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Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis

BACKGROUND: In the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear. PATIENTS AND METHODS: Patients suffering from a LE longer than 3 months were multicentrically and prospectively randomized into a physiotherapeutic group (PT group) and in a physiotherapy...

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Autores principales: Nowotny, J., El-Zayat, B., Goronzy, J., Biewener, A., Bausenhart, F., Greiner, S., Kasten, P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138897/
https://www.ncbi.nlm.nih.gov/pubmed/30219102
http://dx.doi.org/10.1186/s40001-018-0342-9
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author Nowotny, J.
El-Zayat, B.
Goronzy, J.
Biewener, A.
Bausenhart, F.
Greiner, S.
Kasten, P.
author_facet Nowotny, J.
El-Zayat, B.
Goronzy, J.
Biewener, A.
Bausenhart, F.
Greiner, S.
Kasten, P.
author_sort Nowotny, J.
collection PubMed
description BACKGROUND: In the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear. PATIENTS AND METHODS: Patients suffering from a LE longer than 3 months were multicentrically and prospectively randomized into a physiotherapeutic group (PT group) and in a physiotherapy group plus wrist orthosis (PT + O group). Physiotherapy consisted of daily eccentric strengthening exercises under initial professional supervision. Inclusion criteria were a Placzek score greater than 4. Exclusion criteria were previous surgery, rheumatic arthritis, elbow instability, radicular symptoms, higher-grade extensor tendon rupture, or cervical osteoarthritis. The clinical evaluation was performed after 12 weeks and 12 months. The Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, Placzek Score, the pain rating (VAS), range of motion and the Subjective Elbow Score were evaluated. RESULTS: Of the initially 61 patients, 31 were followed up after 12 weeks and 22 after 12 months. Twenty-nine patients (43%) were male, the mean age was 46, and 44 patients (66%) had the right elbow involved. At 12 weeks, there was a pain reduction on the VAS in both groups (PT + O: 6.5–3.7 [p = .001]; PT: 4.7–4.1 [p = .468]), albeit it was only significant for the PT + O group. At 12 months, reduction was significant in both groups (PT + O: 1.1 [p = .000]; PT: 1.3 [p = .000]). The painless maximum hand strength in kg improved in both groups significant after 3 and 12 months. The Placzek score was reduced from 8.25 to 3.5 [p = .001] after 12 weeks for the PT + O group and from 8.1 to 3.8 [p = .000] in the PT group, as well as after 12 months in the PT + O group to 0 [p = .000] and in the PT group to 2.0 [p = .000]. The PRTEE improved in both groups after 12 weeks (PT + O: 52.8––31.3 [p = .002]; PT: 48.6–37.6 [p = .185]) and 12 months (PT + O: 16.15 [p = .000]; PT: 16.6 [p = .000]), although the reduction at 12 weeks was not significant for the PT group. CONCLUSION: The elbow orthosis appears to accelerate the healing process with respect to the PRTEE and pain on the VAS (12 weeks follow-up), although there is an adjustment after 12 months in both groups and a significant improvement of symptoms is achieved in all endpoints.
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spelling pubmed-61388972018-09-15 Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis Nowotny, J. El-Zayat, B. Goronzy, J. Biewener, A. Bausenhart, F. Greiner, S. Kasten, P. Eur J Med Res Research BACKGROUND: In the treatment of lateral epicondylitis (LE), the role of a new dynamic wrist orthosis is unclear. PATIENTS AND METHODS: Patients suffering from a LE longer than 3 months were multicentrically and prospectively randomized into a physiotherapeutic group (PT group) and in a physiotherapy group plus wrist orthosis (PT + O group). Physiotherapy consisted of daily eccentric strengthening exercises under initial professional supervision. Inclusion criteria were a Placzek score greater than 4. Exclusion criteria were previous surgery, rheumatic arthritis, elbow instability, radicular symptoms, higher-grade extensor tendon rupture, or cervical osteoarthritis. The clinical evaluation was performed after 12 weeks and 12 months. The Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, Placzek Score, the pain rating (VAS), range of motion and the Subjective Elbow Score were evaluated. RESULTS: Of the initially 61 patients, 31 were followed up after 12 weeks and 22 after 12 months. Twenty-nine patients (43%) were male, the mean age was 46, and 44 patients (66%) had the right elbow involved. At 12 weeks, there was a pain reduction on the VAS in both groups (PT + O: 6.5–3.7 [p = .001]; PT: 4.7–4.1 [p = .468]), albeit it was only significant for the PT + O group. At 12 months, reduction was significant in both groups (PT + O: 1.1 [p = .000]; PT: 1.3 [p = .000]). The painless maximum hand strength in kg improved in both groups significant after 3 and 12 months. The Placzek score was reduced from 8.25 to 3.5 [p = .001] after 12 weeks for the PT + O group and from 8.1 to 3.8 [p = .000] in the PT group, as well as after 12 months in the PT + O group to 0 [p = .000] and in the PT group to 2.0 [p = .000]. The PRTEE improved in both groups after 12 weeks (PT + O: 52.8––31.3 [p = .002]; PT: 48.6–37.6 [p = .185]) and 12 months (PT + O: 16.15 [p = .000]; PT: 16.6 [p = .000]), although the reduction at 12 weeks was not significant for the PT group. CONCLUSION: The elbow orthosis appears to accelerate the healing process with respect to the PRTEE and pain on the VAS (12 weeks follow-up), although there is an adjustment after 12 months in both groups and a significant improvement of symptoms is achieved in all endpoints. BioMed Central 2018-09-15 /pmc/articles/PMC6138897/ /pubmed/30219102 http://dx.doi.org/10.1186/s40001-018-0342-9 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Nowotny, J.
El-Zayat, B.
Goronzy, J.
Biewener, A.
Bausenhart, F.
Greiner, S.
Kasten, P.
Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title_full Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title_fullStr Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title_full_unstemmed Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title_short Prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
title_sort prospective randomized controlled trial in the treatment of lateral epicondylitis with a new dynamic wrist orthosis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138897/
https://www.ncbi.nlm.nih.gov/pubmed/30219102
http://dx.doi.org/10.1186/s40001-018-0342-9
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