The Elbow-EpiTrainer : A method of delivering graded resistance to the extensor carpi radialis brevis. Effectiveness of a prototype device in a healthy population

This document is the Accepted Manuscript version of the following article: Navsaria R, Ryder DM, Lewis JS, et al, 'The Elbow-EpiTrainer: a method of delivering graded resistance to the extensor carpi radialis brevi:. Effectiveness of a prototype device in a healthy population', British Journal of Sports Medicine, Vol. 49(5):318-322, March 2015, available online at: http://bjsm.bmj.com/content/49/5/318. Published by the BMJ Publishing Group Limited.Background: Tennis elbow or lateral epicondylopathy (LE) is experienced as the lateral elbow has a reported prevalence of 1.3%, with symptoms lasting up to 18 months. LE is most commonly attributed to tendinopathy involving the extensor carpi radialis brevis (ECRB) tendon. The aim of tendinopathy management is to alleviate symptoms and restore function that initially involves relative rest followed by progressive therapeutic exercise. Objective: To assess the effectiveness of two prototype exercises using commonly available clinical equipment to progressively increase resistance and activity of the ECRB. Method: Eighteen healthy participants undertook two exercise progressions. Surface electromyography was used to record ECRB activity during the two progressions, involving eccentric exercises of the wrist extensors and elbow pronation exercises using a prototype device. The two progressions were assessed for their linearity of progression using repeated ANOVA and linear regression analysis. Five participants repeated the study to assess reliability. Results: The exercise progressions led to an increase in ECRB electromyographic (EMG) activity (p0.7) between the first and second tests for five participants. Conclusions: Manipulation of resistance and leverage with the prototype exercises was effective in creating significant increases of ECRB normalised EMG activity in a linear manner that may, with future research, become useful to clinicians treating LE. In addition, between trial reliability for the device to generate a consistent load was acceptable.Peer reviewe

BEAST angio-170

MCC tree of the angio-170 analysis with BEAST

r8s angio-140

PL tree (with 95% credibility intervals for age estimates) of the angio-140 analysis with r8s

BEAST angio-200

MCC tree of the angio-200 analysis with BEAST

BEAST angio-150

MCC tree of the angio-150 analysis with BEAST

r8s angio-130

PL tree (with 95% credibility intervals for age estimates) of the angio-130 analysis with r8s

BEAST angio-130

MCC tree of the angio-130 analysis with BEAST

BEAST angio-140

MCC tree of the angio-140 analysis with BEAST

r8s angio-200

PL tree (with 95% credibility intervals for age estimates) of the angio-200 analysis with r8s

Phylogenetic structure of Australian rainforests.

<p>Net Relatedness Index by grid cell (50×50 km) based on continental and regional species pools for all woody plants combined, for freestanding (trees and shrubs), and climbing (vines) plants. For clarity of presentation cells are clipped to the coastline and off-shore islands are not shown. Clus (sig) - significant clustering; Clus (weak) - weak clustering; Disp (sig) - significant evenness (over-dispersion); Disp (weak) - weak evenness (over-dispersion); No pattern - no phylogenetic structure (relative to null model).</p