title: Effectiveness of manual physical therapy to the cervical spine in the management of lateral epicondylalgia: a retrospective analysis.
abstract: METHODS
  Retrospective ex-post facto design.
  
  
  OBJECTIVE
  To retrospectively review the management of patients with lateral epicondylalgia, and to compare self-reported outcomes to assess the potential benefit of manual physical therapy to the cervical spine.
  
  
  BACKGROUND
  It has been postulated that dysfunction of the cervical spine may contribute to the symptoms associated with lateral epicondylalgia; however, the literature assessing the effectiveness of manual physical therapy to the cervicothoracic region in this patient population has been inconclusive. Documentation and analysis of outcomes of management strategies focusing on the cervical spine may lead to determining the most effective and efficient clinical practices.
  
  
  METHODS
  Of the 213 charts reviewed, 112 satisfied inclusion-exclusion criteria and were divided into 2 groups: those who received treatment solely directed at the elbow (local management [LM]), or those who received treatment directed at the elbow and cervical manual therapy (LM+C). Telephone follow-up interviews were used to determine the number of successful outcomes. Percentages of successful outcomes in each group were compared using chi-square analysis. An independent samples t test was used to compare the total number of visits per group.
  
  
  RESULTS
  Sixty-one of the 112 patients were in the LM group, while 51 received LM+C. Seventy five percent of the patients available for follow-up in the LM group and 80% in the LM+C group reported a successful outcome. Patients in the LM group received a greater number of visits (mean, 9.7; SD, 2.4) than patients in the LM+C group (mean, 5.6; SD, 1.7; P<.01).
  
  
  CONCLUSIONS
  The results of this retrospective review suggest that most patients had successful outcomes regardless of the inclusion of manual therapy interventions to the cervical spine. The LM+C group achieved the successful long-term outcome in significantly fewer visits.
authors.affiliation: Department of Physical Therapy, Franklin Pierce College, Concord, NH 03301, USA. clelandj@fpc.edu
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cleland
authors.forename: Julie M
authors.initials: JM
authors.lastname: Whitman
authors.forename: Julie M
authors.initials: JM
authors.lastname: Fritz
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D017679:Cryotherapy; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007478:Iontophoresis; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods; D010147:Pain Measurement; D012189:Retrospective Studies; D016037:Single-Blind Method; D013716:Tennis Elbow / Q000188:drug therapy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014464:Ultrasonic Therapy