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Antonassi DP, Rodacki CL, Lodovico A, Ugrinowitsch C, Rodacki ALF. Immediate Effects of Acupuncture on Force and Delayed Onset of Muscle Soreness. Med Acupunct 2021; 33:203-211. [PMID: 34239662 PMCID: PMC8236298 DOI: 10.1089/acu.2020.1491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The ability to produce force is critical to several daily activities. Strategies to reduce delayed onsent muscle soreness (DOMS) and restore force-generating properties that occur in response to training and impair physical performance have been proposed. Acupuncture has been proposed to accelerate recovery and optimize muscle functioning. It was to determine the effects of acupuncture on DOMS and on the muscle force production capacity. Methods: Thirty physically active volunteers (26.3 ± 3.1 years old, 1.70 ± 0.08 m, 66.5 ± 12.6 kg) were allocated in a control (CG; n = 10), placebo (PG; n = 10), and acupuncture (AG; n = 10) groups. The groups were subjected to an exercise protocol to induce DOMS and were assessed for muscle force, threshold, and rate of perceived pain and activation of the biceps brachialis muscle before (PRE) and 20 minutes after (POST) a single acupuncture session using a mixed model analysis. Results: The threshold and rate of perceived pain were reduced in the AG (P < 0.05) but remained unchanged in the other groups (P > 0.05). Muscle activation also showed larger changes in the AG in comparison with the other groups (P < 0.05). No changes in the ability to produce force were found after acupuncture in any groups (P > 0.05). Conclusions: Acupuncture may reduce discomfort and improve muscle activation but was not effective to promote force improvement and/or restore the force-generating properties. It may be speculated that muscle disruption may have played a role and did not allow participants to restore their muscular performance. Rebec Number; RBR-8bh5k7 (www.ensaiosclinicos.gov.br/rg/RBR-8bh5k7); Clinical Trial Registry (UTN No.: U1111-1234-9553).
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Affiliation(s)
| | - Cintia L.N. Rodacki
- Department of Physical Education, Paraná Technological Federal University, Curitiba, Brazil
| | | | - Carlos Ugrinowitsch
- Department of Sports, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - André Luiz Felix Rodacki
- Department of Physical Education, Paraná Federal University, Biological Sciences Sector, Curitiba, Brazil
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Jeon J, Bussin E, Scott A. Temporal divergence of changes in pain and pain-free grip strength after manual acupuncture or electroacupuncture: an experimental study in people with lateral epicondylalgia. Chin Med 2017; 12:22. [PMID: 28785304 PMCID: PMC5543448 DOI: 10.1186/s13020-017-0143-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/31/2017] [Indexed: 12/31/2022] Open
Abstract
Background The objective of this study was to examine, in individuals with lateral epicondylalgia (LE), the acute time course of acupuncture-induced hypoalgesia and change in pain-free grip strength (PFGS). Methods This was an experimental study, conducted at a single research center in Vancouver, BC. Twenty-one participants with unilateral LE lasting more than 6 weeks duration were enrolled. Participants received a single treatment of acupuncture (either electroacupuncture, 10–30 Hz, or manual acupuncture, assigned randomly). The primary outcome measure was pain level (0–10) during tendon loading (while making a fist) immediately after treatment, and over a 72 h follow-up period. Secondary outcome measures included pain-free grip strength (N). Results There was a small but statistically significant reduction in participants’ perceived pain level immediately after acupuncture (mean improvement of 1.2, 95% CI 0.45–1.9). This change in pain was not accompanied by a change in PFGS. No difference was observed between the two types of acupuncture at any time point. Conclusions The use of acupuncture or electroacupuncture, as administered in the current study, is unlikely to acutely enhance the ability of people with LE to engage in pain-free rehabilitation exercise. Trial registration Registered February 25, 2015. ISRCTN14667535, http://www.isrctn.com/ISRCTN14667535 Electronic supplementary material The online version of this article (doi:10.1186/s13020-017-0143-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jaewon Jeon
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute and Department of Physical Therapy, University of British Columbia, 2635 Laurel Street, Vancouver, BC V5Z3M9 Canada
