Comparison of two different orthoses used in the treatment of lateral epicondylitis

Abstract

Background: Lateral epicondylitis (LE) is one of the most common causes of lateral elbow pain, and orthoses are often used in its conservative treatment. However, the number of studies examining the effectiveness of the orthoses used and their differences compared to each other is limited. Objective: To determine the effects of 2 orthoses types, wrist orthosis (WO) and counterforce brace (CB), commonly used in the treatment of lateral epicondylitis on muscle activation, grip strength, hand function, and satisfaction level in healthy individuals. Study Design: Quasi-experimental study. Methods: Thirty-seven healthy individuals were recruited. Muscle activation was evaluated by surface electromyography, and maximum grip strength was evaluated with a handheld dynamometer. Hand function and satisfaction level were evaluated with Jebsen Taylor Hand Function Test and Orthotics and Prosthetics Users Survey, respectively. All evaluations were conducted for each individual in 3 conditions (no orthosis, WO, and CB). Results: Extensor carpi radialis (ECR) muscle activation was greater when using CB compared with that when without orthosis (p = 0.036). There was no significant difference in extensor digitorum communis (EDC) muscle activation and maximum grip strength among the conditions (p > 0.05). Hand function was worse when using the WO compared with the other conditions (p < 0.001). In terms of orthosis satisfaction, individuals were found to be significantly more satisfied with the use of CB (p = 0.001). Conclusions: In our study highlight the use of CB in terms of EDC muscle activity, grip strength, hand function, and satisfaction, while the use of WO is prominent in terms of keeping extensor carpi radialis muscle activity low, which has been shown to be important for LE. To obtain definitive results on the effectiveness of different orthoses in the treatment of LE, more research is needed to compare the muscular activation in the extensor carpi radialis brevis (ECRB) and EDC muscles with objective methods.