Comparative study of the Effectiveness of the use of the universal tennis elbow splint compared to elbow brace in treatment of Lateral Epicondylitis

2020 ◽  
Vol 7 (4) ◽  
pp. 118-124
Author(s):  
Dr. Uday B. Pote ◽  
Aishwarya Solge ◽  
Vaishnavi Karpe ◽  
Mihir A Ghare ◽  
Antara A Thatte
Keyword(s):  
Functional Outcome ◽  
Grip Strength ◽  
Tennis Elbow ◽  
Statistical Significance ◽  
Lateral Epicondylitis ◽  
P Value ◽  
Vas Score ◽  
Group A ◽  
Group B ◽  
Wrist Splint

Background: Lateral epicondylitis is a serious condition affecting 1 to 3% of adult population between the age group of 30 to 50 year old. This group represents the working force and tennis elbow causes debilitating pain and patients are unable to perform the affected limb functions of lifting or holding anything. The main cause for tennis elbow is the tendinopathy of the extensor carpi radialis brevis muscle (ECRB). There are multiple treatment measures to relieve the pain and bring back the function of the limb to normalcy as early as possible. The elbow brace is used to reduce the expansion of the ECRB and thereby reducing the symptoms of tennis elbow. It was hypothesized that wrist splints would reduce the activation of the ECRB muscle and thereby will reduce the symptoms of the tennis elbow. Streek et al performed a study using the wrist splint with 20-30 degrees extension and mentioned in limitations the changing the degree of extension may improve outcomes as compared to elbow braces. On that hypothesis we used a brace with only 5-10 degrees of extension. Aims: 1) To study the symptomatic and functional outcome of the elbow brace. 2) To study the symptomatic and functional outcome of the wrist splint. 3) To compare the symptomatic and functional outcomes between the wrist splint and the elbow brace. Material & Methods: The patients included in the study were divided into Group A receiving the wrist splint and group B elbow brace. The patient rated tennis elbow evaluation score (PRTEE), grip strength and pain visual assisted (VAS) score on the day of enrolment and 6 weeks after using either the elbow brace or wrist splint was noted. We used Mann-Whitney U test to calculate P-value intergroup and for P-value intra-group we used Wilcoxon’s signed rank test. Result: Group A distribution of median 6 weeks PRTEE score improved significantly compared to median baseline PRTEE score (P-value<0.001). The VAS score, grip strength and improvement in PRTEE score at 6 weeks is relatively better in Group A compared to Group B, however the difference did not reach statistical significance (P-value>0.05).Conclusion: The use of wrist splint significantly improved the symptoms of the tennis elbow. The outcome is comparable to use of tennis elbow brace. The outcome is not statistically significant if compared between the two groups.

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 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 A study to assess functional outcome of cemented and uncemented total hip replacement in a tertiary care center

2019 ◽  
Vol 5 (5) ◽  
pp. 828
Author(s):  
Kunal Ajitkumar Shah ◽  
Mohan Madhav Desai
Keyword(s):  
Functional Outcome ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Cost Effective ◽  
Harris Hip Score ◽  
Total Hip ◽  
Vas Score ◽  
Group A ◽  
The Difference ◽  
Group B

<p class="abstract"><strong>Background:</strong> Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.</p><p class="abstract"><strong>Methods:</strong> This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.</p>

FOREARM BAND VERSUS ELBOW TAPING: AS A MANAGEMENT OF LATERAL EPICONDYLITIS

2013 ◽  
Vol 16 (01) ◽  
pp. 1350003 ◽  
Author(s):  
Shaji John Kachanathu ◽  
Smriti Miglani ◽  
Deepak Grover ◽  
Abdul R Zakaria
Keyword(s):  
Grip Strength ◽  
Total Duration ◽  
Lateral Epicondylitis ◽  
Functional Independence ◽  
Functional Improvement ◽  
Control Group ◽  
Group A ◽  
Conventional Physiotherapy ◽  
Group B ◽  
Taping Technique

Purpose: There are several treatments available for the management of lateral epicondylitis, but there is a dearth of clinical trials compared to the efficacy of a forearm band over supportive elbow taping technique as an adjunct measure in the management of lateral epicondylitis. Materials and Methods: Totally 45 subjects with the mean age of 30±5 years diagnosed with lateral epicondylitis participated in the study based upon inclusion and exclusion criteria. Subjects were randomly allocated to three groups (n = 15 in each); Group-A (forearm band), Group-B (elbow taping) and Group-C (control), provided with a forearm band, supportive elbow taping technique and as a control group, respectively, although all groups received the conventional physiotherapy in addition to these adjunct measures. The outcome measurements included pain-free grip strength and functional improvement, assessed by using hand-held dynamometer and patient-rated forearm evaluation questionnaire (PRFEQ), respectively. Total duration of study was four weeks. Results: Although all the groups showed improvement with respect to increase in the pain-free grip strength and enhancement of functional independence, however, Group-A has shown the maximum improvement followed by Group-B which in turn proved to be more effective than conventional physiotherapy alone. Conclusion: The application of the forearm band produced a significant increase in the grip strength and function as compared to the elbow taping and control groups. The study implies the potential use of a forearm band in the future in addition to the conventional therapy in the management of patients with lateral epicondylitis.