| | - Erin Bussin
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute and Department of Physical Therapy, University of British Columbia, 2635 Laurel Street, Vancouver, BC V5Z3M9 Canada
| | - Alex Scott
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute and Department of Physical Therapy, University of British Columbia, 2635 Laurel Street, Vancouver, BC V5Z3M9 Canada
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Wong CWY, Ng EYL, Fung PW, Mok KM, Yung PSH, Chan KM. Comparison of treatment effects on lateral epicondylitis between acupuncture and extracorporeal shockwave therapy. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2016; 7:21-26. [PMID: 29264270 PMCID: PMC5721919 DOI: 10.1016/j.asmart.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/17/2016] [Accepted: 10/18/2016] [Indexed: 11/03/2022]
Abstract
Background Lateral epicondylitis is one of the most common overuse injuries, and has been reported to reduce function and affect daily activities. There is no standard therapy for lateral epicondylitis. In Hong Kong, acupuncture and extracorporeal shockwave therapy (ESWT) have been popular in treating lateral epicondylitis in recent years. Objective This study is to compare the treatment effects of acupuncture and ESWT on lateral epicondylitis. Methods In this study, we evaluated 34 patients (34 elbows) with lateral epicondylitis. Seventeen patients were treated by 3-week ESWT, one session per week. Another 17 were treated by 3-week acupuncture therapy, two sessions per week. The outcome measures included pain score by visual analogue scale, maximum grip strength by Jamar dynamometer, and level of functional impairment by disability of arms, shoulders, and hands questionnaire. Participants were assessed at three time points: baseline; after treatment; and 2-week follow-up. Results The two treatments showed no significant difference at any assessment time-point. Both treatment groups had significant improvement in pain score in longitudinal comparisons. No significant difference was found in maximum grip strength and functional impairment in either treatment group, but a trend of improvement could be observed. In addition, improvement in pain relief stopped when treatment ended for either groups. Conclusions The treatment effects of acupuncture and ESWT on lateral epicondylitis were similar. The pain relief persisted for at least two weeks after treatment.
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Affiliation(s)
- Clara Wing-Yee Wong
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Elaine Yin-Ling Ng
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Pui-Wa Fung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kam-Ming Mok
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick Shu-Hang Yung
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai-Ming Chan
- Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Liu YS, Gadau M, Zhang GX, Liu H, Wang FC, Zaslawski C, Li T, Tan YS, Berle C, Li WH, Bangrazi S, Liguori S, Zhang SP. Acupuncture Treatment of Lateral Elbow Pain: A Nonrandomized Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:8182071. [PMID: 27006679 PMCID: PMC4783565 DOI: 10.1155/2016/8182071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/28/2016] [Indexed: 11/28/2022]
Abstract
In planning for a large-scale multicenter trial to evaluate the effect of acupuncture for the treatment of lateral elbow pain, a pilot study was conducted. This was a prospective, investigator- and patient-blinded, nonrandomized, placebo controlled trial. Subjects were evaluated at baseline, before fourth, seventh, and ninth treatment, and at a two-week posttreatment follow-up. The treatment group received unilateral acupuncture at LI 10 and LI 11 at the affected side with manual needle manipulation; the control group received sham-laser acupuncture at the same acupoints. Measures included (i) disabilities of the arm, shoulder, and hand (DASH) questionnaire, (ii) pain-free grip strength (PFGS), and (iii) a visual analogue scale (VAS) for pain. Significant differences in DASH score, PFGS, and VAS between treatment and control group were found at the ninth treatment (n = 20 for each group, P < 0.05). Only DASH showed significant differences compared to the control for all the measurement time points after treatment commenced and appears to be a sensitive and appropriate primary outcome measure for the future multisite trial. Results from this pilot study provided relevant information about treatment efficacy, credibility of control treatment, and sensitivity of different outcome measures for the planning of the future trial.
