Efficacy of wrist manipulation in the management of lateral epicondylitis

2021 ◽  
Vol 9 (5) ◽  
pp. 4019-4027
Author(s):  
Aparna Sudhan M ◽  
◽  
Thresiamma V.T. ◽  
Sreejesh M.S. ◽  
Arun Vijay Subbarayalu ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Grip Strength ◽  
Lateral Epicondylitis ◽  
Mean Difference ◽  
Therapeutic Interventions ◽  
P Value ◽  
Ultrasound Therapy ◽  
Disability Score ◽  
Lateral Epicondyle ◽  
Experimental Group

Background: Lateral epicondylitis is the most common clinical condition characterized by pain generally localized around the lateral epicondyle but sometimes radiating distally to the forearm. Objectives: The study's primary objective was to find out the efficacy of multiple therapeutic interventions consisting of wrist manipulation, ultrasound therapy, and stretching exercise on lateral epicondylitis patients. Subjects and methods: A pre-test, post-test experimental study design was used. A criterion-based simple random sampling was used to recruit patients (N=30) diagnosed with lateral epicondylitis, and they were randomized into two treatment groups. The experimental group-1 was exposed to ultrasound therapy and stretching exercises, whereas those assigned to experimental group-II were given ultrasound therapy, stretching exercise, and wrist manipulation for the period of 2 weeks. The efficacy of treatment was measured through visual analogue scale (VAS), manual hand dynamometer, and DASH Scale. Both paired and unpaired ‘t’ test was employed to study the treatment effectiveness. A p-value <0.05 was considered ‘significant’. Result: The group, which was exposed to the treatment combinations of wrist manipulation, ultrasound therapy, and stretching exercise showed a better reduction in pain intensity (mean difference 1.4) & self-reported upper extremity disability score (mean difference 8.06) and a notable improvement in grip strength (mean difference 4.73) than the other group, that was exposed to the treatment combinations of ultrasound therapy and stretching exercise at 0.05 levels of significance. Conclusion: There is a significant reduction in pain intensity, improvement in pain-free grip strength, and the overall function of the arm following the application of 2 weeks of wrist manipulation technique along with conventional treatment in Lateral Epicondylitis patients. Clinical Implications: Manipulation of the wrist is found to produce a significant effect when combined with conventional methods like ultrasound stretching and strengthening to manage lateral epicondylitis patients. KEY WORDS: Lateral epicondylitis, Ultrasound, Passive stretching, Wrist manipulation.

scholarly journals EFFECTS OF DEEP FRICTION MASSAGE ON TENDINITIS (LATERAL EPICONDYLITIS) IN COMPARISON TO ULTRASOUND THERAPY

2014 ◽  
Vol 3 (2) ◽  
pp. 36-40
Author(s):  
Jetindar Puri ◽  
Dr Nabiha Ahmed
Keyword(s):  
Grip Strength ◽  
Pain Score ◽  
Tennis Elbow ◽  
Tertiary Care ◽  
Lateral Epicondylitis ◽  
P Value ◽  
Ultrasound Therapy ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVE To compare the effects of deep friction massage and ultrasound therapy in subjects with tennis elbow in terms of pain, grip strength and functional activities. STUDY DESIGN Randomized Control Trial. STUDY SETTINGS AND PARTICIPANTS Study was conducted in Physiotherapy OPD of a tertiary care hospital. A sample of 50 patients were inducted in the study. Sample size calculated through open Epi calculator. OUTCOME MEASURES Patients with the diagnosed lateral epicondylitis (Tennis elbow) presenting to out Patient department of two tertiary care hospitals has been enrolled for study after written informed consent. Subjects were randomly allocated into two groups i.e. group A and group B. Group A = DFM + exercise, Group B = U/S + exercise. RESULTS Total 50 patients were randomized and divided into two groups. Group A: the mean pain score on VAS before treatment was 5.88±1.130 and after treatment 1.80±1.041 p-value=0.006. Group B: the mean pain score on VAS before treatment was 6.56±1.446 and after treatment was 2.72±1.208 p-value=0.006. Group A: the mean grip strength score was 13.92±2.691 and in after treatment was 19.60±5.454 p-value=0.342. Group B: the mean grip strength was 15.12±2.505 and after treatment was 20.92±4.183p-value=0.342. CONCLUSION The present study showed no statistical difference in using deep frictional massage therapy in relieving pain, improving grip strength and functional performance in subject with tennis elbow. KEY WORDS Tennis Elbow, Lateral Epicondylitis, Deep Friction Massage, Hand Held Dynamometer, Ultrasound Therapy, Grip Strength.

