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Unsupervised Isometric Exercise versus Wait-and-See for Lateral Elbow Tendinopathy
Viana Vuvan1, Bill Vicenzino1, Rebecca Mellor1
1School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, AUSTRALIA.
Medicine and Science in Sports and Exercise
|August 20, 2019
Summary
Unsupervised isometric exercise improved pain and disability for lateral elbow tendinopathy but did not significantly enhance global improvement or grip strength compared to a wait-and-see approach. Further research is needed to determine its efficacy as a standalone treatment.
Area of Science:
- Orthopedics
- Sports Medicine
- Rehabilitation Science
Background:
- Lateral elbow tendinopathy, commonly known as tennis elbow, is a prevalent condition causing significant pain and functional limitation.
- Conservative management options are diverse, with exercise therapy being a cornerstone of treatment, yet optimal exercise types and supervision levels remain debated.
Purpose of the Study:
- To compare the effectiveness of unsupervised isometric exercise against a wait-and-see approach for managing lateral elbow tendinopathy.
- To evaluate the impact on pain, disability, overall perceived improvement, and pain-free grip strength.
Main Methods:
- A randomized controlled trial involving 40 participants with unilateral lateral elbow tendinopathy.
- Intervention group received supervised instruction for an 8-week unsupervised daily progressive isometric exercise program; control group adopted a wait-and-see approach.
- Primary outcomes included Patient-Rated Tennis Elbow Evaluation, global rating of change, and pain-free grip strength at 8 weeks.
Main Results:
- The isometric exercise group demonstrated significantly lower Patient-Rated Tennis Elbow Evaluation scores (SMD, -0.92; 95% CI, -1.58 to -0.26), indicating reduced pain and disability.
- No significant group differences were observed in the global rating of change (success rates) or pain-free grip strength.
- Worst pain was moderately lower in the exercise group (SMD, -0.80; 95% CI, -1.45 to -0.14).
Conclusions:
- Unsupervised isometric exercise effectively reduced pain and disability in individuals with lateral elbow tendinopathy compared to a wait-and-see strategy.
- Its efficacy as a sole treatment is questionable given the lack of significant improvement in perceived global change and pain-free grip strength.
- Further investigation is warranted to establish optimal exercise protocols and supervision for this condition.
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