Effects of eccentric training on hand strength in subjects with lateral epicondylalgia: a randomized‐controlled trial

Abstract

The main aim of this study was to evaluate the short-term effects of daily eccentric exercises on functional pain-free hand strength in subjects with long-term lateral epicondylalgia. Forty-two subjects with lateral epicondylalgia were randomly assigned either to a 6-week home exercise regimen receiving eccentric training for their wrist extensors and a forearm band or to a control group receiving a forearm band only. The main outcomes were pain-free hand-grip and wrist-extensor strength at mid- and end-intervention follow-ups, 3 and 6 weeks after inclusion, respectively. Secondary outcomes were a change in the proportion of cases with epicondylalgia and ratings of perceived pain (VAS) at follow-up. Thirty-seven (88%) subjects completed both the mid- and the end-intervention follow-up. Exercise members had significantly higher pain-free hand-grip (P=0.025) and wrist-extensor strength (P<0.001) at the end of follow-up, although there was no such effect at mid-intervention. Regression analysis showed a reduction in the proportion of cases in the exercise group at the end of follow-up (P=0.035). However, no between-groups effect emerged for perceived pain. These data suggest that the daily home eccentric exercise regimen is effective in increasing functional pain-free grip strength and reducing cases suffering from lateral epicondylalgia. However, no effect emerged for global perceived pain during the last week.

What is the clinical effectiveness and cost-effectiveness of conservative interventions for tendinopathy? An overview of systematic reviews of clinical effectiveness and systematic review of economic evaluations

“…Given the paucity of the available data (one RCT with moderate-quality evidence for pain relief in the intermediate term 112 ), the overall low level of evidence as determined using the GRADE principles (see Table 24) and the subsequent publication of four relevant RCTs, 18,164,166,172 we conclude that there is insufficient evidence at present to demonstrate either benefit or lack of effect of exercises for LET. All of the subsequent RCTs identified are recent publications 18,164,166,172 In addition, seven RCTs were identified that were included in an intermediate-/low-quality systematic review.…”

“…All of the subsequent RCTs identified are recent publications 18,164,166,172 In addition, seven RCTs were identified that were included in an intermediate-/low-quality systematic review. 137,141,149,151,157,162,163 An updated, good-quality systematic review of exercises for LET is needed before stronger recommendations can be made; however, we suggest that some consideration should also be given to conducting large-scale, good-quality RCTs of clearly defined exercise modalities with sufficient follow-up periods (to 1 year).…”

Ejercicio terapéutico para epicondilalgia lateral: revisión sistemática

“…Sobre la base de los criterios de selección de nuestra RS, sólo 36 artículos fueron incluidos (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)27,29,31,(33)(34)(37)(38)(39)(40)(43)(44)(45)61,(73)(74)(75)(82)(83)(84). El riesgo de sesgo se evaluará utilizando la herramienta propuesta en el "Cochrane Handbook" para Ensayos Clínicos Aleatorizados (91).…”

“…En base a los resultados de nuestra búsqueda agrupamos los artículos seleccionados en las siguientes comparaciones: ejercicio terapéu-tico sólo versus otra intervención sola (15,18,33,61), ejercicio terapéutico sólo versus un programa de tratamiento (7,9,12,17,19,20,29,34,37,39,43,45,(73)(74)(75) y programa de tratamiento que incluya ejercicio terapéuti-co versus otro programa de tratamiento (8,11,14,16,(21)(22)(23)25,27,31,38,40,44,(82)(83)(84).…”

“…Se define como un síndrome de dolor en el área del epicóndilo lateral (3)(4)(5), causado por el exceso de movimientos repetitivos, rápidos y monótonos (6)(7)(8)(9), teniendo como principales síntomas el dolor, la disminución de la función de agarre y resistencia en la flexión dorsal de muñeca (10)(11)(12). Esta condición músculo esquelé-tica afecta principalmente entre 1-3% de la población general (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), incrementándose a un 15 % en trabajadores de industrias que requieren tareas manuales repetitivas (24). Además, aunque ocurre en todas las edades (25), afecta predominantemente entre los 30 y 60 años (2,26,27).…”