scholarly journals Comparison between prolotherapy using 25% dextrose versus extracorporeal shock wave therapy in the management of pain and improvement of functional outcome in patients suffering from chronic lateral epicondylitis: a randomized controlled trial

2020 ◽  
Vol 8 (11) ◽  
pp. 4056
Author(s):  
Debasish Deb ◽  
Akoijam Joy Singh ◽  
Naorem Bimol Singh ◽  
Yumnam Nandabir Singh ◽  
Rakesh Das ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Functional Outcome ◽  
Grip Strength ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Study Group ◽  
Extracorporeal Shockwave Therapy ◽  
Lateral Epicondyle ◽  
Shockwave Therapy ◽  
Randomized Controlled

Background: Lateral epicondylitis is a tendinopathy characterized by pain around the lateral aspect of the elbow occuring more frequently in nonathletes than athletes significantly affecting the patient’s life in terms of the quantity and quality of work done. In resistant cases of tennis elbow, a number of treatment options have been tried including extracorporeal shockwave therapy, autologous blood injections and surgery as last resort but none of them has proved to be superior over another. Recent studies show that 25% dextrose prolotherapy which induces an inflammatory reaction at site of administration would be a better treatment option in resistant cases.Methods: A prospective randomized controlled trial was done in Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences, Imphal to compare the effectiveness of 25% dextrose prolotherapy injection and extracorporeal shockwave therapy in management of pain and improvement of functional outcome in patients suffering from chronic lateral epicondylitis.Results: The outcome variables VAS for pain and Grip strength for function were measured at baseline, 1 month, 3 months and 6months. Data collected were analysed using SPSS version 21. For analytical purpose, description statistics like mean and standard deviation were used. Statistical tests like t-test, Chi square test, Fisher’s exact test were used for intra group and inter group analysis. P-value <0.05 was taken as significant. In study group 2ml of 25% dextrose mixed with 2% lignocaine (0.5ml) was given to the affected lateral epicondyle. In control group, weekly sessions of single sitting ESWT was given to the lateral epicondyle for 3 consecutive weeks. In the follow up assessment at 1 month, 3 months and 6 months, there was significant improvement in mean score of VAS and Grip Strength scores in both the groups (p<0.05). When both the groups were compared with each other, study group showed a better improvement and was found to be significantly more effective than shockwave therapy group in reducing pain and improvement of functional outcome in chronic lateral epicondylitis (p = 0.001).Conclusions: Prolotherapy may be considered as a novel alternative conservative management before opting for surgery in resistant cases of lateral epicondylitis.

scholarly journals The Effect of Effleurage Massage to Pain Intensity of First Stage Labor in Inpartu Mothers at Linez Clinic of Gunungsitoli in 2018

2019 ◽  
Vol 14 (2) ◽  
pp. 54-58
Author(s):  
Hanna Sriyanti Saragih
Keyword(s):  
Pain Intensity ◽  
Labor Pain ◽  
Wilcoxon Test ◽  
World Health ◽  
Primary Data ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Uterine Muscle ◽  
Experimental Group

