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Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.

Weber C, Thai V, Neuheuser K, Groover K, Christ O - BMC Musculoskelet Disord (2015)

Bottom Line: Control group gains were 50 to 66% as high as treatment group gains.Still, only treatment groups with their combination of therapy specific and non-therapy specific factors reliably met criteria for clinical relevance.Results are discussed with respect to stability and their potential meaning for the use of non-therapy specific agents to optimize patients' gain.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, TU Darmstadt, Alexanderstrasse 10, 64287, Darmstadt, Germany. weber@diempuberater.de.

ABSTRACT

Background: Physical therapy for the treatment of lateral epicondylitis (LE) often comprises movement therapies, extracorporeal shockwave therapy (ECSWT), low level laser therapy (LLLT), low frequency electrical stimulation or pulsed electromagnetic fields. Still, only ECSWT and LLLT have been meta-analytically researched.

Methods: PUBMED, EMBASE and Cochrane database were systematically searched for randomized controlled trials (RCTs). Methodological quality of each study was rated with an adapted version of the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pain reduction (the difference between treatment and control groups at the end of trials) and pain relief (the change in pain from baseline to the end of trials) were calculated with mean differences (MD) and 95%-Confidence intervals (95 % CI).

Results: One thousand one hundred thirty eight studies were identified. One thousand seventy of those did not meet inclusion criteria. After full articles were retrieved 16 studies met inclusion criteria and 12 studies reported comparable outcome variables. Analyses were conducted for overall pain relief, pain relief during maximum handgrip strength tests, and maximum handgrip strength. There were not enough studies to conduct an analysis of physical function or other outcome variables.

Conclusions: Differences between treatment and control groups were larger than differences between treatments. Control group gains were 50 to 66% as high as treatment group gains. Still, only treatment groups with their combination of therapy specific and non-therapy specific factors reliably met criteria for clinical relevance. Results are discussed with respect to stability and their potential meaning for the use of non-therapy specific agents to optimize patients' gain.

No MeSH data available.


Related in: MedlinePlus

Overall pain relief in ECSWT groups
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Fig4: Overall pain relief in ECSWT groups

Mentions: If only ECSWT studies were analysed combined treatment groups reported −34.79 [95 % CI = −39.98, −29.60] (I2 = 24 %) (s.) (Fig. 4) units of pain relief (difference from baseline). Combined Control groups in ECSWT studies reported −24.48 [95 % CI = −32.65, −16.31] (I2 = 66 %) (s.) (Fig. 5) units of pain relief (difference from baseline). Comparing pain intensity between ECSWT and control groups at the end of studies resulted in a statistically non significant pain reduction of −7.20 [95 % CI = −17.44, 3.04] (I2 = 82 %) (n.s.) (Additional file 2). Three of these four studies were of high methodological quality reporting a combined pain reduction of 5.13 [95 % CI = −16.71, 6.46] (I2 = 82 %) (n.s.) (difference between treatment and control groups).Fig. 4


Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis.

Weber C, Thai V, Neuheuser K, Groover K, Christ O - BMC Musculoskelet Disord (2015)

Overall pain relief in ECSWT groups
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4549077&req=5

Fig4: Overall pain relief in ECSWT groups
Mentions: If only ECSWT studies were analysed combined treatment groups reported −34.79 [95 % CI = −39.98, −29.60] (I2 = 24 %) (s.) (Fig. 4) units of pain relief (difference from baseline). Combined Control groups in ECSWT studies reported −24.48 [95 % CI = −32.65, −16.31] (I2 = 66 %) (s.) (Fig. 5) units of pain relief (difference from baseline). Comparing pain intensity between ECSWT and control groups at the end of studies resulted in a statistically non significant pain reduction of −7.20 [95 % CI = −17.44, 3.04] (I2 = 82 %) (n.s.) (Additional file 2). Three of these four studies were of high methodological quality reporting a combined pain reduction of 5.13 [95 % CI = −16.71, 6.46] (I2 = 82 %) (n.s.) (difference between treatment and control groups).Fig. 4

Bottom Line: Control group gains were 50 to 66% as high as treatment group gains.Still, only treatment groups with their combination of therapy specific and non-therapy specific factors reliably met criteria for clinical relevance.Results are discussed with respect to stability and their potential meaning for the use of non-therapy specific agents to optimize patients' gain.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, TU Darmstadt, Alexanderstrasse 10, 64287, Darmstadt, Germany. weber@diempuberater.de.

ABSTRACT

Background: Physical therapy for the treatment of lateral epicondylitis (LE) often comprises movement therapies, extracorporeal shockwave therapy (ECSWT), low level laser therapy (LLLT), low frequency electrical stimulation or pulsed electromagnetic fields. Still, only ECSWT and LLLT have been meta-analytically researched.

Methods: PUBMED, EMBASE and Cochrane database were systematically searched for randomized controlled trials (RCTs). Methodological quality of each study was rated with an adapted version of the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Pain reduction (the difference between treatment and control groups at the end of trials) and pain relief (the change in pain from baseline to the end of trials) were calculated with mean differences (MD) and 95%-Confidence intervals (95 % CI).

Results: One thousand one hundred thirty eight studies were identified. One thousand seventy of those did not meet inclusion criteria. After full articles were retrieved 16 studies met inclusion criteria and 12 studies reported comparable outcome variables. Analyses were conducted for overall pain relief, pain relief during maximum handgrip strength tests, and maximum handgrip strength. There were not enough studies to conduct an analysis of physical function or other outcome variables.

Conclusions: Differences between treatment and control groups were larger than differences between treatments. Control group gains were 50 to 66% as high as treatment group gains. Still, only treatment groups with their combination of therapy specific and non-therapy specific factors reliably met criteria for clinical relevance. Results are discussed with respect to stability and their potential meaning for the use of non-therapy specific agents to optimize patients' gain.

No MeSH data available.


Related in: MedlinePlus