Effects of eccentric training on hand strength in subjects with lateral epicondylalgia: a randomized-controlled trial

The main aim of this study was to evaluate the short-term effects of daily eccentric exercises on functional pain-free hand strength in subjects with long-term lateral epicondylalgia. Forty-two subjects with lateral epicondylalgia were randomly assigned either to a 6-week home exercise regimen receiving eccentric training for their wrist extensors and a forearm band or to a control group receiving a forearm band only. The main outcomes were pain-free hand-grip and wrist-extensor strength at mid- and end-intervention follow-ups, 3 and 6 weeks after inclusion, respectively. Secondary outcomes were a change in the proportion of cases with epicondylalgia and ratings of perceived pain (VAS) at follow-up. Thirty-seven (88%) subjects completed both the mid- and the end-intervention follow-up. Exercise members had significantly higher pain-free hand-grip (P=0.025) and wrist-extensor strength (P<0.001) at the end of follow-up, although there was no such effect at mid-intervention. Regression analysis showed a reduction in the proportion of cases in the exercise group at the end of follow-up (P=0.035). However, no between-groups effect emerged for perceived pain. These data suggest that the daily home eccentric exercise regimen is effective in increasing functional pain-free grip strength and reducing cases suffering from lateral epicondylalgia. However, no effect emerged for global perceived pain during the last week.