Pain in labor is a manifestation of the contraction (shortening) of the uterine muscle, and it was caused by stretching of the uterine and cervical segments as well as the presence of uterine muscle ischemia. According to WHO (World Health Organization) in 2015, it was estimated that every year 830 women died from complications of pregnancy and childbirth. One method that was very effective in dealing with pain is effleurage massage which was massage technique using the palms of the fingers with a circular motion pattern on the abdomen, waist or thighs. The purpose of this study was to determine the effect of effleurage massage on the intensity of first-stage labor pain in maternal mothers at Linez clinic of Gunungsitoli in 2018. This type of research was guasy Experiment research design with non equivalent control group design. In this design, the grouping of sample members in experimental group and the control group was not random, using wilcoxon test. The population in this study were mothers in first pregnancy as many as 52 people, with a total sample of 20 experimental groups and 20 control groups. The data used were primary data using observation sheets. From the research results, obtained p value 0.0001, it can be concluded that there was significant effect between experimental group and control group. It was hoped that midwives will update their midwifery service and practices such as participating in the latest midwifery training, so that they can increase their knowledge and apply it when conducting childbirth care as effort to reduce labor pain. Keywords: Effluerage Massage, Pain Intensity of First Stage Labor

Redefining the Neck: A Retrospective Review Utilizing Hyoid Suspension

2018 ◽  
Vol 35 (4) ◽  
pp. 198-204
Author(s):  
Sami A. Nizam ◽  
Rhys Branman
Keyword(s):  
Standard Deviation ◽  
Statistical Significance ◽  
Biomechanical Testing ◽  
Retrospective Chart Review ◽  
Mean Difference ◽  
Control Group ◽  
P Value ◽  
Hyoid Suspension ◽  
The Mean ◽  
Experimental Group

Neck contouring is one of the most frequent reasons patients seek cervicofacial rhytidectomy. But what makes for aesthetically pleasing youthful neck? Ellenbogen and Karlin described 5 criteria in their 1980 landmark publication, including having a cervicomental angle between 105° and 120° and a visible subhyoid depression. Recent advances in neck anatomy have revealed the existence of ligamentous like structures attaching the skin and platysma to the hyoid. These have been termed the hyoplatysmal ligament (HPL) and cervicomental suspensory angle ligament by different authors. This study was undertaken to determine whether surgically reestablishing the above structures utilizing a hyoid suspension technique resulted in statistically significant changes in cervicomental contour. A retrospective chart review was performed from January 2014 to present. After December 2016, the second author began utilizing a hyoid suspension technique where the inter- and subplatysmal fat was resected and the HPL was reestablished surgically (hyoid suspension). Cases before this date served as controls if a similar neck manipulation was performed without reestablishing the HPL. In total, 104 charts were queried, of which, 21 charts fit inclusion criteria to serve as controls and 20 as the experimental group. Before and after profile pictures were then compared for differences in cervicomental angle utilizing commercially available imaging software (Canfield Mirror, Parsippany, New Jersey). An unpaired Student t test was then performed to determine whether this 2 groups differed significantly utilizing a P value of .05 to denote statistical significance. The mean difference between pre- and postoperative cervicomental angle for the control group was 17.38° with a standard deviation of 8.05°. The mean difference between pre and postoperative cervicomental angle for the experimental group was 28.75° with a standard deviation of 15.52°. The resulting 11.37° difference in cervicomental angle between the 2 groups was found to be statistically significant with a P value of .0051. Our cosmetic surgical and anatomical knowledge continues to progress. Brant first described a ligamentous structure that attaches the platysma to the hyoid. Through biomechanical testing, he noted this ligament to be one of the weakest in the face and neck. Thereafter, in 2016 Yousif et al and Le Lourn separately described similar procedures to attach the platysma to the hyoid, in effect reestablishing this ligament. Utilizing one simple surgical maneuver, the hyoid suspension reestablishes the HPL. This surgically creates an acute cervicomental angle, resulting in less platysmal displacement postoperatively, with virtually no addition to surgical time or morbidity.

scholarly journals The Effect of Celery Therapy and Abdominal Stretching Exercise on Pain Intensity in Adolescent with Dysmenorrhea at the Soppeng High School

2020 ◽  
Vol 8 (T2) ◽  
pp. 55-58
Author(s):  
Sri Rezkiani Kas ◽  
Nur Nasry Noor ◽  
Muh Tahir Abdullla ◽  
Anwar Mallongi ◽  
Erniwati Ibrahim
Keyword(s):  
High School ◽  
Reproductive Health ◽  
Pain Intensity ◽  
Rating Scale ◽  
Wilcoxon Test ◽  
Therapeutic Interventions ◽  
P Value ◽  
Average Pain Intensity ◽  
Before And After ◽  
Average Pain