Comparing the effectiveness of mulligan mobilization versus cyriax approach in the management of patients with subacute lateral epicondylitis

2020 ◽  
pp. 1-11
Author(s):  
Aqeel Ahmed ◽  
Muhammad Ibrar ◽  
Aatik Arsh ◽  
Sonia Wali ◽  
Shoukat Hayat ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Functional Disability ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Evaluation Index ◽  
Pain Subscale ◽  
Significant Difference ◽  
Group A ◽  
Physical Tests ◽  
Group B

Abstract Objective: To determine the effectiveness of Mulligan mobilisation versus Cyriax approach in the management of patients with subacute lateral epicondylitis. Methods: The clinical trial was conducted at the District Headquarter Hospital, Bahawalnagar, Pakistan, from September to December 2018, and comprised lateral epicondylitis patients having symptoms for >2 weeks. The diagnosis was confirmed on the basis of physical tests and musculoskeletal ultrasound. The subjects were randomly allocated to two equal groups A and B. Group A received deep transverse friction and Mill’s manipulation according to Cyriax approach, while group B received Mulligan mobilisation with movement techniques. Patient-related tennis elbow evaluation index was used to collect data which was analysed using SPSS 20. Results: Of the 60 patients, there were 30(50%) in each of the two groups. The overall mean age was 35.27±7.30 years, and 38(63.3%) participants were male.  After 4 weeks of treatment sessions, both groups showed significant improvements (p<0.05) in pain and functional disability scores. Group A showed significantly more improvement (p<0.05) in pain subscale scores compared to group B, while group B showed significant improvement (p<0.05) in functional disability subscale scores compared to group A. There was no significant difference (p>0.05) between the groups on total the patient-related tennis elbow evaluation index score. Conclusion: Both Mulligan mobilisation with movement and Cyriax approach decreased pain and improved functional status in lateral epicondylitis patients. Key Words: Elbow, Lateral epicondylitis, Massage, Mobilisation, Physiotherapy. Continuous..,

scholarly journals Comparative Study of Oral Clonidine and Midazolam as Premedication in Pediatric Patients Undergoing Tonsillectomy

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Statistical Significance ◽  
Anxiety Score ◽  
P Value ◽  
Parental Separation ◽  
Oral Clonidine ◽  
Oral Midazolam ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
Induction Of Anaesthesia

Background and Aim: Anxiety and fear of operation, injections, physicians, operation theatre environment and parental separation are all traumatizing experiences in children. The aim of the study was to compare the effects of oral midazolam and oral clonidine as premedication in children undergoing tonsillectomy .The preoperative sedation, anxiolytic, acceptance of mask for induction of anaesthesia, intravenous cannulation and post-operative recoverywere assessed in both groups. Methods: Aprospective randomized double blinded study of 100 patients of age group 4 -12 yrs undergoing tonsillectomy under general anaesthesia were selected. They were divided into 2 groups of 50 patients each. Group A (oral clonidine) received 4 mcg/kg 90 minutes before induction. Group B (oral midazolam) received 0.5 mg/kg 90 minutes before induction. The sedation and anxiety score was noted at the time of parental separation. The reaction to IV cannulation was assessed by sedation and anxiety scoring at the same time all of them were taken under GA with controlled ventilation. The Mask acceptance was graded by 5 point scoring system .Grade 3,4 and 5 are satisfactory.They were monitored throughout the surgery for any complications. Post operative status was assessed by Modified Objective Pain score. Results: The sedation score and anxiety score at venipuncture was better with clonidine group with statistical significance (p< 0.000 and<0.003). The mask acceptance was better with clonidine group with statistical significance (p <0.000).Postoperative score was also better with clonidine group with statistical significance of p value <0.000. Conclusion: We concluded that oral clonidine and midazolam can be used as better premedicants to produce optimal sedation and emotional state.Clonidine 4 μg / kg has been shown to be a more effective premedication for children undergoing elective tonsillectomy than midazolam 0.5mg/kg

scholarly journals Comparison in Wrist Splints and Wrist-­Metacarpophalangeal Splints Use for Patients with Carpal Tunnel Syndrome Evi

1970 ◽  
Vol 1 (1) ◽  
pp. 63-69
Author(s):  
Evi Yuliani ◽  
Widjajalaksmi Kusumaningsih ◽  
Vitriana ◽  
Hadyana Sukandar
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Functional Improvement ◽  
P Value ◽  
Symptom Severity Scale ◽  
Group A ◽  
Tunnel Syndrome ◽  
Group B ◽  
Improvement Score ◽  
Wrist Splint

