A prospective, randomized single-blinded trial

ObjectiveThe aim of the study was to compare the effects of forearm counter force brace (FCB) and kinesio taping (KT) on pain severity, grip strength and functionality of patients with lateral elbow tendinopathy (LET). MethodsThe study was planned as a prospective, randomized and assessor-blinded study with 1-month follow-up period. Seventy-two patients, diagnosed as LET were randomly assigned to FCB (n = 41) or KT (n = 31) groups. In the FCB group, the patients were informed and instructed to wear the brace for three weeks continuously. In the KT group, tape was applied once a week for four weeks with muscle inhibition and fascia correction techniques. The outcome measures were pain pressure threshold (PPT), maximal pain-free hand grip strength measurement and patient-rated tennis elbow evaluation questionnaire (PRTEE). The assessments were performed at the baseline, immediately after treatment and one month later after treatment. ResultsPPT and grip strength were significantly increased over time in both groups. Pain, function and total scores of PRTEE were significantly decreased in both FCB and KT groups. The effect size of the improvement in PRTEE function score was within acceptable clinical significance in the KT group. However, there was no significant difference between groups. ConclusionsPain severity, grip strength and functionality of patients with LET improved over time in both FCB and KT groups. However, neither was superior in the management of LET.

The Efficacy of Blood Flow Restriction Training for Grip Strength and Disability in Lateral Epicondylitis

Background: Lateral epicondylitis is a work-related musculoskeletal disorder caused by inflammation of the extensor carpi radialis longus and brevis muscles tendons with symptoms of pain in the lateral side of the elbow and decreased range of motion that causes forearm muscle weakness and disability. This study aimed to compare the effectiveness of blood flow restriction (BFR) training with resistance exercise (RE) in increasing grip strength and forearm disability in lateral epicondylitis patients. Methods: This study used the randomized controlled trial design that involved 28 subjects who were divided into intervention and control groups. All subjects received the treatment 3 times per week for 4 weeks, including the standard ultrasound therapy and electro-muscular stimulation interventions for 20 mins with additional treatment of the low-load BFR training for the intervention group and the high-intensity RE for the control group. This study measured grip muscle strength using a handgrip dynamometer, and functional ability was measured using a patient-rated tennis elbow evaluation questionnaire (PrTEEQ) before and after the treatment session. The statistical analyses of paired t-tests and independent t-tests were used in this study. Results: This study found significant differences between pretest and posttest scores in the measurements of forearm muscle strength (change= 20.0~49.0%, p-values &lt;0.001) and PrTEEQ (change= 64.5~70.5%, p-value &lt;0.001) in the intervention and control groups. In addition, the independent t-tests resulted in significant differences in the score changes of forearm muscle strength and PrTEEQ measurement between these groups with p-values &lt;0.001. Conclusion: This study described that BFR training had better effects on grip strength and functional ability than RE in people with lateral epicondylitis.

Responsiveness and Minimally Important Changes for Persian-version of Patient-Rated Tennis Elbow Evaluation Questionnaire in Patients with Lateral Elbow Tendinopathy Following Physiotherapy Intervention.

Evaluating responsiveness and calculating minimally important change (MIC) for the Persian-version of the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire following physiotherapy in patients with lateral elbow tendinopathy (LET). We enrolled 82 patients with LET to complete the PRTEE. After completing four weeks of physiotherapy, all patients were reevaluated by the PRTEE. The patients also rated their changes on a 7-point global rating of change scale (GRoC). The receiver operating characteristic (ROC) curve and correlation analysis were used for evaluating the responsiveness. The MIC was determined by determining a desirable cutoff on the ROC curve. The results showed a moderate relationship (Spearman's correlation coefficient= 0.43-0.56) of total PRTEE, pain subscale, and function subscale with the GRoC scale. The total PRTEE, pain subscale, and function subscale revealed an area under the curve of 0.87, 0.82, and 0.83, respectively. We found the MICs 31.33, 14.5, and 15.5 points for total PRTEE, pain subscale, and function subscale, respectively. The Persian-version of the PRTEE questionnaire has acceptable responsiveness and can measure changes in patients with LET following physiotherapy. We advocate using the PRTEE questionnaire in both clinical settings and research.

