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.

scholarly journals Tennis Elbow, study protocol for a randomized clinical trial: Needling With and Without Platelet-rich Plasma After Failure of Up-to-date Rehabilitation

2020 ◽  
Author(s):  
ADRIEN J-P SCHWITZGUEBEL ◽  
Mitko Bogoev ◽  
Viktor Nikolov ◽  
Freddy Ichane ◽  
Alexandre Laedermann
Keyword(s):  
Success Rate ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Intervention Group ◽  
Case Series ◽  
Rehabilitation Program ◽  
Saline Control ◽  
Control Group ◽  
Lesion Pattern ◽  
Study Results

Abstract Background: The conservative management of lateral epicondylitis is known to be a difficult-to-treat annoying condition. A treatment with platelet-rich plasma (PRP) is often performed, but its efficacy remains controversial. Methods: This study is a single-center, randomized double-blind controlled trial, preceded by a case series. All the 232 planned patients of the case series will undergo an up-to-date comprehensive rehabilitation program, including focused extracorporeal shock waves therapy. This rehabilitation program is expected to have a maximum success rate 75%. It is therefore aimed to allocate a minimum of 58 patients with rehabilitation failure into the 1:1 randomized trial. Stratification is planned on age and lesion pattern. The masking will be quadruple (Participant, Care Provider, Investigator & Outcome Assessor). The patients will undergo an ultrasound (US)-guided needling combined with either PRP (intervention group) or saline (Control group). The primary endpoint will be the pain improvement from baseline (month 0) at 3 months on a 0-10 visual analog scale (VAS) during a maximal strength isometric contraction of the extensor carpialis brevis muscle. The main secondary endpoints will include the rehabilitation success rate and improvements from baseline at 3, 6 and 12 months of the following outcomes: (i) Single Assessment Numeric Evaluation (SANE) score, (ii) Patient-Rated Tennis Elbow Evaluation (PRTEE) score, (iii) maximal grip strength on Jamar test, and (iv) the ultrasonographic evaluation of the US of the epicondylar tendons.Discussion: The study results will provide insight into the effect of PRP as adjuvant therapy to tendon fenestration, and may contribute to identify the best preceding and concomitant rehabilitation protocol. Trial registration: ClinicalTrials.gov: NCT03987256, registered 20 August 2019

scholarly journals Tennis elbow, study protocol for a randomized clinical trial: needling with and without platelet-rich plasma after failure of up-to-date rehabilitation

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
A. J. Schwitzguebel ◽  
M. Bogoev ◽  
V. Nikolov ◽  
F. Ichane ◽  
A. Lädermann
Keyword(s):  
Success Rate ◽  
Tennis Elbow ◽  
Platelet Rich Plasma ◽  
Intervention Group ◽  
Case Series ◽  
Rehabilitation Program ◽  
Saline Control ◽  
Control Group ◽  
Lesion Pattern ◽  
Study Results

Abstract Background The conservative management of lateral epicondylitis is known to be a difficult-to-treat annoying condition. A treatment with platelet-rich plasma (PRP) is often performed, but its efficacy remains controversial. Methods This study is a single-center, randomized double-blind controlled trial, preceded by a case series. All the 232 planned patients of the case series will undergo an up-to-date comprehensive rehabilitation program, including focused extracorporeal shock waves therapy. This rehabilitation program is expected to have a maximum success rate 75%. It is therefore aimed to allocate a minimum of 58 patients with rehabilitation failure into the 1:1 randomized trial. Stratification is planned on age and lesion pattern. The masking will be quadruple (Participant, Care Provider, Investigator & Outcome Assessor). The patients will undergo an ultrasound (US)-guided needling combined with either PRP (intervention group) or saline (control group). The primary endpoint will be the pain improvement from baseline (month 0) at 3 months on a 0–10 visual analog scale (VAS) during a maximal strength isometric contraction of the extensor carpialis brevis muscle. The main secondary endpoints will include the rehabilitation success rate and improvements from baseline at 3, 6, and 12 months of the following outcomes: (i) Single Assessment Numeric Evaluation (SANE) score, (ii) Patient-Rated Tennis Elbow Evaluation (PRTEE) score, (iii) maximal grip strength on Jamar test, and (iv) the ultrasonographic evaluation of the US of the epicondylar tendons. Discussion The study results will provide insight into the effect of PRP as adjuvant therapy to tendon fenestration, and may contribute to identify the best preceding and concomitant rehabilitation protocol. Trial registration ClinicalTrials.gov NCT03987256. Registered on 20 August 2019.

scholarly journals Extracorporeal Shock Wave Therapy for Lateral Epicondylitis, Lonely or in Combination with Topical Corticosteroid; Which Approach is Superior?

