A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia (tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.
Purpose The purpose of this review is to systematically explore and summarise the validity and reliability of telerehabilitation (TR)-based physiotherapy assessment for musculoskeletal disorders. Method A comprehensive systematic literature review was conducted using a number of electronic databases: PubMed, EMBASE, PsycINFO, Cochrane Library and CINAHL, published between January 2000 and May 2015. The studies examined the validity, inter- and intra-rater reliabilities of TR-based physiotherapy assessment for musculoskeletal conditions were included. Two independent reviewers used the Quality Appraisal Tool for studies of diagnostic Reliability (QAREL) and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool to assess the methodological quality of reliability and validity studies respectively. Results A total of 898 hits were achieved, of which 11 articles based on inclusion criteria were reviewed. Nine studies explored the concurrent validity, inter- and intra-rater reliabilities, while two studies examined only the concurrent validity. Reviewed studies were moderate to good in methodological quality. The physiotherapy assessments such as pain, swelling, range of motion, muscle strength, balance, gait and functional assessment demonstrated good concurrent validity. However, the reported concurrent validity of lumbar spine posture, special orthopaedic tests, neurodynamic tests and scar assessments ranged from low to moderate. Conclusion TR-based physiotherapy assessment was technically feasible with overall good concurrent validity and excellent reliability, except for lumbar spine posture, orthopaedic special tests, neurodynamic testa and scar assessment.
Background and Purpose. Mulligan has proposed the use of mobilization with movement for lateral epicondylalgia. In this study, mobilization with movement for the elbow was examined to determine whether this intervention was capable of inducing physiological effects similar to those reported for some forms of spinal manipulation. Participants. Seven women and 17 men (mean ageϭ48.5 years, SDϭ7.2) with chronic lateral epicondylalgia participated in the study. Methods. A placebo, control, repeated-measures study was conducted to evaluate whether mobilization with movement at the elbow produced concurrent hypoalgesia and sympathoexcitation. Results. The treatment demonstrated an initial hypoalgesic effect and concurrent sympathoexcitation. Improvements in pain resulted in increased pain-free grip force and pressure pain thresholds. Sympathoexcitation was indicated by changes in heart rate, blood pressure, and cutaneous sudomotor and vasomotor function. Discussion and Conclusion. This study showed that a mobilization with movement treatment technique exerted a physiological effect similar to that reported for some spinal manipulations. M ulligan 1 has recently described an intervention in which a therapist applies a passive glide mobilization to a joint (usually an accessory motion) and sustains it while the client performs a physical task involving the limbs. The techniques, called "mobilization with movements" (MWM), are claimed to bring about improvements in pain and function immediately following their application in the clinic, 1 but there is a lack of experimental data reported in peer-reviewed publications. The MWM group of techniques are claimed to achieve this rapid improvement in persistent musculoskeletal pain states that have been recalcitrant to other forms of therapy. 2,3 To date, the postulated mechanism(s) of action of this treatment approach has focused on mechanical effects such as the restoration of bony positional faults. 4,5 The physiological effects have largely been ignored.Much of the research about manipulation over the past decade has not focused on evaluating the subluxation theory of spinal manipulation, but rather such research has concentrated on elucidating the physiological effects of spinal manipulations. 6 -13 Most of this research, however, has not dealt with the effects of the MWM technique. Several authors 6 -13 have reported data that have been interpreted as reflecting possible neurophysiologic mechanism(s) for hypothesized actions. Some studies 6,7 have shown that passive mobilization treatments of the cervical spine, techniques frequently used by physical therapists, may produce an initial hypoalgesia and concurrent excitation in the motor system and the sympathetic nervous system (SNS). 6,7 Any concurrent initial hypoalgesic and physiological effects have not been studied in manipulation of peripheral joints. Our study represents an initial investigation of the effect of a MWM treatment technique at the elbow A Paungmali, PT, MPT, is a doctoral student, Department of Physiot...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.