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Affiliation(s)
- Yan-Song Liu
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Marcus Gadau
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Guo-Xue Zhang
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Hao Liu
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Fu-Chun Wang
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Christopher Zaslawski
- College of Traditional Chinese Medicine, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Tie Li
- Changchun University of Traditional Chinese Medicine, Changchun 130117, Jilin, China
| | - Yuan-Sheng Tan
- World Federation of Acupuncture and Moxibustion Societies, Beijing 100061, China
| | - Christine Berle
- College of Traditional Chinese Medicine, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Wei-Hong Li
- College of Traditional Chinese Medicine, University of Technology Sydney, Sydney, NSW 2007, Australia
| | | | | | - Shi-Ping Zhang
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon Tong, Hong Kong
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Chang WD, Lai PT, Tsou YA. Analgesic Effect of Manual Acupuncture and Laser Acupuncture for Lateral Epicondylalgia: A Systematic Review and Meta-Analysis. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2014; 42:1301-14. [PMID: 25384448 DOI: 10.1142/s0192415x14500815] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lateral epicondylalgia is a common orthopedic disorder. In traditional Chinese medicine, acupuncture is often used for treating lateral epicondylalgia. Laser acupuncture, compared with manual acupuncture, has more advantages because it is painless, aseptic and safe. However, the analgesic effect of manual acupuncture and laser acupuncture on lateral epicondylalgia has rarely been explored. We conducted a systematic review and meta-analysis to compare the analgesic effect of laser acupuncture and manual acupuncture for the treatment of lateral epicondylalgia. We investigated studies published in the Medline, PubMed, and CINAHL databases from January 1980 to December 2013. This review included 9 randomized articles. Six of them examined manual acupuncture and the others focused on laser acupuncture. We analyzed the meta-analysis results regarding the analgesic effect of the treatment, and observed substantial differences in 4 articles related to manual acupuncture. Manual acupuncture is effective in short-term pain relief for the treatment of lateral epicondylalgia; however, its long-term analgesic effect is unremarkable. A suitable acupuncture point and depth can be used to treat lateral epicondylalgia. Manual acupuncture applied on lateral epicondylalgia produced stronger evidence of an analgesic effect than did laser acupuncture, and further study on the analgesic effect of laser acupuncture is required.
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Affiliation(s)
- Wen-Dien Chang
- Department of Sports Medicine, China Medical University, Taichung City, Taiwan, R.O.C
| | - Ping-Tung Lai
- Department of Physical Therapy and Rehabilitation, Da-Chien General Hospital, Miaoli City, Taiwan, R.O.C
| | - Yung-An Tsou
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung City, Taiwan, R.O.C
- Department of Otorhinolaryngology, China Medical University and Hospital, Taichung City, Taiwan, R.O.C
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Gadau M, Yeung WF, Liu H, Zaslawski C, Tan YS, Wang FC, Bangrazi S, Chung KF, Bian ZX, Zhang SP. Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:136. [PMID: 24726029 PMCID: PMC4012509 DOI: 10.1186/1472-6882-14-136] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 02/13/2014] [Indexed: 01/23/2023]
Abstract
Background Acupuncture and moxibustion have widely been used to treat lateral elbow pain (LEP). A comprehensive systematic review of randomized controlled trials (RCTs) including both English and Chinese databases was conducted to assess the efficacy of acupuncture and moxibustion in the treatment of LEP. Methods Revised STRICTA (2010) criteria were used to appraise the acupuncture procedures, the Cochrane risk of bias tool was used to assess the methodological quality of the studies. A total of 19 RCTs that compared acupuncture and/or moxibustion with sham acupuncture, another form of acupuncture, or conventional treatment were included. Results All studies had at least one domain rated as high risk or uncertain risk of bias in the Cochrane risk of bias tool. Results from three RCTs of moderate quality showed that acupuncture was more effective than sham acupuncture. Results from 10 RCTs of mostly low quality showed that acupuncture or moxibustion was superior or equal to conventional treatment, such as local anesthetic injection, local steroid injection, non-steroidal anti- inflammatory drugs, or ultrasound. There were six low quality RCTs that compared acupuncture and moxibustion combined with manual acupuncture alone, and all showed that acupuncture and moxibustion combined was superior to manual acupuncture alone. Conclusion Moderate quality studies suggest that acupuncture is more effective than sham acupuncture. Interpretations of findings regarding acupuncture vs. conventional treatment, and acupuncture and moxibustion combined vs. manual acupuncture alone are limited by the methodological qualities of these studies. Future studies with improved methodological design are warranted to confirm the efficacy of acupuncture and moxibustion for LEP.
