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Updated: Feb 15, 2026

A Method to Study Adaptation to Left-Right Reversed Audition
Published on: October 29, 2018
A service evaluation and improvement project: a three year systematic audit cycle of the physiotherapy treatment for
1Physiotherapy Department, Salford Royal Foundation Trust, Stott Lane, Salford, M6 8HD, United Kingdom.
Objectives:
To improve outcomes of physiotherapy treatment for patients with Lateral Epicondylalgia.
Design:
A systematic audit and quality improvement project over three phases, each of one year duration.
Setting:
Salford Royal NHS Foundation Trust Teaching Hospital Musculoskeletal Physiotherapy out-patients department.
Participants:
n=182.
Interventions:
Phase one - individual discretion; Phase two - strengthening as a core treatment however individual discretion regarding prescription and implementation; Phase three - standardised protocol using high load isometric exercise, progressing on to slow combined concentric & eccentric strengthening.
Main Outcome Measures:
Global Rating of Change Scale, Pain-free grip strength, Patient Rated Tennis Elbow Evaluation, Tampa Scale of Kinesophobia-11.
Results:
Phase three demonstrated a reduction in the average number of treatments by 42% whilst improving the number of responders to treatment by 8% compared to phase one. Complete cessation of non-evidence based treatments was also observed by phase three.
Conclusions:
Strengthening should be a core treatment for LE. Load setting needs to be sufficient. In phase three of the audit a standardised tendon loading programme using patient specific high load isometric exercises into discomfort/pain demonstrated a higher percentage of responders compared to previous phases.
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