scholarly journals A Comparative study to evaluate the efficacy of Supervised Exercise Program and Cyriax Physiotherapy on pain and function in Lateral Epicondylitis

2021 ◽  
Author(s):  
Gouri Kalaskar ◽  
R. K. Sinha ◽  
Pratik Phansopkar
Keyword(s):  
Tennis Elbow ◽  
Exercise Program ◽  
Lateral Epicondylitis ◽  
Exercise Programme ◽  
Functional Improvement ◽  
Lateral Epicondyle ◽  
Supervised Exercise ◽  
Time Period ◽  
Elbow Function ◽  
And Function

Abstract Background: A typical musculotendinous degenerative condition of the extensors cause at the humerus lateral epicondyle is known as Lateral epicondylitis. Various treatment methods are used in treating lateral epicondylitis. Methods: Thirty Participants with Lateral Epicondylitis shall be recruited in a comparative experimental study. Subjects will be randomized to either (1) Supervised Exercise Programme group, or (2) Cyriax Physiotherapy group. Over a 4-week time period, a 3 times in week for the total of 12 sessions, immediately following baseline assessment and randomization, subjects in both groups will receive Extensor Carpi Radialis Brevis muscle’s static stretching along with the wrist extensor’s eccentric strengthening and Ultrasound and transverse deep friction massage for 10 min with Mill’s manipulation and Ultrasound respectively. Discussion: Effectiveness of the interventions on the pain and the functional improvement will be assessed by visual analogue scale and the Tennis Elbow Function Scale respectively.

scholarly journals A Comparative Study to Evaluate the Efficacy of Supervised Exercise Program and Cyriax Physiotherapy on Pain and Function in Lateral Epicondylitis

2021 ◽  
pp. 87-97
Author(s):  
Gouri Kalaskar ◽  
Pratik Phansopkar
Keyword(s):  
Comparative Study ◽  
Tennis Elbow ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Exercise Programme ◽  
Research Subjects ◽  
Supervised Exercise ◽  
Group I ◽  
Post Test ◽  
And Function

Aims: To see the effectiveness of supervised exercises and cyriax physiotherapy both including therapeutic ultrasound for improving pain and function in adults with lateral epicondylitis. Study Design: Comparative study- to find out the efficacy of effectiveness of two different interventions for reducing pain and improving function in patients with lateral epicondylitis Place and Duration of Study: Department of Musculoskeletal  Physiotherapy Sciences, Ravi Nair Physiotherapy College, Sawangi (Meghe), Wardha, for 12 months. Methodology: A total of 30 people with lateral epicondylitis (tennis elbow) were selected to take part in a comparative research. Subjects were randomized 1:1 to either (1) supervised exercise programme group, or (2) cyriax physiotherapy group. Over just a 4-week period, three times each week for a sum of 12 sessions, promptly after baseline evaluation and randomization, subjects received static stretching of Extensor Carpi Radialis Brevis followed by eccentric strengthening of the wrist extensors and Therapeutic Ultrasound in supervised exercise programme group. While those in cyriax physiotherapy group received deep transverse friction massage for 10 min immediately followed by Mill’s manipulation and Ultrasound. The study concluded at the 4 weeks. Results: Out of 30 patients half were placed in each group, where p=.0001. Significant increase in mean in the group I and II in pre ad post-test VAS score (4.20±0.77 and 5.20±0.67) and TEFS score pre and post-test (17.33±1.44 and 19.80±1.42). analysis showed significant improvement in both the groups. Conclusion: From the observations and results, the conclusion drawn that there is significant improvement in both the groups but effect of cyriax physiotherapy in the form of deep friction massage and mills manipulation combined with therapeutic ultrasound for improving pain on VAS and function on TEF scale.

scholarly journals Autologous Blood Injection and Wrist Immobilisation for Chronic Lateral Epicondylitis

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Nicola Massy-Westropp ◽  
Stuart Simmonds ◽  
Suzanne Caragianis ◽  
Andrew Potter
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Contralateral Limb ◽  
Cortisone Injection ◽  
Autologous Blood Injection ◽  
Blood Injection ◽  
And Function ◽  
Prospective Longitudinal ◽  
Extensor Carpi Radialis

