Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: A prospective randomized trial
Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: A prospective randomized trial
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DOI：
10.1016/j.jse.2010.04.041
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发表时间：
2010-09-01
影响因子：
3
通讯作者：
McHugh, Malachy P.
中科院分区：
文献类型：
--
作者：
Tyler, Timothy F.;Thomas, Gregory C.;McHugh, Malachy P.
背景：腕伸肌的等速离心训练最近被证明是治疗慢性外上髁病的有效方法。然而，等速测力法在日常运动处方中并不广泛使用或实用。因此，本研究的目的是评估一种新的偏心腕伸肌训练加标准治疗慢性外上髁的疗效。材料和方法：21例慢性单侧外上髁患者随机分为偏心训练组（n = 11，6男，5女;年龄47 ± 2岁）和标准治疗组（n = 10，4男，6女;年龄51 ± 4岁）。在基线和治疗期后记录DASH问卷、VAS、压痛测量以及手腕和中指伸展。结果：两组在症状持续时间方面没有差异（偏心6 +/- 2个月vs标准8 +/- 3个月，P = 0.7）、物理治疗访视次数（9 +/- 2 vs 10 +/- 2，P = 0.81）或治疗持续时间（7.2 +/- 0.8 wk vs 7.0 +/- 0.6 wk，P = 0.69）。与标准治疗组相比，偏心组所有因变量的改善更大（报告的改善百分比）：DASH 76% vs 13%，P = .01; VAS 81% vs 22%，P = .002;压痛71% vs 5%，P = .003;力量（腕关节和中指伸展联合）79%vs15%，P = 0.011。讨论：在标准物理治疗的基础上增加偏心腕伸肌锻炼，慢性外上髁病的所有结果指标均得到显著改善。这种新颖的运动，使用廉价的橡胶棒，提供了一个实用的手段，增加孤立离心训练的治疗慢性外上髁。证据等级：I级，随机对照试验，治疗研究。(C)2010肩肘外科杂志董事会。
Background: Isokinetic eccentric training of the wrist extensors has recently been shown to be effective in treating chronic lateral epicondylosis. However, isokinetic dynamometry is not widely available or practical for daily exercise prescription. Therefore, the objective of this study was to assess the efficacy of a novel eccentric wrist extensor exercise added to standard treatment for chronic lateral epicondylosis.Materials and methods: Twenty-one patients with chronic unilateral lateral epicondylosis were randomized into an eccentric training group (n = 11, 6 men, 5 women; age 47 +/- 2 yr) and a Standard Treatment Group (n = 10,4 men, 6 women; age 51 +/- 4 yr). DASH questionnaire, VAS, tenderness measurement, and wrist and middle finger extension were recorded at baseline and after the treatment period.Results: Groups did not differ in terms of duration of symptoms (Eccentric 6 +/- 2 mo vs Standard 8 +/- 3 mos., P = .7), number of physical therapy visits (9 +/- 2 vs 10 +/- 2, P = .81) or duration of treatment (7.2 +/- 0.8 wk vs 7.0 +/- 0.6 wk, P = .69). Improvements in all dependent variables were greater for the Eccentric Group versus the Standard Treatment Group (percent improvement reported): DASH 76% vs 13%, P = .01; VAS 81% vs 22%, P = .002, tenderness 71% vs 5%, P = .003; strength (wrist and middle finger extension combined) 79% vs 15%, P = .011.Discussion: All outcome measures for chronic lateral epicondylosis were markedly improved with the addition of an eccentric wrist extensor exercise to standard physical therapy. This novel exercise, using an inexpensive rubber bar, provides a practical means of adding isolated eccentric training to the treatment of chronic lateral epicondylosis.Level of evidence: Level I, Randomized Controlled Trial, Treatment Study. (C) 2010 Journal of Shoulder and Elbow Surgery Board of Trustees.