Validity and reliability of the Duruöz Hand Index in patients with lateral epicondylitis.

This study aims to investigate the validity, reliability and clinimetric features of the Duruöz Hand Index (DHI) in patients with lateral epicondylitis. Between October 2019 and January 2020, a total of 78 patients (28 males, 50 females; mean age: 46.4±9.4 years; range, 20 to 65 years) who presented with pain in the forearm and were diagnosed with lateral epicondylitis were included in the study. The patients were evaluated using the Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ), the Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEEQ), the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire at Weeks 0, 1 and 4. The DHI reliability (Cronbach alpha, intraclass correlation [ICC]), validity and factor analyses were performed with the data of 70 and 49 patients who attended to follow-up visit at Weeks 1 and 4. The effect size (ES), standard response mean (SRM), and minimum detectable change (MDC) values of the DHI were calculated. Of the patients, 84.6% were right-handed. The ICC coefficients of DHI were found to be perfect with the test-retest method (ICC; total=0.943). It showed a well-excellent consistency with the internal consistency method (Cronbach alpha; total=0.90). In the structural validity of the DHI, it was very strongly correlated with the DASH (r=0.801; p<0.01), strongly correlated with the PRTEEQ and HAQ total scores (r=0.793; p<0.01; r=0.785; p<0.01), and acceptably correlated with PRTEEQ pain score (r=0.570; p<0.01). The DHI was acceptably correlated with the VAS and grip strength as measured by the hand dynamometer (p<0.05). In our study, three main factors were obtained and MDC and responsiveness sensitivity were found to be moderate (MDC=4.4; SEM=1.61; ES=0.246 p<0.001; SRM=0.538 p<0.001). Duruöz Hand Index is a reliable, valid, and practical functional assessment scale in patients with lateral epicondylitis.

The impact of a hand therapy workplace-based educational approach on the management of lateral elbow tendinopathy: A randomized controlled study

BackgroundLateral elbow tendinopathy (LET) is one of the most prevalent work-related musculoskeletal conditions. Management strategies for LET rarely consider patients’ work environments and have limited focus on education regarding occupational risk factors. Workplace-based rehabilitation has shown benefits in the return to work processes for injured workers with other health conditions, but no studies have investigated the impact of a workplace-based educational approach in the management of LET. PurposesFirst, to identify the impact of an additional workplace-based educational intervention to standard hand therapy care on the outcomes of pain, grip strength, and function. Second, to identify the effectiveness of standard hand therapy on the same clinical outcomes. Study DesignA randomized controlled trial. MethodsForty-nine participants were randomized to the control group (n = 25) or intervention group (n = 24). The control group received standard hand therapy for 12 weeks. The intervention group received standard hand therapy for the first 12 weeks plus an additional workplace-based educational intervention, “Working Hands-ED,” delivered by a hand therapist. Pain levels for provocative tests, grip strength, and function were measured using a Numeric Rating Scale, Jamar Dynamometer, and the Patient-Rated Tennis Elbow Evaluation questionnaire at baseline, weeks 6 and 12. The Patient-Specific Functional Scale was also used for the intervention group. ResultsThere were no statistical differences between both groups for all clinical outcomes by 12 weeks (P> .05). Pain levels for all provocative tests and Patient-Rated Tennis Elbow Evaluation scores statistically improved within both groups (P < .05), however with small effect sizes observed. The Patient-Specific Functional Scale scores statistically improved for the intervention group by 12 weeks (P < .05). ConclusionThe addition of a hand therapy workplace-based intervention did not result in superior clinical outcomes for pain, grip strength, and function. The study identified that a multimodal self-management approach used by hand therapists improved their patients' pain and function regardless of whether the education was given in the clinic or the workplace.