2020 ◽  
Vol 9 ◽  
pp. 1791
Author(s):  
Babak Vahdatpour ◽  
Parisa Taheri ◽  
Fatemeh Abasi
Keyword(s):  
Shock Wave ◽  
Topical Corticosteroid ◽  
Tennis Elbow ◽  
Intervention Group ◽  
Lateral Epicondylitis ◽  
Extracorporeal Shock Wave Therapy ◽  
Control Group ◽  
Topical Steroids ◽  
Shock Wave Therapy ◽  
Extracorporeal Shock Wave

Background: Lateral epicondylitis (LE) is a common musculoskeletal disorder. Although varieties of modalities have been proposed for its treatment, the outcomes are uncertain, and the responses would diminish early by the time passage. The current study was aimed to assess the efficacy of extracorporeal shock wave therapy (ESWT) merely and in combination with topical corticosteroid for the treatment of LE. Materials and Methods: In the current double-blinded randomized clinical trial, 70 patients with the diagnosis of LE were randomly allocated to two intervention groups of ESWT merely (control group) (n=35) or ESWT plus topical corticosteroid (intervention group) (n=35). The ESWT was performed weekly for three weeks. Topical clobetasol was utilized within 30 minutes before ESWT for the intervention group, while Vaseline gel was used in a similar pattern for controls. Pain based on a visual analog scale (VAS), handgrip strength (HGS) and the Patient-Rated Tennis Elbow Evaluation (PRTEE) were assessed for the patients before the intervention, following the intervention cessation, and within two months post-intervention. Results: Statistically significant improvement was found following both interventions in terms of pain, HGS, and function (P-value0.05). Conclusion: The findings of our study are in favor of ESWT use either merely or in combination with topical steroids for the treatment of LE, while the comparison of the two techniques revealed insignificant differences. [GMJ.2020;9:e1791]

Efficacy of powerball versus mulligan mobilization with movement on pain and function in patients with lateral epicondylitis: a randomised control trial

2021 ◽  
Author(s):  
Shivani Uttamchandani ◽  
Pratik Phansopkar
Keyword(s):  
Grip Strength ◽  
Tennis Elbow ◽  
Strength Function ◽  
Intervention Group ◽  
Lateral Epicondylitis ◽  
Randomised Control Trial ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Post Intervention ◽  
And Function

Abstract Background: Lateral epicondylitis (LE), most commonly referred to as Lateral Elbow Tendinopathy (LET) or Tennis Elbow is one of the commonest repetitive stress syndromes seen in elbow joint. Tendinopathy, an injury to forearm extensor muscles. These muscles arise from the distal end of humerus from lateral epicondylar region. In many cases, involvement of extensor carpi radialis brevis muscle’s insertion is seen. This study focuses on the treatment of a person with LE which occurs in repeated upper extremity movements. There is no such research relevant to PowerBall device exercises on Lateral epicondylitis patients' pain and function. “PowerBall device” exercise is considered to be an effective resistance training, putting extrinsic and intrinsic pressure on wrist, elbow and shoulder muscles and has been shown to improve strength, function, ROM, tennis elbow pain and quality of life. Whereas MMWM has been proven to reduce the pain in patients with LE. Methods/Design: The participants (n=50) with lateral epicondylitis will be included in a single-blinded, randomised control trial. Participants will be categorised into either a control group or an intervention group after performing baseline assessments and randomization. The participants in the control group will be given Mulligan Mobilisation with Movement, and those in the intervention group will be given “PowerBall device” exercise and conventional physiotherapy. Basic exercises and ultrasound will be given to both groups with the given protocol. We will evaluate pain, function, grip strength and Range of motion, pre and post intervention period. Discussion: Efficacy of the intervention is evaluated by analysing the pain and function in patients with lateral epicondylitis using PRTEE scale, and grip strength using Hand-held Dynamometer. The results from the study will significantly provide affirmation on the application of “PowerBall device” exercise and Mulligan Mobilisation with Movement on the patients with lateral epicondylitis.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033363.

scholarly journals Impact of exercise based cardiac rehabilitation program in patients with transcatheter aortic valve replacement

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
LE Estrada Martinez ◽  
JA Lara Vargas ◽  
JA Pineda Juarez ◽  
JD Morales Portano ◽  
JB Gomez Alvarez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Rehabilitation ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cardiac Rehabilitation Program ◽  
Double Product ◽  
Oxygen Pulse ◽  
Transcatheter Aortic Valve ◽  
Cardiopulmonary Performance