Purpose. This study explored the effect of autologous blood injection (with ultrasound guidance) to the elbows of patients who had radiologically assessed degeneration of the origin of extensor carpi radialis brevis and failed cortisone injection/s to the lateral epicondylitis.Methods. This prospective longitudinal series involved preinjection assessment of pain, grip strength, and function, using the patient-rated tennis elbow evaluation. Patients were injected with blood from the contralateral limb and then wore a customised wrist support for five days, after which they commenced a stretching, strengthening, and massage programme with an occupational therapist. These patients were assessed after six months and then finally between 18 months and five years after injection, using the patient-rated tennis elbow evaluation.Results. Thirty-eight of 40 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not.Conclusions. Autologous blood injection improved pain and function in a worker’s compensation cohort of patients with chronic lateral epicondylitis, who had not had relief with cortisone injection.

scholarly journals Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Seyed Ahmad Raeissadat ◽  
Leyla Sedighipour ◽  
Seyed Mansoor Rayegani ◽  
Mohammad Hasan Bahrami ◽  
Masume Bayat ◽  
...  
Keyword(s):  
Whole Blood ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Pressure Pain Threshold ◽  
Lateral Epicondylitis ◽  
Autologous Whole Blood ◽  
Significant Difference ◽  
Group 2 ◽  
And Function

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

Chronic exercise and left ventricular structure and function in healthy human subjects

1985 ◽  
Vol 58 (2) ◽  
pp. 409-415 ◽  
Author(s):  
L. A. Wolfe ◽  
R. P. Martin ◽  
D. D. Watson ◽  
R. D. Lasley ◽  
D. E. Bruns
Keyword(s):  
Human Subjects ◽  
Exercise Program ◽  
Left Ventricular ◽  
Control Group ◽  
Healthy Human ◽  
Mean Values ◽  
End Diastolic Volume ◽  
Supervised Exercise ◽  
Fitness Training ◽  
And Function

Twelve healthy well-trained participants in a supervised exercise program (mean age, 41.3 yr) were compared with 12 sedentary control subjects (mean age, 38.9 yr) with physical characteristics similar to the exercised group (EG) before training. Resting echocardiograms revealed significantly lower heart rates (HR) in the EG compared with control group (CG) but no evidence for cardiac structural differences between groups. Radionuclide angiograms performed at rest and during two levels of supine cycling (HR targets: 120 and 140 beats X min-1) resulted in increases in background-corrected end-diastolic counts [EDC(bc)] and confirmed use of the Frank-Starling mechanism in the majority of subjects. Mean values (+/- SD) for ejection fraction (EF) and normalized peak systolic ejection rate (PSER) (P greater than 0.05 between groups) were the following. (Formula: see text) The results suggested that fitness training does not induce significant cardiac enlargement as apparent from measurements at rest or important changes in contractile state during exercise. Increases in exercise stroke volume with such training may be the result of an increased end-diastolic volume.

The Role of the Extensor Digitorum Communis Muscle in Lateral Epicondylitis

2002 ◽  
Vol 27 (5) ◽  
pp. 405-409 ◽  
Author(s):  
S. M. FAIRBANK ◽  
R. J. CORLETT
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Middle Finger ◽  
Clinical Findings ◽  
Extensor Digitorum ◽  
Common Finding ◽  
Extensor Digitorum Communis ◽  
Lateral Epicondyle ◽  
High Prevalence ◽  
Pain Ratings

A common finding in tennis elbow is pain in the region of the lateral epicondyle during resisted extension of the middle finger (Maudsley’s test). We hypothesized that the pain is due to disease in the extensor digitorum communis muscle, rather than to compression of the radial nerve or disease within extensor carpi radialis brevis. Thirteen human forearm specimens were examined. It was found that the extensor digitorum communis was separable into four parts. The part to the middle finger originated from the lateral epicondyle, but the muscle slips to the other fingers originated more distally. Pain ratings were measured in ten patients diagnosed with lateral epicondylitis during isometric finger and wrist extension tests. The results confirmed the high prevalence of a positive Maudsley’s test in lateral epicondylitis, and also that the patients with tenderness at the site of origin of the extensor digitorum communis slip to the middle finger had the greatest pain during middle finger extension. These anatomical and clinical findings clarify the anatomy of extensor digitorum communis, and suggest that this muscle forms the basis for the Maudsley’s test. The muscle may play a greater role in tennis elbow than previously appreciated.