Perineural injection as an alternative treatment of resistant lateral elbow pain

Abstract Background Lateral elbow pain (LEP) or lateral epicondylitis (LE) is a common problem affecting both males and females. Multiple therapeutic modalities are used with different outcomes. Objective The current study aimed at description of the effectiveness of a newly introduced modality, Perineural Injection (PNI) therapy in comparison to the already used therapeutic ultrasound (TUS) as a conventional modality in the treatment of resistant LEP (LE). Patients and methods This is a longitudinal interventional study. Thirty patients of both sexes aged between 21 to 62 years old who had LE were randomly allocated into two groups (15 each). In PNI group, 5% buffered dextrose was injected subcutaneously around the lateral epicondyle once weekly for 8 weeks. In TUS group, continuous US was used 3 sessions per week for 4 weeks. Tenderness grading scale, visual analogue scale (VAS), Patient- Rated Tennis Elbow Evaluation Questionnaire (PRTEE) score, and ultrasonographic evaluation were used before and 12 weeks after treatment. Results In both groups, there was a high significant clinical improvement at 12th week after treatment. However, the improvement was better in the PNI group than the TUS group. By US evaluation at 12th week after treatment, there was a significant decrease in hypoechoic areas and disturbed fibrillar pattern in PNI group compared to before therapy (p &amp;lt; 0.001 and = 0.025) respectively. But in TUS group, there was decrease in hypoechoic areas and tendon thickness compared to before treatment (p = 0.02 and 0.026) respectively. Conclusion Both PNI and TUS therapies for LE gave clinical improvement for pain, functional limitations and some ultrasonographic findings (as echogenity, fibrillar pattern and tendon thickness). However, PNI therapy gave better outcome as compared to TUS.

Comparative Effect of Dry Needling and Neural Mobilization on Pain, Strength, Range of Motion, and Quality of Life in Patients With Lateral Epicondylitis: Protocol for Randomized Clinical Trial

ObjectiveThe purpose of this article is to describe a study protocol that will aim to assess the effectiveness of adding dry needling or neural mobilization to conventional physiotherapy in the treatment of lateral epicondylitis. MethodsWe propose to conduct a 2-group, participant-blinded, randomized clinical trial with recruitment of 36 participants with lateral epicondylitis from a recognized super-speciality tertiary care hospital. After fulfilling eligibility criteria, consenting participants will be randomized to either a dry needling group or a neural mobilization group, both with conventional therapy as well. The outcome measures will be the Patient-Rated Tennis Elbow Evaluation questionnaire, pain pressure threshold, grip strength, and range of motion. ResultsData analysis will be done by Wilcoxon signed-rank test or paired t test and Mann–Whitney U test or independent t test. The significance level will be set at 0.05. All outcome measures will be recorded at baseline and after 2 weeks of intervention. ConclusionThis study protocol will provide data regarding the effects of dry needling and neural mobilization in people with lateral epicondylitis.

The patient-rated tennis elbow evaluation questionnaire was successfully translated to Korean

IntroductionLateral epicondylitis is a common tendinopathy of the elbow. An adequately validated questionnaire is essential to compare the various treatment options, because there is still controversy regarding the best treatment for lateral epicondylitis. Purpose of the studyThe patient-rated tennis elbow evaluation (PRTEE) was introduced to measure the degree of symptoms and the limitation of function in these patients. This English questionnaire was previously translated into several languages and validated; however, it has not been translated into Korean. The aim of this study was to translate and cross-culturally adapt the PRTEE questionnaire into Korean, and to assess the reliability and validity of the translated questionnaire. MethodsEighty-three patients were asked to complete the Korean version of the PRTEE and other questionnaires related to the upper extremity or to the general health condition (the Disabilities of Arm, Shoulder, and Hand questionnaire, Short Form-12, and EQ-5D). The PRTEE responses were recorded twice to evaluate test-retest reliability. Internal consistency, test-retest reliability, concurrent validity, and ceiling and flooring effects were evaluated. ResultsThe Korean version of the PRTEE showed high internal consistency (Cronbach's alpha = 0.968). The overall test-retest reliability was good (intra-class correlation score = 0.94). High correlation efficiencies between the PRTEE and other questionnaires were observed, supporting high concurrent validity (Spearman's correlation = 0.83 for the Disabilities of Arm, Shoulder, and Hand questionnaire; -0.73 for Short Form-12; and -0.57 for EQ-5D). Ceiling and floor effects were not observed on this test. ConclusionWe successfully translated the PRTEE into the Korean language; this version of the PRTEE showed good reliability and construct validity in Korean-speaking patients with lateral epicondylitis.

