Short and long term effects of different physiotherapy methods in the treatment of lateral epiconylitis

Hypothesis: The combined application of mobilization with movement and eccentric overload will reduce pain intensity and improve hands function more than using the methods alone. Aim of the study: to determine effects of mobilization with movement and eccentric overload in the treatment of lateral epicondylitis. Goals of the study: 1. To determine short and long term effects of mobilization with movement in the treatment of lateral epicondylitis. 2. To determine short and long term effects of eccentric overload in the treatment of lateral epicondylitis. 3. To determine short and long term effects of mobilization with movement combined with eccentric overload in the treatment of lateral epicondylitis. 4. To compare short and long term efficacy of different physiotherapy methods and their combination in the treatment of lateral epicondylitis. Methods and organization of the study: The study included individuals aged 30-55 years who had diagnosed lateral epicondylitis with ultrasound. All subjects (n = 30) participated in the study voluntarily and filled in personal information forms. Subjects were randomly divided into three groups: mobilization with movement (n = 10), eccentric overload (n = 10), and the combined group (n = 10), where mobilization with movement was combined with eccentric overload. Subjects on arrival for the first session were tested by assessing their perceived pain using a digital pain analog scale, assessing the maximum and maximum pain free grip on the hand, which reflects the general condition and function of the forearm muscles. Wrist and elbow amplitudes (flexion and extension) were measured and evaluated with a goniometer to determine if there was a significant restriction on movement. The QuickDASH questionnaire was used to assess general hand function and disability. For patients in all groups sessions lasted for up to 30 minutes once a day. The interventions applied were performed for 2 consecutive weeks on work days, for a total of 10 sessions per study subject. The tests were performed five times: before and after the sessions, and there were 3 follow-up times: 2, 6, and 12 weeks after the sessions. Results: This study evaluated the efficacy of different methods in the treatment of lateral epicondylitis for 2 weeks. After analyzing the obtained research data, it can be stated that in all groups of subjects there was a significant (p <0.05) decrease in pain, an increase in hand grip, amplitudes of wrist and elbow movements, and a statistically significant (p <0.05) improvement in overall hand function. Immediately after all sessions, significant differences in pain intensity, grip strength, movement amplitudes, and general arm function were observed between the groups, with the best changes in the indicators being seen in the MSJ group. Assessed at 2, 6 and 12 weeks after the sessions, the most altered indicators of pain intensity, pain free grip strength, and general arm function were seen in the MSJ group, with the worst changes in results being seen in the EV group. From the results obtained, it can be stated that mobilization alone with movement and stretching exercises applied for 2 weeks improves arm function more than applying eccentric exercise with stretching exercises alone, as well as better than combining these techniques together. This is evidenced by more reduced pain, increased hand grip, wrist and forearm flexion and extension amplitudes, and an overall improvement in hand function in the MSJ group. Conclusions: 1. The application “Mulligan’s” mobilization with movement for patients with lateral epicondylitis significantly reduced pain, increased hand grip, wrist and forearm flexion and extension amplitudes, and improved overall hand function. 2. Application of eccentric overload in patients with lateral epicondylitis significantly reduced pain, increased hand grip, wrist and forearm flexion and extension amplitudes, and improved overall hand function. 3. The application of “Mulligan’s” mobilization with movement in combination with eccentric overload in patients with lateral epicondylitis significantly reduced pain, increased hand grip, wrist and forearm flexion and extension amplitudes, and improved overall arm function. 4. When comparing results between groups after procedures, mobilization with movement reduced pain and improved functional parameters the most. In terms of long-term efficacy of the methods, movement mobilization reduced pain and improved hand function more than applied eccentric overload, but compared to the combined group, most of the results did not differ significantly

Short and long-term effects of mobilization with movement and eccentric overload to hand pain and function in the treatment of lateral epicondylitis

Aim. To determine and compare short and long-term effects of mobilization with movement and eccentric overload to hand pain and function in the treatment of lateral epicondylitis. Problem of research & hypothesis. The eccentric overload exercises are one of the best methods in tendinopathy treatment. Mobilization with movement is largely used as an effective treatment method for lateral epicondylitis. Only the short-term effects of these methods in lateral epicondylitis are often evaluated, but no studies were found to use these methods in combination and to evaluate their long-term effects. Methods. The study included individuals (n=30) aged 30–54 years who had been diagnosed with lateral epicondylitis. Subjects were tested by assessing their perceived pain using the visual analogue scale (VAS); handgrip strength was assessed by a dynamometer. The QuickDASH questionnaire was used to assess hand function and perceived disability. Subjects were randomly divided into three groups: mobilization with movement group (n=10), eccentric overload group (n=10), and combined group (combined mobilization with movement and eccentric overload exercises) (n=10). All subjects got 10 physiotherapy procedures, short-term effect evaluated after 10 procedures of physiotherapy, long-term effect evaluated after 2, 6 and 12 weeks post treatment course. Results. Study results revealed that all treatment methods had a significant (p<0.05) effect on pain reduction, increase in handgrip strength as well as improvement in hand function and disability. In follow-up assessments at 2, 6 and 12 weeks after the treatment, the most altered indicators of pain intensity, pain-free handgrip strength and hand function were seen in the mobilization with movement group. Conclusions. An application of mobilization with movement in the treatment of lateral epicondylitis had the greatest positive effect on pain intensity, maximum handgrip strength and hand function and disability compared to mobilization with movement combined with eccentric overload and eccentric overload exercises alone. Keywords: lateral epicondylitis, mobilization with movement, eccentric overload, pain intensity, hand pain-free grip strength