Efficacy of Radial Extracorporeal Shock Wave Therapy on Lateral Epicondylosis, and Changes in the Common Extensor Tendon Stiffness with Pretherapy and Posttherapy in Real-Time Sonoelastography: A Randomized Controlled Study.
OBJECTIVE
To investigate the effects of radial extracorporeal shock wave therapy (rESWT) and to determine the posttreatment common extensor tendon stiffness among patients with lateral epicondylosis.


METHODS
Thirty patients with lateral epicondylosis were randomly divided into experimental and control groups. Participants in the experimental group received rESWT plus physical therapy, and those in the control group received sham shock wave plus physical therapy for 3 weeks. Visual analog scale; grip strength dynamometer; Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; and ultrasonography in 2-dimensional image, and real-time sonoelastography were used in the assessments at baseline and after 6, 12, and 24 weeks (T3).


RESULTS
The experimental group had more significant pain reduction at T3 than the control group. Compared with the control group, the experimental group had significantly higher maximal grip strength at 12 and 24 weeks, with significant increases. Compared to baseline, the experimental group had significantly lower Taiwan version DASH disability/symptom scores and work module scores at all posttreatment follow-up points. Five participants in the experimental group had partial tear within common extensor tendon at their involved elbow, and all the tears totally healed at T3. However, the inter-rater reliabilities for real-time sonoelastography were poor to fair.


CONCLUSIONS
Patients with lateral epicondylosis had better and faster pain reduction, grip strength increase, and functional improvement after receiving rESWT in addition to physical therapy than those who received physical therapy only.
From the Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
Tsung-Hsun
TH
Yang
Yu-Chi
YC
Huang
Yiu-Chung
YC
Lau
Lin-Yi
LY
Wang
D000328:Adult; D054459:Elasticity Imaging Techniques; D005260:Female; D018737:Hand Strength; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013710:Tendons / Q000503:physiopathology; D013716:Tennis Elbow / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome