Evidence for effectiveness of exercise therapy and mobilisation therapy for lateral epicondylitis*
| Exercise therapy | Mobilisation techniques | ||
|---|---|---|---|
| Stretching and strengthening exercises | Manipulation of the cervical or thoracic spine | ||
| ▸ Stretching plus strengthening exercises† vs ultrasound plus friction massage | ▸ Manipulation cervical spine† vs placebo or control | ||
| Short-term: | ++ | Short-term (immediately after treatment): | ± |
| ▸ Stretching plus strengthening exercises† vs ultrasound | ▸ Oscillatory manipulation cervical spine† vs placebo vs control | ||
| Long-term: | + | Short-term (immediately after treatment): | NE |
| Concentric vs eccentric exercises | ▸ Manipulation cervical and thoracic spine† as add on therapy to concentric and eccentric stretching plus mobilisation of the wrist and forearm | ||
| ▸ Conservative therapy vs concentric strengthening vs eccentric strengthening as add on to stretching: | Short-term: | ++ | |
| Short-term: | NE | Mid-term: | ++ |
| Stretching versus eccentric† exercises | Manipulation of the elbow | ||
| ▸ Stretching† vs eccentric exercises: | ▸ Mobilisation of the radial head and nerve vs ultrasound plus friction massage plus stretching and strengthening of the wrist extensors | ||
| Short-term: | NE | Short-term: | NE |
| Mid-term: | + | ▸ Mulligan mobilisation† as add on therapy to ultrasound and graduated exercises | |
| Long-term: | NE | Short-term: | + |
| Exercise therapy plus mobilisation techniques | ▸ Lateral-glide mobilisation with movement treatment technique of the elbow† vs placebo vs control | ||
| ▸ Chiropractic therapy plus strengthening exercises vs ultrasound† | Short-term (immediately after treatment): | + | |
| Short-term: | + | ▸ Lateral-glide mobilisation with movement treatment technique of the elbow: 1.2 N vs 1.9 N vs 2.5 N vs 3.8 N | |
| Short-term (immediately after treatment): | |||
| 2.5 N† vs 1.2 N or 1.9 N: | + | ||
| 3.8 N vs 2.5 N: | NE | ||
| ▸ Oscillating energy manual therapy of the elbow† vs placebo | |||
| Short-term: | + | ||
| Manipulation of the wrist | |||
| ▸ Manipulation of the wrist† vs ultrasound plus friction massage plus stretching and strengthening exercises | |||
| Short-term: | + |
*For medial epicondylitis no RCTs on exercise therapy or mobilisation techniques were found.
†In favour of.
+, limited evidence found; ++, moderate evidence found; ±, conflicting evidence for effectiveness; NE, no evidence found for effectiveness of the treatment: RCT(s) available, but no differences between intervention and control groups were found.