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Shin KM, Kim JH, Lee S, Shin MS, Kim TH, Park HJ, Lee MH, Hong KE, Lee S, Choi SM. Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial. Trials 2013; 14:174. [PMID: 23768129 PMCID: PMC3685553 DOI: 10.1186/1745-6215-14-174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/31/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Lateral epicondylitis is the most frequent cause of pain around the elbow joint. It causes pain in the region of the elbow joint and results in dysfunction of the elbow and deterioration of the quality of life. The purpose of this study is to compare the effects of ipsilateral acupuncture, contralateral acupuncture and sham acupuncture on lateral epicondylitis. METHODS/DESIGN Forty-five subjects with lateral epicondylitis will be randomized into three groups: the ipsilateral acupuncture group, contralateral acupuncture group and the sham acupuncture group. The inclusion criteria will be as follows: (1) age between 19 and 65 years with pain due to one-sided lateral epicondylitis that persisted for at least four weeks, (2) with tenderness on pressure limited to regions around the elbow joint, (3) complaining of pain during resistive extension of the middle finger or the wrist, (4) with average pain of NRS 4 or higher during the last one week at a screening visit and (5) voluntarily agree to this study and sign a written consent. Acupuncture treatment will be given 10 times in total for 4 weeks to all groups. Follow up observations will be conducted after the completion of the treatment, 8 weeks and 12 weeks after the random assignment. Ipsilateral acupuncture group and contralateral acupuncture group will receive acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points. The sham acupuncture group will receive treatment on acupuncture points not related to the lateral epicondylitis using a non-invasive method. The needles will be maintained for 20 minutes. The primary outcome will be differences in the visual analogue scale (VAS) for elbow pain between the groups. The secondary outcome will be differences in patient-rated tennis elbow evaluation (PRTEE), pain-free/maximum grip strength (Dynamometer), pressure pain threshold, clinically relevant improvement, patient global assessment, and the EQ-5D. The data will be analyzed with the paired t-test and ANCOVA (P <0.05). DISCUSSION The results of this study will allow evaluation of contralateral acupuncture from two aspects. First, if the contralateral acupuncture shows the effects similar to ipsilateral acupuncture, this will establish clinical basis for contralateral acupuncture. Second, if the effects of contralateral acupuncture are not comparable to the effects of ipsilateral acupuncture, but are shown to be similar to the effects of the sham acupuncture, we can establish the basis for using the same acupoints of the unaffected side as a control in acupuncture clinical studies. TRIAL REGISTRATION This trial has been registered with the 'Clinical Research Information Service (CRIS)', Republic of Korea: KCT0000628.
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Affiliation(s)
- Kyung-Min Shin
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Joo-Hee Kim
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Seunghoon Lee
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Mi-Suk Shin
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Tae-Hun Kim
- Clinical research center, MokHuri Neck&Back Hospital, Seoul, South Korea
| | - Hyo-Ju Park
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Min-Hee Lee
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kwon-Eui Hong
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Seungdeok Lee
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Dongguk University, Gyeongju, South Korea
| | - Sun-Mi Choi
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
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Bäumler PI, Simang M, Kramer S, Irnich D. Acupuncture point localization varies among acupuncturists. ACTA ACUST UNITED AC 2012; 19:31-7. [PMID: 22398924 DOI: 10.1159/000335825] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. MATERIAL AND METHODS Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DÄGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant's arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. RESULTS The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm(2). The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. CONCLUSION Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies.
