title: The immediate effect of orthotic management on grip strength of patients with lateral epicondylosis.
abstract: METHODS
  Controlled laboratory study using a randomized crossover design.
  
  
  OBJECTIVE
  To determine the immediate effect of 3 common types of orthoses (2 elbow counterforce orthoses and a wrist splint) on grip strength in individuals with lateral epicondylosis.
  
  
  BACKGROUND
  Lateral epicondylosis is a common cause of pain and upper limb dysfunction. Although the effectiveness of orthoses has been reported, comparisons of effectiveness among orthoses are limited.
  
  
  METHODS
  Fifty-two subjects with lateral epicondylosis were recruited (20 men, 32 women; mean +/- SD age, 41 +/- 8 years). Maximum and pain-free grip strength were assessed using a digital hand grip dynamometer immediately after the application of each orthosis. The 4 testing conditions included a placebo orthosis as a control condition, an elbow strap orthosis, an elbow sleeve orthosis, and a wrist splint. Data were analyzed using a 1-way analysis of variance for each outcome measure.
  
  
  RESULTS
  Pain-free grip-strength was greater when using the elbow strap or the elbow sleeve orthosis compared to when using the placebo control orthosis or the wrist splint (P<.02), but there was no difference between the elbow sleeve and strap orthoses (P>.05), nor between the wrist splint and placebo orthosis (P>.05). Maximum grip strength was less when using the wrist splint compared to when tested with the elbow sleeve or the elbow strap (P< or =.003). Use of the elbow strap, elbow sleeve, or wrist splint did not change maximum grip strength compared to the control placebo orthosis condition (P>.05). There was also no difference in maximum grip strength between the elbow strap and the elbow sleeve conditions (P>.05).
  
  
  CONCLUSIONS
  The use of the 2 types of elbow orthoses (strap and sleeve) resulted in an immediate increase in pain-free grip strength. No differences between the 2 orthoses were found, suggesting that either can be used. A wrist splint produced no immediate change in pain-free or maximum grip-strength, indicating that it should not be used as a first-choice orthosis based on those outcome measures.
authors.affiliation: Orthotics and Prosthetics Department, Welfare and Rehabilitaion Sciences University, Tehran, Iran. fahimejafarian@yahoo.com
authors.forename: Fahimeh Sadat
authors.initials: FS
authors.lastname: Jafarian
authors.forename: Ebrahim Sadeghi
authors.initials: ES
authors.lastname: Demneh
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Tyson
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D009989:Orthotic Devices; D010147:Pain Measurement; D013716:Tennis Elbow / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome; D014953:Wrist / Q000502:physiology