Adaptation and transcultural translation into Spanish of the Patient-Rated Tennis Elbow Evaluation Questionnaire.

The purpose of this study was to perform the translation and cross-cultural adaptation of the Patient-Rated Tennis Elbow Evaluation Questionnaire to Spanish language and evaluate its reliability and validity. The translation and cultural adaptation into Spanish was done in accordance with the published guidelines. One-hundred fifty Spanish-speaking patients with unilateral chronic lateral epicondylalgia competed the questionnaire. Test-retest reliability was established by the intraclass correlation coefficient. Internal consistency was established with Cronbach's α. To establish convergent validity, we used the Disabilities of the Arm, Shoulder, and Hand Questionnaire using the Spearman's correlation coefficient. Error estimation in the measurements was calculated with the standard error of measurement. Our results showed a high internal consistency (Cronbach's α = .96) and high test-retest reliability (intraclass coefficient = .9; .89-.94; P < .001). The Spearman's correlation coefficient (r = .765; P < .001) showed a good relationship between the Spanish version of the Patient-Rated Tennis Elbow Evaluation Questionnaire and the Disabilities of the Arm, Shoulder, and Hand Questionnaire. The standard error of measurement (11.9%) showed little variability of measurements. In conclusion, the Spanish version of the Patient-Rated Tennis Elbow Evaluation Questionnaire is a valid and reliable tool that can be used to assess lateral epicondylalgia in Spanish-speaking individuals in order to implement the best treatment and reduce time with pain and disability.

Patient-Rated Tennis Elbow Evaluation (PRTEE).

The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. An official German translation does not yet exist. The aim of this study was to translate and cross-culturally adapt the English version of the PRTEE into German. The translation and cross-cultural adaptation was completed by an expert committee comprising people of varying professional and linguistic backgrounds. According to international guidelines, the English original was first translated into German, then back-translated and the final version was pre-tested on patients. No major difficulties were encountered during the translation process and smaller linguistic discrepancies could be resolved in the expert committee. For the pre-validation testing, 11 patients with extensor repair due to persistent lateral epicondylitis were included. They rated the questionnaire as easy to understand and complete. The final version was approved by the developers of the original questionnaire as the official German translation. Although the measurement properties of the German version were not evaluated in this study, the original shows good reliability, validity and responsiveness. In summary, the PRTEE is a questionnaire quick and easy to complete for patients with lateral epicondylitis. Therefore, it is suitable for the clinical routine assessment of subjective health status or the outcome after an intervention.

Cross-cultural adaptation and measurement properties of the Patient-Rated Tennis Elbow Evaluation for the Persian language

Introduction The Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire is a tool designed for self-assessment of forearm pain and disability in patients with tennis elbow. The aims of this study were to translate and cross-culturally adapt the PRTEE questionnaire into Persian and evaluate its reliability and construct validity. Methods The PRTEE questionnaire was translated into and cross-culturally adapted to Persian in 90 consecutive patients with tennis elbow, according to well-established guidelines. Reliability was tested by means of test–retest and internal consistency. The measurement error was measured by calculating the standard error of measurement. Based on the standard error of measurement, the minimum detectable change was calculated. To evaluate construct and convergent validity, correlation with the PRTEE with the Disabilities of the Arm, Shoulder and Hand questionnaire and Visual analogue scale was used. Results In the process of cross-cultural adaptation, two items (6 and 8) were modified. In item 6, the term “door knob” was changed to “turn a key”, and in the item 8, “cup of coffee” was changed to “cup of milk”. Item-total correlations were greater than 0.55 (ranged from 0.55 to 0.76), internal consistency was high (Cronbach’s alpha, 0.94) and a high intraclass correlation coefficient (0.98) indicated excellent reliability of the P-PRTEE. The standard error of measurement and minimum detectable change were 5.40 and 14.24, respectively. The Persian version of the PRTEE questionnaire (P-PRTEE) shows strong construct and convergent validity ( r values = 0.85, p &lt; 0.05). Conclusions The P-PRTEE is valid and reliable in assessing disability and pain in Persian patients with tennis elbow. The excellent psychometric properties of the P-PRTEE endorse the use of this questionnaire in clinical settings.