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Affiliation(s)
- Petra I Bäumler
- Multidisciplinary Pain Center, Department of Anesthesiology, University of Munich, Germany.
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Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005; 39:411-22; discussion 411-22. [PMID: 15976161 PMCID: PMC1725258 DOI: 10.1136/bjsm.2004.016170] [Citation(s) in RCA: 210] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia (tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.
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Affiliation(s)
- L Bisset
- Division of Physiotherapy, University of Queensland, St Lucia, QLD 4072, Australia
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Trudel D, Duley J, Zastrow I, Kerr EW, Davidson R, MacDermid JC. Rehabilitation for patients with lateral epicondylitis: a systematic review. J Hand Ther 2004; 17:243-66. [PMID: 15162109 DOI: 10.1197/j.jht.2004.02.011] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this systematic review was to determine the effectiveness of conservative treatments for lateral epicondylitis and to provide recommendations based on this evidence. Five reviewers searched computerized bibliographic databases for articles on the conservative treatment of lateral epicondylitis from the years 1983 to 2003. A total of 209 studies were located; however, only 31 of these met the study inclusion criteria. Each of the articles was randomly allocated to reviewers and critically appraised using a structured critical appraisal tool with 23 items. Treatment recommendations were based on this rating and Sackett's Level of Evidence. This review has determined, with at least level 2b evidence, that a number of treatments, including acupuncture, exercise therapy, manipulations and mobilizations, ultrasound, phonophoresis, Rebox, and ionization with diclofenac all show positive effects in the reduction of pain or improvement in function for patients with lateral epicondylitis. There is also at least level 2b evidence showing laser therapy and pulsed electromagnetic field therapy to be ineffective in the management of this condition. Practitioners should use the treatment techniques that have strongest evidence and ensure that studies findings are generalized to patients who are similar to those reported in primary research studies in terms of patient demographics and injury presentation.
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Boisaubert B, Brousse C, Zaoui A, Montigny JP. Les traitements non chirurgicaux de la tendinopathie des épicondyliens. ACTA ACUST UNITED AC 2004; 47:346-55. [PMID: 15297125 DOI: 10.1016/j.annrmp.2004.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review the literature on nonsurgical treatment of tennis elbow. METHODS We searched Medline for all randomized controlled trials (RCTs), controlled clinical trials (CCTs) and literature reviews published from 1966 to December 2003 on nonsurgical treatment of tennis elbow. We used the keys words controlled clinical trial, tennis elbow on lateral epicondylitis, and treatment. We found 46 reports of RCTs and CCTs on 14 nonsurgical treatments and 11 literature reviews. RESULTS Corticosteroid injection is the best treatment option for the short term. However, beneficial effects persisted only for a short time, and the long-term outcome could be poor. For the long term, physiotherapy (pulsed ultrasound, deep friction massage and exercise programme) was the best option but was not significantly different from the "wait-and-see" approach. Some support is offered for the use of topical nonsteroid anti-inflammatory drugs, at least for the short term. There is insufficient evidence to support or refute the use of acupuncture, extracorporeal shock wave therapy, manipulation, orthoses, low-energy laser, glycosaminoglycan polysulfate injection, botulinum toxin injection, or topical nitric oxide application. CONCLUSION Further trials, with use of appropriate methods and adequate sample sizes, are needed before conclusions can be drawn about the effects of many of the treatments for tennis elbow and their ability to change the condition's natural course.
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Affiliation(s)
- B Boisaubert
- Service de médecine physique et de réadaptation, hôpital Foch, 92150 Suresnes, France.
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