Non-electrotherapeutic interventions for lateral epicondylalgia (LE)
| Intervention | Duration of LE (months) | Sample size (N) | INT (n) | Week | Pain (SMD) | MGS (SMD) | PFGS (SMD) | Pressure pain threshold (SMD) |
|---|---|---|---|---|---|---|---|---|
| Summary of validity score, sample size, and effect size (95% confidence interval) for pain, maximum grip strength (MGS), pain-free grip strength (PFGS), and pressure pain threshold for study time intervals on included interventions. Effect size measured as standardised mean difference (SMD) for continuous outcome measures. | ||||||||
| *Global improvement at 6 weeks (relative risk (RR) 1.27 (95% CI 0.83 to 1.94)), †global improvement after treatment (RR 3.17 (95% CI 1.54 to 6.52) for papers presenting global improvement data. 0, Immediately after treatment; 30 m2, 30 minutes after treatment. | ||||||||
| INT, Number of treatment sessions; Week, timing of outcome measures from baseline; US, ultrasound; MWM, mobilisations with movement. | ||||||||
| Exercise | ||||||||
| Stretching+exercise v US+friction massage56 | >3 | 36 | 12 | 6–8 | 0.66 (0.01 to 1.31) | 0.52 (−0.12 to 1.16) | ||
| Manipulations | ||||||||
| MWM v placebo21 | 9 | 24 | 1 | 0 | 1.34 (0.70 to 1.97) | 0.36 (−0.21 to 0.93) | ||
| MWM v placebo23 | 8 | 24 | 1 | 0 | 1.23 (0.61 to 1.85) | 0.63 (0.04 to 1.21) | ||
| MWM v control21 | 9 | 24 | 1 | 0 | 1.63 (0.97 to 2.29) | 0.67 (0.09 to 1.25) | ||
| MWM v control23 | 8 | 24 | 1 | 0 | 1.51 (0.86 to 2.16) | 0.24 (−0.32 to 0.81) | ||
| Cervical glide v placebo19 | 8 | 15 | 1 | 0 | 0.84 (0.09 to 1.59) | 0.26 (−0.46 to 0.98) | 1.02 (0.25 to 1.79) | |
| Cervical glide v control | 8 | 15 | 1 | 0 | 0.12 (−0.60 to 0.84) | 0.72 (−0.02 to 1.46) | ||
| Wrist manipulation v US+friction massage+exercises22* | 3 | 28 | 9 | 6 | 0.87 (0.08 to 1.65) | 0.19 (−0.55 to 0.94) | 0.43 (−0.32 to 1.19) | 0.59 (−0.17 to 1.35) |
| Orthotics | ||||||||
| Orthotic v corticosteroid injection47 | 3 | 30 | 1–2 | 6 | 0.00 (−0.72 to 0.72) | 0.15 (−0.57 to 0.87) | ||
| Orthotic v placebo orthotic (DePuy)51 | 7 | 50 | 1 | 0 | 0.11 (−0.29 to 0.50) | −0.03 (−0.42 to 0.36) | ||
| Orthotic v placebo orthotic (Airprene)51 | 7 | 50 | 1 | 0 | 0.10 (−0.29. 0.50) | −0.06 (−0.45 to 0.34) | ||
| Tape | ||||||||
| Tape v placebo52 | 13 | 16 | 1 | 0 | 0.61 (−0.11 to 1.32) | 0.85 (0.13 to 1.58) | ||
| 30 m2 | 0.57 (−0.14 to 1.28) | 0.66 (−0.05 to 1.38) | ||||||
| Tape v control52 | 13 | 16 | 1 | 0 | 0.71 (0.00 to 1.43) | 0.72 (0.00 to 1.44) | ||
| 30 m2 | 0.72 (0.00 to 1.44) | 0.83 (0.11 to 1.56) | ||||||
| Acupuncture | ||||||||
| Acupuncture v placebo/sham55 | 9 | 42 | 10 | 2 | 0.78 (0.15 to 1.41) | 0.74 (0.11 to 1.37) | ||
| 8 | 0.45 (−0.18 to 1.08) | 0.55 (−0.09 to 1.18) | ||||||
| Acupuncture v placebo/sham48 | 9 | 42 | 10 | 2 | 0.86 (0.23 to 1.50) | |||
| 8 | 0.31 (−0.31 to 0.93) | |||||||
| 52 | 0.44 (−0.30 to 1.18) | |||||||
| Acupuncture v placebo/sham53† | 15 | 48 | 1 | 0 | 0.92 (0.32 to 1.52) | |||
| Acupuncture v US54 | 6 | 16 | 8 | 4 | 0.79 (−0.24 to 1.82) | 0.18 (−0.80 to 1.17) | ||