Comparison of the Supervised and Home-Based Physiotherapy Program in Patients with Lateral Epicondylitis

Year 2021, Volume: 4 Issue: 2, 124 - 129, 20.12.2021

Raziye Şavkın Şule Şimşek

https://doi.org/10.33438/ijdshs.978993

Abstract

Objective: This study aimed to compare the effectiveness of a supervised and home-based physiotherapy program in the reduction of pain and in improving functional status and quality of life in patients with lateral epicondylitis. Method: Patients diagnosed with lateral epicondylitis and referred to the physiotherapy clinic were evaluated retrospectively. A total of 32 patients were separated into two groups as supervised and home-based physiotherapy groups. All the patients received standard physiotherapy program consisting of static stretching exercises of the ECRB tendon, eccentric exercises of the wrist extensors and cold application, for 3 weeks. The groups were compared in terms of pain severity, range of motion, functional status (Quick-DASH) and quality of life (SF-36) after treatment. Results: Fifteen patients (12 females, 3 males) with a mean age of 44.20±7.35 years were included in the supervised physiotherapy group, and 17 patients (15 females, 2 males) with a mean age of 48.65±12.33 years in the home-based physiotherapy group. There was no statistically significant difference in activity (p=0.980) and rest pain (p=0.483), wrist flexion (p=0.775) and extension (p=0.838) range of motion, functionality (p=0.346) and quality of life (p=0.923) between groups. Conclusion: Patients participating in a home-based physiotherapy program had similar clinical outcomes in terms of pain intensity, range of motion, functionality, and quality of life as patients participating in a supervised physiotherapy. Further prospective randomized studies can be conducted by increasing the sample size and comparing with cost analyzes to determine the rehabilitation regimen that will provide the best outcomes in lateral epicondylitis rehabilitation.

Keywords

Lateral Epicondylitis, Home Based Physiotherapy, Supervised Physiotherapy, Pain, Function, Quality of Life

