RT Journal Article
SR Electronic
T1 14 Isometric exercise or wait-and-see on pain, disability and global improvement in patients with lateral epicondylalgia: a randomised clinical trial
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP A5
OP A6
DO 10.1136/bjsports-2018-099334.14
VO 52
IS Suppl 1
A1 Viana Vuvan
A1 Bill Vicenzino
A1 Rebecca Mellor
A1 Luke Heales
A1 Brooke Coombes
YR 2018
UL http://bjsm.bmj.com/content/52/Suppl_1/A5.3.abstract
AB Introduction There is evidence of benefit for multimodal treatments including exercise in the management of lateral epicondylalgia (LE), but little is known of the effects of isometric exercise alone. We investigated the effect of an 8 week home program of graded isometric exercise compared to wait-and-see on clinical outcomes in people with unilateral LE.Methods Forty patients with LE were randomised to either wait-and-see (n=19) or an 8 week home exercise program (n=21). During a single session, patients assigned to exercise were instructed to complete a standardised daily program of isometric wrist extension with weekly increase in exercise volume. Primary outcomes were global rating of change (GROC) and Patient-rated Tennis Elbow Evaluation (PRTEE) at 8 weeks. Secondary outcomes were pain on an 11-point numerical rating scale, pain-free grip force, and thermal and pressure pain thresholds as a measure of nervous system sensitisation at 8 weeks.Results The home exercise group had lower PRTEE scores at 8 weeks compared to the wait–and-see group (standardised mean difference: 0.86, 95% confidence interval 0.2 to 1.5). No significant differences were observed between groups for all other measures.Conclusion Compared to wait-and-see, a home program of graded isometric exercise improved a validated measure of pain and disability for patients with LE. Success rates in both groups for the 8 week trial were comparable to wait-and-see in previous clinical trials, suggesting exercise alone may be insufficient in improving GROC. Isometric exercise may not have an effect on nervous system sensitisation in patients with LE.