The Patient-Rated Tennis Elbow Evaluation Questionnaire was successfully translated to Persian

IntroductionThe Patient-Rated Tennis Elbow Evaluation (PRTEE) is designed to evaluate pain and disability in subjects with lateral elbow tendinopathy. This questionnaire is available in Swedish, Italian, and some other languages. A Persian language version of the questionnaire is needed for both research and clinical purposes. Purpose of the StudyThe purpose of this study was to translate and cross-culturally adapt the PRTEE questionnaire into the Persian language and to determine its validity and reliability. MethodsThe PRTEE was translated and culturally adapted from English into Persian (PRTEE-P) according to the established guidelines. The PRTEE-P was completed by 68 Iranian subjects (44 women, 24 men) diagnosed with chronic lateral elbow tendinopathy. To assess test-retest reliability, all subjects filled out the PRTEE-P on a second admission within one week. The intraclass correlation coefficient (ICC) and Cronbach's alpha were measured to report reliability. The validity was determined by correlating the PRTEE-P questionnaire with the Persian version of the Disabilities of the Arm, Shoulder, and Hand questionnaire. ResultsThe Persian version of the PRTEE showed a high internal consistency with a Cronbach's alpha of 0.99, demonstrating good test-retest reliability (ICC = 0.99). It was well correlated with Disabilities of the Arm, Shoulder, and Hand (r = 0.80). ConclusionThe PRTEE-P is a reliable and valid tool designed for measuring pain and disability in subjects with lateral elbow tendinopathy.

The effects of kinesiotaping on wrist extensor strength using an isokinetic device in patients with chronic lateral epicondylitis: A randomized-controlled trial

This study aims to evaluate short-term effects of kinesiotaping (KT) on pain, arm function, grip strength, and wrist extensor strength in patients with chronic lateral epicondylitis (LE). A total of 48 patients (32 females, 16 males years; mean age 47.6 years; range 27 to 67 years) with chronic LE were randomly assigned to either KT group (n=27) or sham group (n=21). Pain intensity with visual analog sclae (VAS), arm pain and function with Patient-Rated Tennis Elbow Evaluation Questionnaire (PRTEE), grip strength with hand dynamometer, and wrist extensor strength by an isokinetic device were evaluated before and at the end of the treatment. The KT stayed on for five days and the procedure was repeated for three times. Although pain and functional levels of patients with chronic LE were significantly improved both with KT (pain, p=0.001; function, p=0.001) and sham groups (pain, p=0.001; function, p=0.001), no significant difference was observed between the groups. Both KT and sham taping provided similar improvement in pain relief through arm functions in patients with chronic LE.

Efficacy of physical therapy interventions for chronic lateral elbow tendinopathy: a systematic review

