Influence of expectations plus mobilization with movement in patient with lateral epicondylalgia: a pilot randomized controlled trial

Abstract

The aim of this study was to determine the influence of expectations plus mobilization with movement (MWM) in kinesiophobia, perceived disability and sensorimotor variables in patients with lateral epicondylalgia. A pilot randomized controlled trial in 24 patients with lateral epicondylalgia was conducted. Perceived pain, pain-free grip strength, pressure pain detection threshold, kinesiophobia measured with the short version of Tampa Scale of Kinesiophobia, perceived disability of the upper limb measured with disability of the arm, hand and shoulder questionnaire, and perceived disability specifically for the elbow joint measured with patient-rating tennis elbow evaluation, and also satisfaction were assessed. Participants were randomized to receive written instructions in order to create positive expectations regarding the technique in one group (n=12) or neutral expectations in the other one (n=12). All patients were treated for three sessions with the MWM technique. Measures were recorded before and after treatment. The effect size was calculated by Rosenthal “r” for nonparametrical tests. There were no significant statistical differences (P>0.05) between groups after receiving the treatment for none of the physical analyzed variables. The Wilcoxon test showed statistically significant changes in kinesiophobia (Z=−2.278, r=0.47, P=0.023) and perceived disability (Z= −2.934, r=0.61, P=0.003) within positive expectations group. In conclusion this pilot study shows that a positive expectation almost given in a sealed envelope before treatment plus MWM produced changes in kinesiophobia and perceived disability in the immediate term, in patients with lateral epicondylalgia.

The influence of a cognitive behavioural approach on changing patient expectations for conservative care in shoulder pain treatment: a protocol for a pragmatic randomized controlled trial

“…Despite recognition that patient expectations has a role in influencing functional outcomes and the decision to pursue surgical care in patients with RCRSP [8-10], there have been few studies designed to test interventions designed to change expectations [15,16]. Research has shown that the best predictor of functional outcomes with a conservative approach are pre-treatment, patient expectations [15,61].…”

“…Patient expectations are beliefs or attitudes that include pre-treatment thoughts and beliefs regarding the need for specific treatment methods and the timing and intensity of these methods. Brief interventions designed to alter and enhance treatment expectations for conservative treatment appear to result in slight improvements in expectations [15,16], but not outcomes. The few interventions that have been tested have methodological problems including the failure to attend to issues of treatment fidelity and reliance on overly simplistic methods for altering expectations such as a patient handout or a one-time educational program [15,16].…”

A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis

“…Thirty-one studies were included in the final analysis (Beltran-Alacreu et al, 2015 ; Hidalgo et al, 2015 ; Pires et al, 2015 ; Sarig Bahat et al, 2015 ; Castro-Sánchez et al, 2016 ; Pillastrini et al, 2016 ; Cruz-Díaz et al, 2017 ; Martínez-Cervera et al, 2017 ; Yilmaz Yelvar et al, 2017 ; Birinci et al, 2019 ; Gholami et al, 2020 ). The identification process is shown by a flow diagram in Figure 1 (Moher et al, 2009 ).…”

Effects of concentric contraction of the wrists and transcutaneous electrical nerve stimulation cycle on pain and muscle strength in lateralepicondylitis patients

“…Patients with lateral epicondylitis experience decreased grip strength as a result of pain. Grip strength is associated with decrease in bone density in women and may be used to predict early death rates, onset of a disability, post-operative complications, and decreased cognitive ability in elderly people 14 ) . This study examined the effects of active concentric contraction of the wrist flexors and extensors according to the utilized stimulation frequency of TENS on pain and grip strength in patients with lateral epicondylitis.…”