Objectives : To compare the effect of both wrist splint and wrist-­metacarpophalangeal splint at night using Symptom Severity Scale (SSS) and Functional Status Scale (FSS) and to know the validity andreliability of Indonesian version of SSS dan FSS.Methods : This study enrolled 19 subjects in each of the two groups that were given neutral wrist splint and exercise in one group (group A) and neutral wrist-­metacarpophalangeal splint and exercise in theother group (group B).Results : Indonesian version of SSS and FSS have been proven valid with rs lowest = 0.360 and highest 0.810(>0.3) and relable with α SSS=0.762 dan FSS=0.781 (>0.7). There were significant improvement score of SSS and FSS in each group with p value <0.001. There were greater functional improvement in group treated with wrist-­metacarpophalangeal splint (group B) with p value = 0.036 (p<0.05) Conclusions: There was improvement of SSS and FSS in both groups of study with greater improvement of in wrist-­hand splint group.Keywords: Carpal Tunnel Syndrome, wrist splint, wrist-­hand splint,,nerve and tendon gliding, SSS, FSS.

scholarly journals SUPRACONDYLAR HUMERUS FRACTURES;

2019 ◽  
Vol 26 (04) ◽  
Author(s):  
Fayyaz Ahmad Orfi ◽  
Asrar Ahmad ◽  
Irum Saleem ◽  
Maheen Orfi
Keyword(s):  
Functional Outcome ◽  
Posterior Approach ◽  
Operative Time ◽  
Lateral Approach ◽  
P Value ◽  
Supracondylar Fractures ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Objectives: To compare lateral versus posterior approach in the management of supracondylar fractures of humerus in children in terms of functional outcome. Study Design: Retrospective Comparative study. Place and Duration of Study: This retrospective study was carried out over a period of seven years from Oct 2009 to Oct 2016, at Combined Military Hospitals Kharian, Malir and Nowshera. Patients and Methods: All the children having supracondylar fracture (Gartland Type-II and III) who underwent surgical intervention either by posterior or lateral approach were included in the study. In Group-A children operated by posterior approach were placed while in Group-B children were operated by posterior approach. They were followed up in OPD after 6 months. The final functional and cosmetic outcome was assessed by using Flynn’s criteria. Data was analysed by using SPSS version -20. A p-value of less than 0.05 was considered as statistically significant. Results: A total of 104 cases were operated during this study period. Fifty-four cases were done by posterior approach (Group-A), while 50 cases were operated by lateral approach (Group-B). In Group-A the mean age was 6.1 years while in Group-B, mean age was 6.6 years. In Group-A the male to female ratio was 72:28 while in Group-B it was 64:36. The mean weight in Group-A was 19.81Kgs (SD: ±4.53) while in Group-B it was 20.44 Kgs (SD:± 3.97). The mean operative time in Group-A was 36.30 minutes (SD: ±3.32) and in Group-B it was 23.58 minutes (SD: ±2.12). The functional outcome at six months follow-up was excellent in 35 (65%), good in 8 (15%), fair in 7 (13%) and poor in 4(7%) cases in Group-A while in Group-B it was excellent in 35 (70%), good in 10 (20%), fair in 4 (8%) and poor in only one case (2%). This difference was not significant at a p-value of 0.441. Conclusion: Though lateral approach required less operative time but there was no statistically significant difference from the posterior approach comparing the functional outcome in the management of paediatric supracondylar fractures of humerus.

scholarly journals Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
P Value ◽  
Chi Square ◽  
Vas Score ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

scholarly journals A HOSPITAL BASED COMPARATIVE STUDY OF TOLERABILITY AND EFFICACY OF TRAMADOL VERSUS ACECLOFENAC ON PATIENTS WITH OSTEOARTHRITIS OF KNEE JOINT.

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Sara Sultana ◽  
Dr. Braj Nandan Kumar Sah
Keyword(s):  
Visual Analogue Scale ◽  
Knee Joint ◽  
Analogue Scale ◽  
P Value ◽  
Osteoarthritis Of Knee ◽  
Vas Score ◽  
Group A ◽  
Mean Differences ◽  
Group B ◽  
To Receive

Objectives: This present study was done to compare the tolerability and efficacy of tramadol versus aceclofenac in terms of WOMAC Osteoarthritis Index and Visual Analogue Scale of patients with osteoarthritis of knee joint. Methods: A detail history, clinical examinations and relevant investigations were performed to all cases of osteoarthritis of knee joint. Group A patients were advised to receive tramadol 75 mg twice daily for 8 weeks, and group B patients were advised to receive aceclofenac 100 mg twice daily for 8 weeks. And we had evaluated the WOMAC Osteoarthritis Index and VAS score of first day and last day visit of patients with osteoarthritis of knee joint. Results: Data was analyzed by using SPSS (version 26) software. Paired sample statistical methods were used. Mean and standard deviation was observed and mean differences were compared. P value was taken less than or equal to 0.05 (p≤0.05) for significant differences. Conclusions: This present study concluded that the WOMAC Osteoarthritis Index score and VAS score of patients who had received aceclofenac medication had statistically significant differences as well as greater mean differences than patients who received tramadol. Hence, aceclofenac is effective drugs than tramadol in terms of efficacy and tolerability of patients with osteoarthritis of knee joint. Key words: Osteoarthritis of knee, WOMAC osteoarthritis index, Visual Analogue Scale.

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