BACKGROUND: Reproductive health is an important issue and needs to get more attention, especially among adolescents because adolescents are the nation’s next generation so adolescents should have excellent reproductive health because adolescents will later marry and become parents, so the quality of life of adolescents must improve to better direction. AIM: This study aimed to determine the effect of celery therapy and abdominal stretching exercise on pain intensity in adolescents with dysmenorrhea in Soppeng District High School. METHODS: This research uses quasi-experimental. A sample of 30 was selected by consecutive sampling that met the inclusion criteria. Samples taken are non-randomized pre-posttest one-group design with accidental sampling method. Data collection using numeric rating scale measurement tools. Data were not normally distributed by analyzing the Wilcoxon test. RESULTS: The results showed that the characteristics of respondents for age were 14–15 years as many as 16 (53.3%). Based on grade level, the average respondent in class one also had details of 16 (53.3%). The average pain intensity before and after intervention, where the mean value + SD is 0.67 + 0.479–0.27 + 0.450 with p value (P = 0.001 <0.05) which means that there is a difference in the average pain intensity significant before and after therapeutic interventions were given. Celery therapy and abdominal stretching exercise need to be recommended to be used as therapy to treat primary dysmenorrhea in young women at SMAN 1 Watan Soppeng. CONCLUSION: Based on the results of research and hypotheses, it can be concluded that there are significant differences after therapy which means that the administration of celery therapy and abdominal stretching exercise 3 times before menstruation is more effective in reducing pain.

SLOW-STROKE BACK MASSASE TO PAIN INTENSITY OF RHEUMATID ARTHRITIS IN ELDERY

2018 ◽  
Vol 1 (2) ◽  
pp. 186
Author(s):  
Melina Kartika Sari
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Intensity ◽  
Statistical Tests ◽  
Test Group ◽  
Intensity Change ◽  
Control Group ◽  
P Value ◽  
Rheumatic Arthritis ◽  
Post Test ◽  
Experimental Group

Introduction.Rheumatoid arthritis represented an autoimmune disease that attacks the joints causing chronic inflammation. Rheumatoid arthritis experienced by many elderly. One of non-pharmacological ways to overcome this pain was by stimulation of the skin with a technique of slow-stroke back massase. The purpose of this study was to analyse the effect of slow-stroke back massase to pain intensity of Rheumatic arthritis on eldery. Method. The research design in this study was Quasy Experiment with the approach of pre-test and post-test group with control. The sample consisted of 20 respondents selected by purposive sampling technique. And divided into two groups: experimental group (n = 10) and control group (n = 10). Data obtained by interview and observation method of pain intensity for 7 days. Then the processed data statistical test of Wilcoxon Signed Ranks test and Mann Withney test with a standard error of 0.05. Result. The results showed in the control group no change in pain intensity. While the majority of the experimental group (60%), pain intensity change from medium become mild. These results can be seen from statistical tests with the Wilcoxon Signed Ranks test resulted P value = 0.014 and Mann Withney post test resulted P value = 0.007, H0 rejected. Discussion. Based on the research results it can be concluded that there was influence of slow-stroke back massase toward the pain intensity of rheumatoid arthritis in elderly. Thus it can be an alternative to reduce the pain of rheumatoid arthritis in the elderly. Keywords: slow-stroke back massase, intensity of pain, rheumatoid arthritis, elderly

scholarly journals COMPARATIVE ANALYSIS BETWEEN MOBILIZATION WITH MOVEMENT (MWM) AND MANIPULATION IN THE MANAGEMENT OF LATERAL EPICONDYLITIS

2016 ◽  
Vol 5 (1) ◽  
pp. 45-51
Author(s):  
Fareeda Shaheen ◽  
Nazish Rafique ◽  
Aqsa Izhar Ahmed ◽  
Perkash Lal
Keyword(s):  
Grip Strength ◽  
Pain Score ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
P Value ◽  
Functional Activities ◽  
Before And After ◽  
Group A ◽  
The Mean ◽  
Group B

