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Strengthening of Rotator Cuff and Scapular Muscles in Patients With Lateral Elbow Tendinopathy: A Randomized
1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yalova University, Yalova, Türkiye.
Objective:
To assess the impact of scapular and rotator cuff muscle strengthening exercises in addition to an elbow-focused rehabilitation program for patients with lateral elbow tendinopathy (LET).
Design:
Prospective, parallel group, randomized controlled trial.
Setting:
Yalova Research and Training Hospital.
Participants:
Individuals diagnosed with LET, between 18 and 65 years of age, unilateral pain for a minimum of 3 months, and pain in at least 2 of the 4 clinical tests (Cozen's, Maudsley, Mill's maneuver, and Thomsen's tests).
Interventions:
Participants were randomly assigned to 2 groups. Group 1 (n=29) received rotator cuff and scapular muscle strengthening exercises in addition to wrist extensor exercises, whereas Group 2 (n=29) performed only wrist extensor exercises. Participants in both groups received education on activity modifications. Supervised exercise programs for both groups conducted twice a week for 8 weeks.
Main Outcome Measures:
The primary outcomes were the Patient-Rated Tennis Elbow Evaluation (PRTEE) and Numerical Pain Rating Scale (NPRS). Secondary outcomes included maximum and pain-free grip strength, pressure pain threshold (PPT), rotator cuff and scapular muscles strength, and Global Rating of Change score.
Results:
A total of 58 participants (mean age 40.72±8.36y, 63% female, average symptom durations 35.2mo) completed primary and secondary outcomes at each follow-up time point. The mean difference (95% confidence interval) between Group 1 and Group 2 for PRTEE score was -13.06 [-16.73, 9.39] at 1-year follow-up. Group-by-time interaction for repeated measures analysis of covariance was significant for NPRS-activity and NPRS-rest, maximum and pain-free grip strength, PPT, and strength of rotator cuff and scapular muscles (P<.05).
Conclusions:
This study provides evidence of added benefit for the addition of rotator cuff and scapular muscle strengthening exercises to an elbow-focused rehabilitation program for patients with LET compared with an exercise program that targets the wrist extensors alone.
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