Electrotherapeutic interventions for lateral epicondylalgia (LE)
| Intervention | Duration of LE (months) | Sample size (N) | INT (n) | Week | Global improvement (RR) | Pain (SMD) | MGS (SMD) | PFGS (SMD) |
|---|---|---|---|---|---|---|---|---|
| Summary of validity score, sample size, and effect size (95% confidence interval) for global improvement, pain, maximum grip strength (MGS), and pain-free grip strength (PFGS) for study time intervals on included interventions. Effect size measured as standardised mean difference (SMD) for continuous outcome measures and relative risk (RR) for dichotomous outcome measures. | ||||||||
| INT, Number of treatment sessions; Week, timing of outcome measures from baseline, x, no data available; ESWT, extracorporeal shock wave therapy; cortic, corticosteroid; NSAID, non-steroidal anti-inflammatory drug; US, ultrasound; CUS, continuous ultrasound; PUS, pulsed US; DF, deep friction massage. | ||||||||
| Laser | ||||||||
| Laser v placebo60 (NdYAG 204 mW/cm2) | 6.4 | 47 | 12 | 4 | 0.37 (−0.21 to 0.94) | −0.07 (−0.64 to 0.51) | ||
| 8 | 0.58 (−0.01 to 1.17) | −0.13 (−0.71 to 0.45) | ||||||
| Laser v placebo46 (GaAs 30 mW/830 nm) | 3 | 36 | 8 | 4 | 1.10 (0.63 to 1.91) | 0.08 (−0.58 to 0.73) | ||
| 10 | 0.91 (0.52 to 1.58) | 0.03 (−0.62 to 0.69) | ||||||
| Laser v placebo58 (HeNe 632.8 nm, 1.56 mW; GaAs 904 nm, 0.07 mW) | x | 57 | 8 | 6 | 1.08 (0.49 to 2.40) | |||
| 12 | 1.08 (0.49 to 2.40) | 0.98 (0.30 to 1.66) | 1.34 (0.63 to 2.06) | |||||
| Laser v placebo59 (GaAs, 904 nm, 1.5 mW, 3.5 J/cm2) | 3.5 | 30 | 8 | 3 | 7.00 (0.39 to 124.83) | |||
| 7 | 2.33 (0.74 to 7.35) | |||||||
| 26 | 1.21 (0.51 to 2.91) | |||||||
| Laser v placebo44 (HeNe 632.8 nm, 5 mW; GaAs 904 nm, 4 mW) | 5.5 | 58 | 10 | 3 | 1.60 (0.59 to 4.31) | −0.37 (−0.89 to 0.15) | ||
| 12 | 1.09 (0.61 to 1.98) | 0.48 (−0.12 to 1.07) | ||||||
| 26 | 1.65 (0.98 to 2.78) | 0.10 (−0.51 to 0.71) | ||||||
| 52 | 0.22 (−0.45 to 0.88) | |||||||
| Laser v placebo Haker (1991a) (GaAs 904 nm, 12 mW) | 9.5 | 49 | 10 | 3 | 0.47 (−0.10 to 1.04) | |||
| 12 | −0.11 (−0.66 to 0.43) | |||||||
| 52 | −0.29 (−0.92 to 0.33) | |||||||
| ESWT | ||||||||
| ESWT v placebo24 (2000 pulses) | 25 | 246 | 3 | 6 | 1.15 (0.75 to 1.77) | 0.00 (−0.25 to 0.25) | −0.10 (−0.35 to 0.15) | |
| 12 | 1.02 (0.66 to 1.56) | 0.00 (−0.25 to 0.25) | −0.11 (−0.36 to .015) | |||||
| 52 | 1.01 (0.82 to 1.23) | 0.13 (−0.15 to 0.41) | −0.03 (−0.31 to 0.25) | |||||
| ESWT v placebo25 (1500 pulses) | 14 | 71 | 3 | 4 | 0.21 (−0.26 to 0.68) | |||
| 8 | 0.01 (−0.45 to 0.48) | |||||||
| 12 | 1.01 (0.55 to 1.87) | 0.11 (−0.36 to 0.58) | ||||||
| Iontophoresis | ||||||||
| Iontophoresis+cortic v iontophoresis +saline63 (40 mA-minutes) | 2 | 199 | 6 | 2 4 | 1.18 (0.87 to 1.61) 1.11 (0.84 to 1.48) | 0.25 (−0.03 to 0.53) 0.12 (−0.18 to 0.41) | ||
| Iontophoresis+cortic v iontophoresis +saline49 (40 mA-minutes) | 5 | 41 | 4 | 1 12 26 | 0.84 (0.37 to 1.90) 0.93 (0.67 to 1.29) 0.93 (0.71 to 1.24) | |||
| NSAID ionisation v sham62 | ||||||||
| -High dose NSAID | x | 37 | 10 | 2 | 1.55 (1.09 to 2.20) | 1.63 (0.87 to 2.38) | ||
| - Low dose NSAID | x | 36 | 10 | 2 | 1.55 (1.09 to 2.20) | 1.76 (0.97 to 2.54) | ||
| Saline ionisation v sham62 | x | 34 | 10 | 2 | 1.18 (0.76 to 1.83) | 0.38 (−0.30 to 1.06) | ||
| US | ||||||||
| US v placebo57 (CUS 1 MHz, 1.0 W/cm2, 10 min) | >1 | 99 | 10 | 6 | 1.29 (0.78 to 2.13) | |||
| 12 | 1.20 (0.60 to 2.38) | 1.32 (0.78 to 1.85) | −0.23 (−0.71 to 0.26) | |||||
| US v placebo45 (PUS 1:4, 1.0 MHz, 1.0 W/cm2) | >1 | 43 | 10 | 4 | −0.31 (−0.92 to 0.29) | |||
| 12 | 0.84 (0.41 to 1.71) | −0.26 (−1.71 to 1.19) | ||||||
| 52 | −0.23 (−0.92 to 0.47) | |||||||
| US v control57 (CUS 1 MHz, 1.0 W/cm2, 10 min) | >1 | 99 | 10 | 12 | 1.50 (0.71 to 3.19) | 1.68 (1.11 to 2.24) | 0.78 (0.28 to 1.28) | |
| Phonophoresis v US18 (PUS 1:4, 0.5–1.3 w/cm2) | 4 | 40 | 9 | 5 | 2.70 (0.34 to 21.53) | 0.25 (−0.66 to 1.15) | 0.32 (−0.59 to 1.23) | |
| US/DF v US18 (PUS 1:4, 0.5–1.3 w/cm2) | 4 | 40 | 9 | 5 | 3.27 (0.44 to 24.34) | 0.58 (−0.33 to 1.48) | 0.32 (−0.57 to 1.21) | |