Study Design: Systematic review.Background: Existing systematic reviews and meta-analyses do not support a specific physical therapy treatment for lateral elbow tendinopathy (LET). The results of these studies, however, may not accurately represent the current state of evidence. This may be due, in part, to methodological limitations in these studies, specifically the lack of utilization of standardized and disease-specific outcome measures.Objectives: To determine the effectiveness of physical therapy interventions in treating chronic lateral elbow tendinopathy as assessed in randomized controlled trials (RCTs) using pain-free grip strength and/or patient-rated tennis elbow evaluation questionnaire as outcome measures.Methods: A search of PubMed, Physiotherapy Evidence Database (PEDro), Scopus database, Google Scholar and bibliography was conducted from inception to November 2018. The methodological quality of the identified RCTs were assessed using the PEDro scale and the modified Sackett scale was used to appraise findings based on the level of evidence.Results: A total of two thousand nine hundred and six citations were identified, however, only twenty-two RCTs matched the eligibility criteria and were included in the review. The identified studies varied in design, investigated diverse physical therapy modalities that were applied for dissimilar periods, assessed outcome measures at unalike periods, and showed inconsistent results.Conclusion: A rigorous review of literature showed insufficient evidence to support or refute the effectiveness of many of the current physical therapy interventions for chronic LET. Nevertheless, the results might suggest immediate efficacy of mobilization with movement of the elbow joint and short-term efficacy of myofascial release technique.Level of evidence: Therapy, level 1a-

PERBANDINGAN EFEKTIVITAS MYOFASCIAL RELEASE TECHNIQUE DENGAN MUSCLE ENERGY TECHNIQUE PADA INTERVENSI ULTRASOUND DALAM MENURUNKAN DISABILITAS

Introduction: A study shows the prevalence of musculoskeletal pain in the elbow most often diagnosed with elbow and forearm conditions is tennis elbow. Tennis Elbow, a common disease that can cause a decrease in productivity and economic losses. Treatment of physiotherapy that can be given for myofascial syndrome can be therapeutic modalities such as Ultrasound and manual therapy such as Muscle Energy Technique (MET) and Myofascial Release Technique (MRT). Method: This is an experimental study with pre and post test control group design. The number of samples was 24 people, which divided into 2 groups. Group I was given MRT with ultrasound, while Group II was given MET with ultrasound. Disability is measured by the Patient-Rated Tennis Elbow Evaluation Questionnaire. Results: Based on the results of the Paired Sample t-test in Group I and Group II the value of p &lt;0.001 stated that there was a significant change after giving the exercise to each group. Furthermore, the comparison test between both groups used the independent sample t-test and p value &lt;0.05. This shows that there are significant differences between groups. Conclusion: MRT further reduces disability due to tennis elbow compared to MET.Keywords: tennis elbow, disability, PRTEE, MET, MRT.

Management of Chronic Lateral Epicondylitis With Manual Therapy and Local Cryostimulation: A Pilot Study

ObjectiveThe purpose of this pilot study was to evaluate the feasibility and efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. MethodsThe control group (n = 19) was treated with manual therapy consisting of soft-tissue therapy and radial head mobilizations. The experimental group (n = 18) received cryostimulation in addition to manual therapy care similar to that for the control group. Both protocols consisted of 8 treatments over a 4-week period. Outcome measures included pain intensity (visual analog scale), pain-free grip strength (handheld dynamometer), and functional index (Patient-Rated Tennis Elbow Evaluation questionnaire). Assessments were performed at baseline, postintervention, and 3-month follow-up. Adherence and dropout rates were also considered. ResultsBoth groups exhibited significant improvements in pain intensity and functional index at postintervention assessments, which were maintained at follow-up. All participants attended the prescribed number of treatments, but 27% were lost at follow-up. Minor adverse events were reported after cryostimulation in 4 cases. ConclusionsThis study indicated that it is feasible to complete a clinical trial evaluating the efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. On the basis of these preliminary data, the combination of cryostimulation and manual therapy care did not provide any additional benefits in both the short term and the long term. Manual myofascial point treatment and mobilization techniques yielded positive outcomes in chronic lateral epicondylitis. Further studies should focus on the sole therapeutic effect of cryostimulation in both patients with acute and those with chronic conditions.