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Due to the increase in global prevalence of degenerative valve disease, aortic stenosis (AS) has played a preponderant role in the cardiovascular scenario, especially in patients undergoing transcatheter aortic valve replacement (TAVR). An alternative management for this patients are the cardiac rehabilitation programs (CRP); however, their effect has not been completely understood, both in exercise capacity and quality of life, but neither in the improvement of cardiopulmonary performance and other cardiovascular outcomes.  Purpose: To evaluate the effect of the CRP on exercise tolerance and cardiopulmonary performance in patients with AS undergoing TAVR.  Methods: A cohort study was conducted including 26 patients with AS undergoing TAVR and divided into an intervention group who performed a 4-week supervised training program in the Cardiac Rehabilitation Service and a control group to whom instructions and recommendations to performed unsupervised exercise at home were given. Demographic and clinical data (VO2Max, METS12, oxygen pulse, heart rate, double product, left ventricular ejection fraction, body mass index) were collected at baseline and after a 4-week follow-up. Results: 15 patients were included in the intervention group and 11 patients in the control group. There were no baseline significant differences between groups. After the intervention, significant differences were observed in the METS 12 final gain variable between the control and intervention group (4.55 vs 3.1 p = 0.01). Intergroup analysis showed significant differences (percentage changes) in the intervention group with an increase of METS12 (67.4%, p = 0.001), oxygen pulse (18.21%, p = 0.01), final METS (39.47% p = 0.001) and a decrease in VO2 recovery time (-12.5%, p = 0.05), in the ergometric performance index by heart rate (-38.17%, p = 0.001) and by double product (-38.1%, p = 0.001). Conclusions  A 4-week cardiac rehabilitation program is effective to improve exercise tolerance and cardiopulmonary response in patients with AS undergoing TAVR; improvement was statistically significant in METS12, oxygen pulse, VO2 recovery time, METS-load and ergometric performance index for heart rate and double product. METS12 final gain was statistically significant in intervention group in comparison with the control group. Abstract Figure. Control vs Intervention Group (METS12)

scholarly journals Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty

2021 ◽  
Author(s):  
Ahmed Negm ◽  
Milad Yavarai ◽  
Gian Jhangri ◽  
Robert Haennel ◽  
Allyson Jones
Keyword(s):  
Physical Activity ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Intervention Group ◽  
Young Patients ◽  
Rehabilitation Program ◽  
Control Group ◽  
Total Hip ◽  
The Impact

Abstract BackgroundThe increase rate seen in Total Hip Arthroplasty (THA) for younger patients has implications for future rehabilitation demands for primary and revision THA surgery. This study aims to determine the impact of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA) and function compared to age- and a sex-matched control group received usual postoperative care at 12-week post-THA. MethodsIn this quasi-experimental study, a cohort of THA candidates was recruited during their 6-week postoperative visit to their surgeons. The out-patient rehabilitation program consisted of 12 structured exercise classes (2 hrs/class) over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention. ResultsThe intervention group took significantly more steps/day at the follow-up compared to baseline. The intervention group had a higher mean change in the number of weekly PA bouts than the control group. Within the intervention groups, all HOOS subscales were significantly higher at the follow-up compared to baseline. ConclusionThe augmented rehabilitation program may have immediate effects on pain relief and symptom reduction for patients (≤60 years) following THA.

Effect of an early mobilisation programme on pain intensity after laparoscopic surgery: a randomised clinical trial

2020 ◽  
pp. bmjspcare-2020-002618
Author(s):  
Azam Dehghani ◽  
Ali Hajibagheri ◽  
Ismail Azizi-Fini ◽  
Fatemeh Atoof ◽  
Noushin Mousavi
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Surgery ◽  
Pain Intensity ◽  
Repeated Measures ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Early Mobilisation ◽  
Repeated Measures Analysis ◽  
The Mean

BackgroundPain is a common complication after laparoscopic surgery. This study aimed to examine the effect of an early mobilisation programme on postoperative pain intensity after laparoscopic surgery.MethodsA randomised controlled clinical trial was conducted on 80 patients who underwent laparoscopic surgery in Shahid Beheshti Hospital in Kashan, Iran. The patients were randomly allocated to intervention (n=40) and a control (n=40) group. In the intervention group, an early mobilisation programme was implemented in two rounds. The patient’s perceived pain was assessed using a Visual Analogue Scale 15 min before and 30 min after each round of early mobilisation. Data were analysed through the independent samples t, χ2 and Fisher’s exact tests and the repeated measures analysis.ResultsThe repeated measures analysis showed that the mean pain scores have been decreased over time (F=98.88, p<0.001). Considering the observed interaction between time and the intervention, the t test was used for pairwise comparisons and showed that the mean pain score was not significantly different between the two groups in 15 min before the first round of early mobilisation (p=0.95). However, the mean pain in the intervention group was significantly less than the control group in all subsequent measurements (p<0.05).ConclusionEarly mobilisation programmes such as the one implemented in the current study are easy and inexpensive and can be implemented safely for the reduction of pain after laparoscopic surgeries.

