Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia
Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia
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DOI：
10.1034/j.1600-0838.2001.110603.x
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发表时间：
2001-12-01
影响因子：
4.1
通讯作者：
Adolfsson, L
中科院分区：
文献类型：
--
作者：
Svernlöv, B;Adolfsson, L
在一项初步研究中，38例肱骨外上髁痛患者被随机分配到两个治疗组。S组（牵拉组）采用收缩-放松-牵拉程序，E组（离心运动组）采用离心运动程序。两组人每晚都接受前臂带和手腕支撑。这些程序在12周内每天在家中进行。评价前和3。治疗后6个月和12个月，包括使用视觉模拟量表和握力测量对症状进行主观评估。35例患者可接受随访。5名患者（S组3名，E组2名）由于疼痛加重而未完成治疗，而30名（86%）患者报告完全康复或改善。两个治疗组均观察到疼痛减轻和握力增加，但E组17名患者中有12名（71%）认为自己完全康复，而S组18名患者中有7名（39%）认为自己完全康复（P=0.09），E组6个月后握力的增加在统计学上显着大于S组。在第二项研究中，离心训练方案被用于连续系列的129例外侧上髁痛患者。患者被分为两组，一组由症状持续时间少于一年的患者组成，另一组由症状持续时间超过一年的患者组成。治疗结果以与初步研究相同的方式进行评价，并且在3.4年后使用Verhaar等人的评分系统进行评价。治疗期结束时，所有VAS记录和握力均出现统计学显著性改善。3.4年后，根据评分，38%的结果为优，28%为良，25%为可，9%为差。在自评结果中，54%认为自己完全康复，43%改善，2%不变，2%恶化。症状持续时间超过一年的患者与症状持续时间不到一年的患者之间没有显著差异。离心训练方案可以大大减轻大多数肱骨外上髁痛患者的症状，无论持续时间长短，并且可能上级传统的拉伸。
In a pilot study 38 patients with lateral humeral epicondylalgia were randomly allocated to two treatment groups. Group S (stretching) was treated with a contract-relax-stretching program while group E (eccentric exercise) underwent an eccentric exercise program. Both groups also received forearm bands and wrist support nightly. The programs were carried out daily at home during 12 weeks. Evaluation before and 3. 6 and 12 months after treatment, included subjective assessment of symptoms using visual analogue scales and grip strength measurements. Thirty-five patients were available for follow-up. Five patients, three in group S and two in group E, did not complete the programs due to increased pain while 30 (86%) reported complete recovery or improvement. Reduced pain and increased grip strength were seen in both treatment groups but 12 out of 17 patients (71%) in group E rated themselves as completely recovered as compared to 7 out of 18 (39%) in group S (P=0.09), and in group E the increase in grip strength after 6 months was statistically significantly larger than in group S. In a second study the eccentric training regime was used in a consecutive series of 129 patients with lateral epicondylalgia. The patients were divided into two groups with one group consisting of patients with less than one year duration of symtoms and the other comprised patients with a duration of symptoms for more than one year. The results of treatment were evaluated in the same way as in the pilot study, and also after 3.4 years using the scoring system by Verhaar et at. At the end of the treatment period statistically significant improvements were seen in all VAS recordings and in grip strength. After 3.4 years 38% had excellent, 28% good, 25% fair and 9% poor results according to the score. In the self-rated outcome 54% regarded themselves as completely recovered, 43% improved, 2% unchanged and 2% worse. No significant differences were seen between patients with a duration of symptoms for more than one year compared to patients with symptoms for less than one year. The eccentric training regime can considerably reduce symptoms in a majority of patients with lateral humeral epicondylalgia, regardless of duration, and is possibly superior to conventional stretching.