Pain intensity, pain-free grip strength and elbow disability (DASH) for eccentric exercise compared with concentric (±eccentric) exercises with or without physiotherapy or home exercise programme
| Outcomes | No of studies | Comparisons | Effects estimate (95% CI), P value | Certainty (GRADE) | Heterogeneity | |
| Average estimate/assumed risk in eccentric group | Average estimate/assumed risk in concentric (±eccentric) group | |||||
|
Mean change in pain rating
Short-term follow-up | 3 | Mean pain score was 22.6 (range 13.0 to 29.0) in 49 participants | Mean pain score was 35.7 (range 26.0 to 49.0) in 48 participants |
SMD −0.49*
(−1.17 to 0.19), p=0.16 |
⊕
Very low†‡§¶ | χ2=4.79, I2=58%, p=0.09 |
|
PFGS
Short-term follow-up | 2 | Mean pain-free grip strength was 37.0 (range 26.0 to 64.0) in 38 participants | Mean pain-free grip strength was 38.4 (range 25.0 to 67.5) in 38 participants |
MD −1.99
(−6.15 to 2.18), p=035 |
⊕⊕
Low†§ | χ2=1.07, I2=6%, p=0.30 |
|
Elbow disability
Very short-term follow-up | 2 | Mean score was 14.0 (range 9.0 to 16.0) in 38 participants | Mean score was 21.4 (range 17.0 to 33.0) in 36 participants |
MD −10.92
(−33.25 to 11.4), p=0.34 |
⊕
Very Low†‡§ | χ2=5.07, I2=80%, p=0.02 |
Values for PFGS are presented in pounds (lb).
*Pooled weighted baseline pain was 55.8—clinically significant difference 16.7 points change on pain scale (0–100); pooled weighted SD at short-term was 21.0 points.
†High risk of bias.
‡Inconsistent results between included studies.
§Indirect comparison in one or more included studies.
¶Substantial differences at baseline pain among included studies.
DASH, Disability of the Arm, Shoulder and Hand; GRADE, Grading of Recommendations Assessment, Development and Evaluation; HEP, home exercise programme; MD, mean difference; PFGS, pain free grip strength; PT, physiotherapy; SMD, standardised mean difference.