Lateral Epikondilit Tanısı Olan Hastalarda Farklı Ortez Kullanımının Ağrı, Kavrama Gücü ve Fonksiyonellik Üzerine Etkilerinin Karşılaştırılması: Randomize Klinik Çalışma

Abstract

Amaç: Lateral epikondilit (LE), önkol ekstansör yüzeyinde ve lateral epikondilde ağrı ile karakterize, elin kavrama gücünde azalmaya neden olan kronik bir dejenerasyondur. LE’nin konservatif tedavisinde farklı ortez uygulamaları kullanılmaktadır. Bu çalışmanın amacı, LE tanısı olan hastalarda, ön kol bandı (ÖKB) ile epikondil destekli dirseklik (EDD) ortezlerinin ağrı, kavrama gücü, dirsek fonksiyonelliği ve ortez memnuniyeti üzerindeki etkinlerini karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya LE tanısı olan 40-60 yaş aralığında 28 katılımcı alındı. Katılımcılar ÖKB ortezi kullananlar Grup 1 (n=14) ve EDD ortezi kullananlar Grup 2 (n=14) olarak randomize iki gruba ayrıldı. Ortez kullanım öncesi ve 4 hafta sonrası tüm katılımcıların numerik değerlendirme skalası ile istirahat ve aktivite sırasında ağrı şiddeti, el dinamometresi ile ağrısız ve maksimum kavrama kuvveti, Hasta Bazlı Önkol Değerlendirme Anketi (HBÖDA) ile dirsek fonksiyonelliği değerlendirildi. Ayrıca, numerik değerlendirme skalası ile katılımcıların ortez memnuniyeti değerlendirildi. Bulgular: Tüm katılımcıların istirahat ve aktivite sırasında ağrı şiddeti, HBÖDA ağrı, fonksiyon ve toplam skorlarında grup içi değişim istatistiksel olarak anlamlı iyileşmeler görülürken (sırasıyla Grup 1: p=0,045, p=0,002, p=0,008, p=0,017, p= 0,011; Grup 2: p=0,003, p=0,001, p=0,001, p=0,001, p=0,001), sadece Grup 2’de maksimum kavrama kuvvetinde istatistiksel olarak anlamlı artış (p=0,013) görüldü. Sonuç: LE tanısı olan hastalarda, dört hafta ÖKB ve EDD ortezlerinin kullanımı istirahat ve aktivite sırasında ağrı şiddeti ile dirsek fonksiyonelliğinde iyileşmeler sağladığı, ayrıca maksimum kavrama kuvvetinin artışında EDD ortezinin daha etkili olduğu belirlendi.

Keywords

• ön kol bandı
• lateral epikondilit
• ortez
• ön kol bandı
• epikondil destekli dirseklik
• kavrama kuvveti

Comparison of the Effects of Different Orthosis Use on Pain, Grip Strength and Functionality in Patients with Lateral Epicondylitis: A Randomised Clinical Study

Abstract

Objectives: Lateral epicondylitis (LE) is a chronic degeneration of the forearm extensor surface and lateral epicondyle characterised by pain and decreased grip strength of the hand. Different orthosis applications are used in the conservative treatment of LE. Aim of our study was to compare the efficacy of forearm band (FAB) and epicondyle supported elbow brace (ESEB) orthoses on pain, grip strength, functionality and orthosis satisfaction in patients with LE. Materials and Methods: The study included 28 participants aged 40-60 years with diagnosis of LE. The participants were randomly divided into two groups as Group 1 (n=14) with FAB orthosis and Group 2 (n=14) with ESEB orthosis. Pain intensity at rest and during activity using numeric rating scale, pain-free and maximum grip strength using hand dynamometer, and elbow functionality using the Patient-Based Lateral Epicondylitis Evaluation scale (PRTEE) were evaluated before and 4 weeks after orthosis use. In addition, orthotic satisfaction of the participants was evaluated with numeric rating scale. Results: All participants showed statistically significant improvements in pain intensity at rest and during activity and in pain, function and total scores of the PRTEE within-group change (Group 1: p=0. 045, p=0.003, p=0.008, p=0.017, p=0.011; Group 2: p=0.003, p=0.001, p=0.001, p=0.001, p=0.001, respectively), whereas only Group 2 showed statistically significant increase in maximum grip strength (p=0.013). Conclusion: In patients with LE, four-week use of FAB and ESEB orthoses provided improvements in pain intensity and elbow functionality at rest and during activity, and ESEB orthosis was more effective in increasing maximum grip strength.

Keywords

• forearm band
• lateral epicondylitis
• orthosis
• forearm band
• epicondyle supported elbow brace
• grip strength

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