Effects of a novel manipulative physiotherapy technique on tennis elbow: a single case study

A single case study design was used to investigate the effect of a novel manipulative physiotherapy technique on the pain and dysfunction which characterises tennis elbow. The technique involves the physiotherapist sustaining a lateral glide of the elbow while the patient performs an activity which usually aggravates pain. To be judged successful, the technique should abolish pain. A pain visual analogue scale (VAS) and pressure algometer were used to measure pain. Function was measured with a grip dynamometer, function VAS and pain-free function questionnaire. The study involved three phases in a ABC design. They were a 2-week pre-treatment assessment phase, a 2-week treatment phase and a 6-week post-treatment assessment phase. The patient received four treatment sessions over the treatment phase. The technique's effect was to reduce pain and increase function during and immediately after its application. Improvement in pain and function as measured by VASs was correlated (r = -0.92, p < 0.0001). The rate of pain reduction was greater than that for improvement in function. Although the single case study design limits generalisation of the results, it does provide evidence of the beneficial response obtained by use of this technique in patients affected by tennis elbow.