Effects of Low-Level Laser and Plyometric Exercises in the Treatment of Lateral Epicondylitis

Stergioulas, Apostolos

doi:10.1089/pho.2007.2041

Cited by 69 publications

(96 citation statements)

References 40 publications

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“…Future studies should be conducted using ultrasound and eccentric training in the management of LET, in order to find out whether the combination of the two treatments is more effective than the eccentric training alone in the management of LET. Similar studies have been conducted for other physical modalities such as low level laser therapy [39]. These studies showed that using a therapeutic modality with eccentric training, patients with LET managed quicker.…”

Section: Limitationssupporting

confidence: 59%

Are there Effective Ultrasound Parameters in the Management of Lateral Elbow Tendinopathy? A Systematic Review of the Literature

Stasinopoulos¹

2013

Int J Phys Med Rehabil

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Section: Limitationssupporting

confidence: 59%

Are there Effective Ultrasound Parameters in the Management of Lateral Elbow Tendinopathy? A Systematic Review of the Literature

Stasinopoulos¹

2013

Int J Phys Med Rehabil

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“…We identified one relevant RCT not currently included in a systematic review; 186 this was a placebo-controlled study and had a sample size of 47 participants, thus, on its own, it may have limited impact on the existing recommendations regarding this intervention. 156,158,186 In addition, we identified three RCTs included in intermediate-/low-quality reviews. 153,156,158 As there is insufficient evidence to demonstrate either benefit or lack of effect of laser for LET, and given there are recent RCTs (2003-13) we recommend that an updated systematic review may be of benefit.…”

Section: Laser Therapymentioning

confidence: 99%

“…156,158,186 In addition, we identified three RCTs included in intermediate-/low-quality reviews. 153,156,158 As there is insufficient evidence to demonstrate either benefit or lack of effect of laser for LET, and given there are recent RCTs (2003-13) we recommend that an updated systematic review may be of benefit. However, some consideration should also be given to conducting good-quality RCTs.…”

Section: Laser Therapymentioning

confidence: 99%

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

Long

Briscoe

Cooper

et al. 2015

Health Technology Assessment

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BackgroundLateral elbow tendinopathy (LET) is a common complaint causing characteristic pain in the lateral elbow and upper forearm, and tenderness of the forearm extensor muscles. It is thought to be an overuse injury and can have a major impact on the patient’s social and professional life. The condition is challenging to treat and prone to recurrent episodes. The average duration of a typical episode ranges from 6 to 24 months, with most (89%) reporting recovery by 1 year.ObjectivesThis systematic review aims to summarise the evidence concerning the clinical effectiveness and cost-effectiveness of conservative interventions for LET.Data sourcesA comprehensive search was conducted from database inception to 2012 in a range of databases including MEDLINE, EMBASE and Cochrane Databases.Methods and outcomesWe conducted an overview of systematic reviews to summarise the current evidence concerning the clinical effectiveness and a systematic review for the cost-effectiveness of conservative interventions for LET. We identified additional randomised controlled trials (RCTs) that could contribute further evidence to existing systematic reviews. We searched MEDLINE, EMBASE, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Web of Science, The Cochrane Library and other important databases from inception to January 2013.ResultsA total of 29 systematic reviews published since 2003 matched our inclusion criteria. These were quality appraised using the Assessment of Multiple Systematic Reviews (AMSTAR) checklist; five were considered high quality and evaluated using a Grading of Recommendations, Assessment, Development and Evaluation approach. A total of 36 RCTs were identified that were not included in a systematic review and 29 RCTs were identified that had only been evaluated in an included systematic review of intermediate/low quality. These were then mapped to existing systematic reviews where further evidence could provide updates. Two economic evaluations were identified.LimitationsThe summary of findings from the review was based only on high-quality evidence (scoring of > 5 AMSTAR). Other limitations were that identified RCTs were not quality appraised and dichotomous outcomes were also not considered. Economic evaluations took effectiveness estimates from trials that had small sample sizes leading to uncertainty surrounding the effect sizes reported. This, in turn, led to uncertainty of the reported cost-effectiveness and, as such, no robust recommendations could be made in this respect.ConclusionsClinical effectiveness evidence from the high-quality systematic reviews identified in this overview continues to suggest uncertainty as to the effectiveness of many conservative interventions for the treatment of LET. Although new RCT evidence has been identified with either placebo or active controls, there is uncertainty as to the size of effects reported within them because of the small sample size. Conclusions regarding cost-effectiveness are also unclear. We consider that, although updated or new systematic reviews may also be of value, the primary focus of future work should be on conducting large-scale, good-quality clinical trials using a core set of outcome measures (for defined time points) and appropriate follow-up. Subgroup analysis of existing RCT data may be beneficial to ascertain whether or not certain patient groups are more likely to respond to treatments.Study registrationThis study is registered as PROSPERO CRD42013003593.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…However, there is still no approved evidence-based treatment method for lateral epicondylitis [3,5,15]. One of the widely-suggested treatments which has been used in past two decades leading to reduce pain in musculoskeletal disorders with various etiologies is Low Level Laser Therapy (LLLT) [16]. Physiotherapists apply the LLLTs in different cases such as carpal tunnel syndrome, joint disorders, tendinopathy, medial/lateral epicondylitis, osteoarthritis, back pain, ankle sprains, venous ulcers, and diabetes [16].…”

