title: Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial.
abstract: BACKGROUND
  Isokinetic eccentric training of the wrist extensors has recently been shown to be effective in treating chronic lateral epicondylosis. However, isokinetic dynamometry is not widely available or practical for daily exercise prescription. Therefore, the objective of this study was to assess the efficacy of a novel eccentric wrist extensor exercise added to standard treatment for chronic lateral epicondylosis.
  
  
  METHODS
  Twenty-one patients with chronic unilateral lateral epicondylosis were randomized into an eccentric training group (n = 11, 6 men, 5 women; age 47 +/- 2 yr) and a Standard Treatment Group (n = 10, 4 men, 6 women; age 51 +/- 4 yr). DASH questionnaire, VAS, tenderness measurement, and wrist and middle finger extension were recorded at baseline and after the treatment period.
  
  
  RESULTS
  Groups did not differ in terms of duration of symptoms (Eccentric 6 +/- 2 mo vs Standard 8 +/- 3 mos., P = .7), number of physical therapy visits (9 +/- 2 vs 10 +/- 2, P = .81) or duration of treatment (7.2 +/- 0.8 wk vs 7.0 +/- 0.6 wk, P = .69). Improvements in all dependent variables were greater for the Eccentric Group versus the Standard Treatment Group (percent improvement reported): DASH 76% vs 13%, P = .01; VAS 81% vs 22%, P = .002, tenderness 71% vs 5%, P = .003; strength (wrist and middle finger extension combined) 79% vs 15%, P = .011.
  
  
  CONCLUSIONS
  All outcome measures for chronic lateral epicondylosis were markedly improved with the addition of an eccentric wrist extensor exercise to standard physical therapy. This novel exercise, using an inexpensive rubber bar, provides a practical means of adding isolated eccentric training to the treatment of chronic lateral epicondylosis.
authors.affiliation: PRO Sports Physical Therapy, Scarsdale, NY 10583, USA. shoulderpt@yahoo.com
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Tyler
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Thomas
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Nicholas
authors.forename: Malachy P
authors.initials: MP
authors.lastname: McHugh
mesh_terms: D002908:Chronic Disease; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013716:Tennis Elbow / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014953:Wrist / Q000502:physiology*