OBJECTIVES To compare the effect of Mobilization with Movement (MWM) and Manipulation in the management of lateral epicondylitis with regard to ache, grip power and functional activities. METHODOLOGY 20 patients presented with lateral epicondylitis (Tennis elbow) to OPD in Ziauddin Hospital (Clifton, North and Kemari campuses). They were enrolled for the purpose of research study after written informed consent. Subjects were erratically assigned into 2 groups, i.e. group A for MWM and group B for manipulation. All patients were examined before and after the treatment and then findings were evaluated. Pain was sedated by Visual analogue scale (VAS), grip strength was measured by hand–held dynamometer and functional activities’ outcomes were measured by forearm analysis questionnaire survey for lateral epicondylitis, by H B Leung et al 2004. RESULT A total of 20 patients were randomly selected and divided into two groups i.e. Group–A & Group–B. The result shows for Group A: The mean of pain score on VAS before treatment was 4.70±1.418 while after treatment was 0.10±0.316 with P value (0.05) and the mean of grip strength score before treatment was 13.40±7.442 while after treatment was 22.60±8.501. For Group B: The mean of pain score on VAS before treatment was 5.20±0.632 while after treatment was 0.5±0.527 with P value (0.05) and the mean of grip strength before treatment was 26.20±21.028 and after treatment was 32.00±24.33. CONCLUSION This study shows evidence to support the effectiveness of both approaches (MWM + Manipulation) for relieving ache, strengthening and functionality along with tennis elbow. KEYWORDS Lateral epicondylitis, Manipulation, Mobilization with movement (MWM), dynamometer, visual analog scale, and analysis.

scholarly journals COMPARATIVE STUDY REGARDING THE BENEFITS OF USING MEDICAL FLOSSING IN LATERAL EPICONDYLITIS

2021 ◽  
Author(s):  
Diana VRABIE ◽  
Beatrice-Aurelia ABALAȘEI ◽  
George-Sebastian IACOB
Keyword(s):  
Pain Intensity ◽  
Tennis Elbow ◽  
Intervention Group ◽  
Lateral Epicondylitis ◽  
Rehabilitation Program ◽  
Initial Assessment ◽  
Functional Score ◽  
Control Group ◽  
Jump Performance ◽  
Lateral Epicondyle

Although there are multiple published reviews about the effects of the most common techniques, such as stretching or the use of foam roller on the range of motion (Behm et al., 2016; Wilke et al., 2020) or performance parameters (Behm & Wilke, 2019; Konrad et al., 2021), there is no analysis on the effects of medical flossing. To date, two reviews have been publishedabout effectiveness of using ankle flossing to improve dorsiflexion amplitude or jump performance (Pisz et al., 2020; Kielur & Powden, 2020). This study aimed to investigate the effectiveness of medical flossing added to routine treatment in patients with epicondylitis, compared to conventional physiotherapy treatment. The study included 6 subjects who showed localized pain in the area of the lateral epicondyle exacerbated with the Cozen test. The other criteria for selecting patients were the duration of the symptoms, less than 3 months from the onset of the disease and pain intensity more than 5 on the Visual Analog scale.To monitor the evolution of the subjects involved, we used a visual analog pain scale to assess the intensity of pain at different times during the application of therapy, before and after the end of the treatment. Another tool used to measure the degree of pain and dysfunction was the PRTEE Questionnaire (Patient-Rated Tennis Elbow Evaluation). The rehabilitation program took place between August and September 2021, for 30 days, with afrequency of 3 times per week. 6 patients with lateral epicondylitis were included and medical flossing was used only in the case of 3 patients at each therapy session. The differences between groups at the time of the initial assessment, in terms of pain intensity were statistically insignificant (p=0.288, p>0.05). The results obtained in terms of decreasing pain were in favor of the use of medical flossing as an adjuvant method in specific pain existing in lateral epicondylitis. Although in both groups there was a decrease in pain after 4 weeks of treatment, the intervention group recorded significant reduced values compared to the control group (p=0.024; p<0.05). Regarding PRTEE Functional Score, at the final assesment there was a decrease in both groups, which means the functional condition of the patients has improved.