Section: Introductionmentioning

confidence: 99%

“…One of the widely-suggested treatments which has been used in past two decades leading to reduce pain in musculoskeletal disorders with various etiologies is Low Level Laser Therapy (LLLT) [16]. Physiotherapists apply the LLLTs in different cases such as carpal tunnel syndrome, joint disorders, tendinopathy, medial/lateral epicondylitis, osteoarthritis, back pain, ankle sprains, venous ulcers, and diabetes [16]. Low level or cold laser therapy with a wavelength of 904 nm has less than 500 mW power and high level laser with similar wavelength has a power higher than 500 mW.…”

Section: Introductionmentioning

confidence: 99%

Effects of Gallium Arsenide Laser on Pain and Grip Strength in Patients With Tennis Elbow

Olyaei

Tajali

Mansouri

et al. 2017

Journal of Modern Rehabilitation

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Introduction:Tennis elbow (Lateral Epicondylitis) is one the most common elbow and arm musculoskeletal disorders. About 1% to 3% of active population in modern societies suffer from tennis elbow. Tennis elbow is usually caused by repetitive activities of hand and wrist, especially wrist extension and forearm supination. This research aimed to study high and also medium power gallium arsenide (Ga-As) laser irradiation on improving pain and grip strength (functional mobility) in patients with tennis elbow. Materials and Methods:Thirty female [Mean(SD) age: 49(2.3) y] patients with acute tennis elbow were recruited for this study. The patients were randomly divided into two groups based on random allocation table. Group A (15 patients) had been received 10 J/cm 2 under a 0.5 W beam medium power Ga-As laser irradiation of 980 nm wave length. Group B (15 patients) had been received same energy density under 2 W beam high Ga-As laser irradiation with the same wavelength. Laser irradiation was performed on a 9 cm 2 surface of lateral elbow epicondyle based on Grid laser application technique. The patients were under treatment for 10 sessions every other day. The outcome measures of pain at rest and ring finger extension against loading, grip strength and hand function were recorded and analyzed in a pre-and post-setting. The pain severity was measured by VAS (Visual Analog Scale) and McGill questionnaire and upper extremity function was measured by DASH questionnaire.Results: Significant pain reduction was observed in resting position and ring finger extension against loading after application of both high and medium power (980 nm, 0.5-2 W) laser therapy (P<0.05) for 10 sessions. High power laser irradiation could also increase grip strength and mobility in patients with lateral epicondylitis (P<0.05). Conclusion:High and low power Ga-As laser irradiation may improve pain and grip strength in patients with acute tennis elbow.

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Effects of Low-Level Laser and Plyometric Exercises in the Treatment of Lateral Epicondylitis

Cited by 69 publications

References 40 publications

Are there Effective Ultrasound Parameters in the Management of Lateral Elbow Tendinopathy? A Systematic Review of the Literature

Are there Effective Ultrasound Parameters in the Management of Lateral Elbow Tendinopathy? A Systematic Review of the Literature

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

Effects of Gallium Arsenide Laser on Pain and Grip Strength in Patients With Tennis Elbow

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