Cross-cultural adaptation and validation of the Patient-Rated Tennis Elbow Evaluation Questionnaire on lateral elbow tendinopathy for French-speaking patients

Study DesignTranslation and validation of algo-functional questionnaire. IntroductionThe lateral elbow tendinopathy is a common injury in tennis players and physical workers. The Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire was specifically designed to measure pain and functional limitations in patients with lateral epicondylitis (tennis elbow). First developed in English, this questionnaire has since been translated into several languages. Purpose of the studyThe aims of the study were to translate and cross-culturally adapt the PRTEE questionnaire into French and to evaluate the reliability and validity of this translated version of the questionnaire (PRTEE-F). MethodsThe PRTEE was translated and cross-culturally adapted into French according to international guidelines. To assess the reliability and validity of the PRTEE-F, 115 participants were asked twice to fill in the PRTEE-F, and once the Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and the Short Form Health Survey (SF-36). Internal consistency (using Cronbach's alpha), test-retest reliability (using intraclass correlation coefficient (ICC), standard error of measurement and minimal detectable change), and convergent and divergent validity (using the Spearman's correlation coefficients respectively with the DASH and with some subscales of the SF-36) were assessed. ResultsThe PRTEE was translated into French without any problems. PRTEE-F showed a good test-retest reliability for the overall score (ICC 0.86) and for each item (ICC 0.8-0.96) and a high internal consistency (Cronbach's alpha = 0.98). The correlation analyses revealed high correlation coefficients between PRTEE-F and DASH (convergent validity) and, as expected, a low or moderate correlation with the divergent subscales of the SF-36 (discriminant validity). There was no floor or ceiling effect. Discussion and ConclusionsThe PRTEE questionnaire was successfully cross-culturally adapted into French. The PRTEE-F is reliable and valid for evaluating French-speaking patients with lateral elbow tendinopathy.

Greek adaptation and validation of the Patient-Rated Tennis Elbow Evaluation (PRTEE)

Purpose of the studyTo cross-culturally adapt and validate the Greek version of the Patient-Rated Tennis Elbow Evaluation (PRTEE-G) Questionnaire. MethodsFour bi-lingual translators were involved in the translation and cultural adaptation procedures. Eighty-two patients (61 women and 21 men) with Lateral Elbow Tendinopathy (LET) participated in the study. To establish test - retest reliability, the patients were asked to complete the PRTEE-G Questionnaire before and after the first physiotherapy treatment. Internal consistency of the translated instrument was measured using Cronbach ‘alpha’. An intraclass correlation coefficient was used to assess the test - retest reliability of the PRTEE-G Questionnaire. Concurrent validity was measured by correlating the PRTEE-G Questionnaire scores with the Greek version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) scores using Pearson's correlation coefficient. ResultsThe Greek PRTEE questionnaire has acceptable internal consistency (Cronbach ‘alpha’ = 0.95), excellent test - retest reliability (ICC = 0.94) and demonstrates expected concurrent validity (r > 0.72). ConclusionThe Greek version of PRTEE Questionnaire is a reliable and valid measure when administered to patients with LET.

Neural Tissue Mobilisation Using ULTT2b and Radial Head Mobilisation v/s Exercise Programme in Lateral Epicondylitis

Background & Purpose: Lateral epicondylitis has been associated with adverse neural tension in radial nerve. Research also implicates the affection of radial head in this condition. Exercise program advocates claim that it is the most effective treatment for lateral epicondylitis. Thus comparison between Exercises alone and Neural tissue mobilisation along with Radial head mobilisation seems to give an insight into its different treatment strategy. Methodology: Total 40 subject with lateral epicondylitis were recruited. They were divided in 2 groups. 20 in Experimental Group and 20 in Control Group. In Experimental group, NDS + Radial Head Mobilisation + Exercise programme was given and in Control group only Exercise programme was given to the patient. The outcome measures were Visual Analogue Scale (VAS), Pain Free Grip Strength (GS), Pain Pressure Threshold (PPT) and Patient Rated Tennis Elbow Evaluation Questionnaire (PRTEE) were assessed Pre and Post treatment. Duration of treatment was 4 days/ week for 4 weeks. Results: Experimental group, have shown that Mulligan's MWM to Radial head and Neural tissue mobilisation have found to achieve favourable outcome as compared to exercise group and even Exercise group, have been shown to have significant effects. Conclusion: Neural tissue mobilization along with radial head mobilization was found to have a favourable outcome as compared to exercise programme.