Perineural injection as an alternative treatment of resistant lateral elbow pain

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hanaa Ahmed Hany Abd Eldayem Ahmed El-Naggar ◽  
Mona Mansour Mohammed Hasab El-Naby ◽  
Naglaa Youssef Mohammed Assaf ◽  
Mohja Ahmed Abd El-Fattah Elbadawy
Keyword(s):  
Clinical Improvement ◽  
Tennis Elbow ◽  
Functional Limitations ◽  
Lateral Epicondylitis ◽  
Elbow Pain ◽  
Lateral Epicondyle ◽  
Lateral Elbow Pain ◽  
Perineural Injection ◽  
Lateral Elbow ◽  
Tendon Thickness

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 &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.

Lateral Epicondylitis: A Common Cause of Elbow Pain in Primary Care

2021 ◽  
pp. 34-38
Author(s):  
Jeffrey Fleming ◽  
Christian Muller Muller ◽  
Kathryn Lambert Lambert
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Tennis Elbow ◽  
Imaging Modality ◽  
Treatment Options ◽  
Lateral Epicondylitis ◽  
Repetitive Motion ◽  
Lateral Epicondyle ◽  
Magnetic Resonance Imaging Mri ◽  
Standard Radiographs

Lateral epicondylitis (LE) is an overuse injury of the lateral elbow. LE is caused by repetitive motion leading to micro-injury of the wrist extensor muscles that originate along the elbow's lateral aspect. Although LE is commonly referred to as “tennis elbow” many cases are observed in non-athletes. Due to its prevalence in the general population, primary care physicians must be prepared to diagnose and treat LE. Physicians should look for a history of repetitive activities involving patient’s jobs or recreational activities. Exam findings are characterized by pain and tenderness just distal to the lateral epicondyle of the humerus. Resisted movement with an extension of the wrist will typically elicit pain. Ultrasonography is considered the imaging modality of choice for diagnosing LE. Standard radiographs and magnetic resonance imaging (MRI) may be helpful. However, diagnosis can usually be made by history and physical examination alone. Most cases of LE respond favorably to conservative therapy. There are several nonoperative options for treatment, but a combination of non-steroidal anti-inflammatory drugs (NSAIDs) and physical therapy that utilizes eccentric muscle stretching is considered first-line. Osteopathic manipulative medicine is also useful in the treatment of LE. Muscle energy (ME) and joint mobilization techniques have been shown to be particularly effective. If non-surgical therapy fails, surgical intervention may provide patients with an additional benefit. This article will review some of the treatment options described above and discuss other diagnostic and therapeutic considerations relevant to LE's management in the primary care setting.

ANATOMIC AND CLINICAL STUDY OF A NEUROVASCULAR CAUSE OF LATERAL EPICONDYLITIS

2009 ◽  
Vol 12 (01) ◽  
pp. 11-19
Author(s):  
Xin-Ru Du ◽  
Ling-Xiu Zhao
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Extensor Tendon ◽  
Triceps Brachii ◽  
Tissue Samples ◽  
Lateral Epicondyle ◽  
The Common ◽  
Pass Through ◽  
The Right ◽  
Neurovascular Bundles

Because of few anatomic reports investigating the mechanism of lateral epicondylitis (tennis elbow), we performed cadaveric and clinical studies to investigate the involvement of neurovascular bundles passing through the common extensor origin. We dissected and observed under a light microscope tissue samples of neurovascular bundles passing through the common extensor tendon from 40 upper left and right limbs from cadavers. Tissue samples were prepared by hematoxylin & eosin and Weil's myelin staining. We also investigated the records of 20 patients who had been treated for lateral epicondylitis between 1991 and 2004. From cadavers, we found 60 bundles in the common extensor tendon, each 0.5 to 1.0 mm in diameter, with more bundles in the right than left limbs. Twenty-four of these bundles passed over the vertex of the lateral epicondyle of the humerus, and most of the bundles contained only one artery each. The bundles mostly originated from the radial recurrent artery, passing through the aponeurosis of the extensor corpi radialis brevis, but in some cases originated from the radial collateral artery, passing through the aponeurosis of the triceps brachii muscle. The bundles had a membranous covering when passing through the aponeurosis and produced a hiatus. Histological analysis of resected common extensor tendon tissue, 1 cm in diameter, of patients showed hyaline degeneration and fibrosis formation infiltration. Neurovascular bundles passed through the common extensor tendon in nine cases; six cases showed pulsing bleeding. After a mean follow-up of two years (6–48 months), 16 cases showed excellent results, two showed good results and two showed reliefs. Lateral epicondylitis could be caused by damage to neurovascular bundles when they pass through the common extensor origin; one cause of pain is the neurovascular bundle being compressed when passing through the common extensor tendon, secondary to the pathologic degeneration of the origin of the common extensor tendon.

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