Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up.
BACKGROUND
The aim of this prospective randomized clinical trial was to investigate the efficacy of a home-based program of isometric strengthening exercises for the treatment of the lateral epicondylitis (LE) of the distal humerus. We hypothesized that 1) use of isometric strengthening exercises would result in clinical benefits similar to those provided by medication and pain relief and 2) functional improvements after exercise would be time-dependent.


METHODS
Patients were assigned to one of two groups: 1) an immediate physical therapy group (group I), or 2) a delayed physical therapy group (group D). Group I patients (n = 16) were instructed how to do the exercises at their first clinic visit and immediately carried out the exercise program. Group D patients (n = 15) learned and did the exercises after being on medications for 4 weeks.


RESULTS
Outcomes at the 1-month clinic visit indicated that pain (measured using a visual analogue scale [VAS]) had been significantly reduced in group I compared to group D (p < 0.01). However, significant differences between groups were not found at 3-, 6-, and 12-month follow-up for either VAS scores or Mayo elbow performance scores. For modified Nirschl/Pettrone scores, a significant difference between groups was found only at the 1-month follow-up visit. By then, the number of participants who returned to all activities with no pain or occasional mild pain was six (37%) in Group I and two (13%) in Group D (p = 0.031). At the final follow-up visit, 88% of all participants performed physical activities without pain.


CONCLUSIONS
Isometric strengthening exercises done early in the course of LE (within 4 weeks) provides a clinically significant improvement.
Park
Jin-Young
JY
Department of Orthopaedic Surgery, Konkuk University Hospital, Seoul, Korea.
Park
Hong-Keun
HK
Choi
Jin-Hyung
JH
Moon
Eun-Sun
ES
Kim
Byung-Soo
BS
Kim
Wan-Seok
WS
Oh
Kyung-Soo
KS
D000328:Adult; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D010349:Patient Compliance; D013716:Tennis Elbow / Q000628:therapy*; D016896:Treatment Outcome
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