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Proprioceptive elbow training reduces pain and improves function in painful lateral epicondylitis—a prospective trial

Authors
  • Schiffke-Juhász, B.1
  • Knobloch, K.2
  • Vogt, P. M.3
  • Hoy, L.4
  • 1 Herzogin Elisabeth Hospital, Braunschweig, Germany , Braunschweig (Germany)
  • 2 Sportpraxis Knobloch, Hannover, Germany , Hannover (Germany)
  • 3 Formerly Medizinische Hochschule Hannover, Hannover, Germany , Hannover (Germany)
  • 4 Medizinische Hochschule Hannover, Hannover, Germany , Hannover (Germany)
Type
Published Article
Journal
Journal of Orthopaedic Surgery and Research
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jul 27, 2021
Volume
16
Issue
1
Identifiers
DOI: 10.1186/s13018-021-02602-3
Source
Springer Nature
Keywords
Disciplines
  • Research Article
License
Green

Abstract

BackgroundIn painful epicondylitis, previous studies reported deficiencies in elbow proprioception. In line, proprioceptive training of the lower limb has been reported substantial beneficial in a number of indications. Therefore, we have asked if a specified proprioceptive training using training devices that are capable of activating the deep musculature in the upper limb is able to reduce the symptoms of epicondylitis.Materials and methodsWe included 71 patients with painful lateral epicondylitis > 3 months. Interventions: Group A: Proprioceptive training intervention with a Flexibar® (9 min daily for 12 weeks). Group B: at least 40 min running or walking/week with the XCO® in addition to the proprioceptive training with the Flexibar® (9 min daily for 12 weeks), follow-up for 12 weeks. Primary end point: Pain on visual analogue scale (VAS, 0-10); secondary end points: DASH-Score (0 = very good, 100 = very poor), grip strength according to Jamar dynamometer (kg), vibration sensation measured with a 128 Hz tuning fork.ResultsThe pain on VAS in group A was reduced significantly. 3.6 ± 2.0 to 2.4 ± 2.1 (−33%, p = 0.013), and from 3.7 ± 2.4 to 2.2 ± 1.9 (−41%, p = 0.004) in group B after 12 weeks. There was no significant difference between A and B (p = 0.899). In both groups, there was a significant improvement of the DASH-Score (A: 32 ± 15 to 14 ± 12, −56%, p < 0.001; B: 27 ± 12 to 12 ± 11, −55%, p = 0.001) without any difference between groups A and B (p = 0.339). Grip strength improvement in group A from 24 ± 12 to 33 ± 11 kg (+38%, p < 0.001), and from 29 ± 14 to 34 ± 11 kg (+15%, p < 0.001) in group B. In line, vibration sensation improved in both groups (A: 6.3 ± 0.6 to 6.5 ± 0.5, p = 0.0001; B: 6.3 ± 0.7 to 6.6 ± 0.5, p = 0.003).ConclusionA 12-week proprioceptive training with the Flexibar® improves pain, quality of life, grip strength and vibration sensation in patients with painful lateral epicondylitis.Level of evidenceIb, randomised clinical trialTrial registrationGerman Clinical Trials Register, DRKS00024857, registered on 25 March 2021—retrospectively registered, http://apps.who.int/trialsearch/

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