scholarly journals The Effectiveness of Mindfulness-Based Stress Reduction on Perceived Pain Intensity and Quality of Life in Patients With Chronic Headache

2015 ◽  
Vol 8 (4) ◽  
pp. 142 ◽  
Author(s):  
Nour Mohammad Bakhshani ◽  
Ahmadreza Amirani ◽  
Hamed Amirifard ◽  
Mahnaz Shahrakipoor
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Stress Reduction ◽  
Chronic Headache ◽  
Intervention Group ◽  
Pharmacological Intervention ◽  
Control Group ◽  
Perceived Pain ◽  
Mindfulness Based Stress Reduction

<p>The aim of this study was to determine the effectiveness of Mindfulness-Based Stress reduction (MBSR) on perceived pain intensity and quality of life in patients with chronic headache. Thus, forty patients based on the diagnosis of a neurologist and diagnostic criteria of the International Headache Society (IHS) for migraine and chronic tension-type headache were selected and randomly assigned to the intervention group and control group, respectively. The participants completed the Pain and quality of life (SF-36) questionnaire. The intervention group enrolled in an eight-week MBSR program that incorporated meditation and daily home practice, per week, session of 90-minutes. Results of covariance analysis with the elimination of the pre-test showed significantly improvement of pain and quality of life in the intervention group compared with the control group. The findings from this study revealed that MBSR can be used non-pharmacological intervention for improvement the quality of life and development of strategies to cope with pain in patients with chronic headache. And can be used in combination with other therapies such as pharmacotherapy.</p>

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.

scholarly journals Acceptance and Commitment Therapy Delivered via a Mobile Phone Messaging Robot to Decrease Postoperative Opioid Use in Patients With Orthopedic Trauma: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Chris A Anthony ◽  
Edward Octavio Rojas ◽  
Valerie Keffala ◽  
Natalie Ann Glass ◽  
Apurva S Shah ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Pain Intensity ◽  
Acceptance And Commitment Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Orthopedic Trauma ◽  
Opioid Use ◽  
Acceptance And Commitment ◽  
Patient Reported ◽  
The Mean

BACKGROUND Acceptance and commitment therapy (ACT) is a pragmatic approach to help individuals decrease avoidable pain. OBJECTIVE This study aims to evaluate the effects of ACT delivered via an automated mobile messaging robot on postoperative opioid use and patient-reported outcomes (PROs) in patients with orthopedic trauma who underwent operative intervention for their injuries. METHODS Adult patients presenting to a level 1 trauma center who underwent operative fixation of a traumatic upper or lower extremity fracture and who used mobile phone text messaging were eligible for the study. Patients were randomized in a 1:1 ratio to either the intervention group, who received twice-daily mobile phone messages communicating an ACT-based intervention for the first 2 weeks after surgery, or the control group, who received no messages. Baseline PROs were completed. Two weeks after the operative intervention, follow-up was performed in the form of an opioid medication pill count and postoperative administration of PROs. The mean number of opioid tablets used by patients was calculated and compared between groups. The mean PRO scores were also compared between the groups. RESULTS A total of 82 subjects were enrolled in the study. Of the 82 participants, 76 (38 ACT and 38 controls) completed the study. No differences between groups in demographic factors were identified. The intervention group used an average of 26.1 (SD 21.4) opioid tablets, whereas the control group used 41.1 (SD 22.0) tablets, resulting in 36.5% ([41.1-26.1]/41.1) less tablets used by subjects receiving the mobile phone–based ACT intervention (<i>P</i>=.004). The intervention group subjects reported a lower postoperative Patient-Reported Outcome Measure Information System Pain Intensity score (mean 45.9, SD 7.2) than control group subjects (mean 49.7, SD 8.8; <i>P</i>=.04). CONCLUSIONS In this study, the delivery of an ACT-based intervention via an automated mobile messaging robot in the acute postoperative period decreased opioid use in selected patients with orthopedic trauma. Participants receiving the ACT-based intervention also reported lower pain intensity after 2 weeks, although this may not represent a clinically important difference. CLINICALTRIAL ClinicalTrials.gov NCT03991546; https://clinicaltrials.gov/ct2/show/NCT03991546

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