Effectiveness of a Custom-Made below Elbow Lateral Counterforce Splint in the Treatment of Lateral Epicondylitis (Tennis Elbow)

1993 ◽  
Vol 60 (3) ◽  
pp. 137-144 ◽  
Author(s):  
Linda G. Clements ◽  
Susanna Chow
Keyword(s):  
Grip Strength ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Control Group ◽  
Custom Made ◽  
Maximum Grip Strength ◽  
Experimental Group ◽  
Maximum Grip

The purpose of the study was to determine the effectiveness of a custom-made below elbow lateral counterforce splint along with standard physiotherapy compared with physiotherapy alone, for the treatment of lateral epicondylitis. It was hypothesized that the recovery from lateral epicondylitis is greater following four weeks of standard physiotherapy and the use of the splint, than following four weeks of standard physiotherapy alone. The experimental group (with the splint and physiotherapy) demonstrated a significant improvement in pain (p = 0.05) and maximum grip strength (p = 0.025) of the affected arm compared to the control group. The experimental group showed a greater improvement in function approaching but not reaching significance. The results indicate that this custom-made splint is of value in facilitating the recovery from lateral epicondylitis.

scholarly journals EFFECTIVENESS OF THERAPEUTIC ULTRASOUND WITH AND WITHOUT MULLIGAN MOBILZATION IN LATERAL EPICONDYLITIS

2016 ◽  
Vol 22 (1) ◽  
pp. 47 ◽  
Author(s):  
Muhammad Waqar Afzal ◽  
Ashfaq Ahmad ◽  
Muhammad Sharif Waqas ◽  
Umair Ahmad
Keyword(s):  
Recovery Of Function ◽  
Tennis Elbow ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Repeated Measure ◽  
P Value ◽  
Ultrasound Therapy ◽  
Elbow Pain ◽  
Pulsed Mode ◽  
Group A

ABSTRACTBackground and Introduction: Mechanical malfunction of elbow joint is the usual cause of lateral elbow pain. Even though varied procedures have suggested for maximizing elbow movements and decreasing elbow pain but mobilization of joints has validated the most efficacious technique. The outcome of manual therapy procedure i.e. Mulligan Mobilization along with Therapeutic ultrasound in lateral epicondylitis to reduce pain and recovery of function had been assimilated in this recent research.Methods: Study is true experimental in nature, randomized control trial adopted to select the subjects with lateral epicondylitis.Thirtypatients 15 in each group having LE were chosen Simple random sampling technique and arranged into two groups as guided by CONSORT (Consolidated Standards of Reporting Trials) guidelines. Group A received Ultrasound therapy with intensity of 1.2 W/cm2 with pulsed mode (3MHZ) and duration is 5 minutes .Group B received Ultrasound therapy with an intensity of 1.2 W/cm with pulsed mode (3MHZ) for 5 minutes and MWM applied on elbow in supine position shoulder positioned as internal rotation, forearm pronation and elbow extension with 10 repetition for 6 seconds with 15 seconds duration of rest.Total 12 sessions was conducted in duration of 4 weeks after including the patient in study. Four questionnaires was asked to fill i.e one after every 3 sessions Pain and functional activities were evaluated by PRTEE. Repeated measure ANOVA was used to compare the significance at different time intervals.Results: The results exhibited that The P-value for PRTEE (patient-rated tennis elbow evaluation) in group A using Therapeutic Ultrasound and was after four weeks of treatment which was less than the level of significance 0.05. So Therapeutic Ultrasound with Mulligan mobilization was more effective than Therapeutic Ultrasound to reduce pain and restoration of function.Conclusion: It was concluded that combination of mobilization of Mulligan and Therapeutic ultrasound was more effective compared with Therapeutic Ultrasound in and PRTEE scores in sufferers of lateral epicondylitisKey Words:Lateral Epicondylitis, Therapeutic Ultrasound, Mulligan mobilization, PRTEE.

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