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A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia
  1. L Bisset1,
  2. A Paungmali1,
  3. B Vicenzino2,
  4. E Beller3
  1. 1Division of Physiotherapy, University of Queensland, St Lucia, Queensland, Australia
  2. 2Musculoskeletal Pain and Injury Research Unit, Division of Physiotherapy, University of Queensland
  3. 3Queensland Clinical Trials Centre, University of Queensland
  1. Correspondence to:
 Dr Vicenzino
 Division of Physiotherapy, University of Queensland, St Lucia, QLD 4072, Australia; b.vicenzinouq.edu.au

Abstract

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.

  • CI, confidence interval
  • ESWT, extracorporeal shock wave therapy
  • LE, lateral epicondylalgia
  • MGS, maximum grip strength
  • MWM, mobilisations with movement
  • NSAID, non-steroidal anti-inflammatory drug
  • PFGS, pain-free grip strength
  • PVAS, pain visual analogue scale
  • RCT, randomised controlled trial
  • RR, relative risk
  • SMD, standardised mean difference
  • US, ultrasound
  • tennis elbow
  • systematic review
  • lateral epicondyle
  • physiotherapy
  • randomised controlled trial

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Footnotes

  • Financial support: The University of Queensland Research Development Scheme; National Health and Medical Research Council Project Grant No 252710.

  • Competing interests: none declared