References

• Ahmad, Z., Siddiqui, N., Malik, S. S., Abdus-Samee, M., Tytherleigh-Strong, G., & Rushton, N. (2013). Lateral epicondylitis: a review of pathology and management. The Bone & Joint Journal, 95-B(9), 1158–1164. Doi:10.1302/0301-620x.95b9.29285
• Alizadehkhaiyat, O., & Frostick, S. P. (2015). Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis. Journal of Electromyography and Kinesiology, 25(6), 876–886. Doi.1016/j.jelekin.2015.10.013
• Argent, R., Daly, A., & Caulfield, B. (2018). Patient Involvement with Home-Based Exercise Programs: Can Connected Health Interventions Influence Adherence? JMIR mHealth and uHealth, 6(3), e47. Doi: 10.2196/mhealth.8518
• Brummel, J., Baker, C. L., 3rd, Hopkins, R., & aker, C. L., Jr (2014). Epicondylitis: lateral. Sports Medicine and Arthroscopy Review, 22(3),e1–e6.Doi:10.1097/JSA.00000000000 00024
• Cohen, M., & da Rocha Motta Filho, G. (2015). Lateral Epicondylitis of The Elbow. Revista Brasileira de Ortopedia, 47(4), 414–420. Doi:10.1016/S2255-4971(15)30121-X
• Day, J. M., Lucado, A. M., & Uhl, T. L. (2019). A Comprehensive Rehabilitation Program for Treating Lateral Elbow Tendinopathy. International Journal of Sports Physical Therapy, 14(5), 818–829.
• Dimitrios S. (2016). Lateral Elbow Tendinopathy: Evidence of Physiotherapy Management. World Journal of Orthopedics, 7(8), 463–466. Doi: 10.5312/wjo.v7.i8.463
• Dimitrios, S. & Manias, P. (2013). Comparing Two Exercise Programmes for the Management of Lateral Elbow Tendinopathy (Tennis Elbow/Lateral Epicondylitis)-A Controlled Clinical Trial. The Open Access Journal of Science and Technology, 1: 1-8. DOI: 10.11131/2013/100013
• Düger, T., Yakut, E., Öksüz, Ç., Yörükan, S., Semin Bilgütay, B., Ayhan, Ç., Leblebicioğlu, G., Kayıhan, H., Kırdı, N., Yakut, Y., Güler, Ç. (2006). Reliability and Validity of the Turkish Version of the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire. Physiotherapy Rehabilitation, 17(3);99-107.
• Granviken, F., & Vasseljen, O. (2015). Home Exercises and Supervised Exercises Are Similarly Effective for People with Subacromial Impingement: A Randomised Trial. Journal of Physiotherapy, 61(3), 135–141. Doi: 10.1016/j.jphys.2015.05.014
• Gutiérrez-Espinoza, H., Araya-Quintanilla, F., Cereceda-Muriel, C., Álvarez-Bueno, C., Martínez-Vizcaíno, V., & Cavero-Redondo, I. (2020). Effect of Supervised Physiotherapy Versus Home Exercise Program in Patients with Subacromial Impingement Syndrome: A Systematic Review and Meta-Analysis. Physical Therapy in Sport, 41, 34–42. Doi: 10.1016/j.ptsp.2019.11.003
• Koçyiğit, H., Aydemir, Ö., Ölmez, N. ve Memiş, A. (1999). Reliability and Validity of the Turkish Version of Short Form-36 (SF36). Journal of Medicine and Treatment, 12(2), 102-106.
• Ma, K. L., & Wang, H. Q. (2020). Management of Lateral Epicondylitis: A Narrative Literature Review. Pain Research & Management, 2020, 6965381. Doi:10.1155/2020/6965381
• Manias, P., & Stasinopoulos, D. (2006). A Controlled Clinical Pilot Trial to Study the Effectiveness of Ice as a Supplement to the Exercise Programme for the Management of Lateral Elbow Tendinopathy. British Journal of Sports Medicine, 40(1), 81–85. Doi:10.1136/bjsm.2005.020909
• Martinez-Silvestrini, J. A., Newcomer, K. L., Gay, R. E., Schaefer, M. P., Kortebein, P., & Arendt, K. W. (2005). Chronic Lateral Epicondylitis: Comparative Effectiveness of a Home Exercise Program Including Stretching Alone Versus Stretching Supplemented with Eccentric or Concentric Strengthening. Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists, 18(4), 411–420. Doi: 10.1197/j.jht.2005.07.007
• Peterson, M., Butler, S., Eriksson, M., & Svärdsudd, K. (2014). A Randomized Controlled Trial of eccentric vs. Concentric Graded Exercise in Chronic Tennis Elbow (Lateral Elbow Tendinopathy). Clinical Rehabilitation, 28(9), 862–872. Doi: 10.1177/0269215514527595
• Samagh, P., Sudhakar, K., & Jindal, R. (2015). The Impact of Lateral Epicondylitis On Quality of Life. International Journal of Physiotherapy, 2, 627-632.
• Stasinopoulos, D., Stasinopoulou, K., & Johnson, M. I. (2005). An Exercise Programme for the management of Lateral Elbow Tendinopathy. British Journal of Sports Medicine, 39(12), 944–947. Doi:10.1136/bjsm.2005.019836
• Svernlöv, B., & Adolfsson, L. (2001). Non-operative Treatment Regime Including Eccentric Training for Lateral Humeral Epicondylalgia. Scandinavian Journal of Medicine & Science in Sports, 11(6), 328–334. Doi: 10.1034/j.1600-0838.2001.110603.x
• van Ark, M., Cook, J. L., Docking, S. I., Zwerver, J., Gaida, J. E., van den Akker-Scheek, I., & Rio, E. (2016). Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial. Journal of science and medicine in sport, 19(9), 702–706
• Vaquero-Picado, A., Barco, R., & Antuña, S. A. (2017). Lateral Epicondylitis of the Elbow. EFORT Open Reviews, 1(11), 391–397. Doi:10.1302/2058-5241.1.000049
• Waugh, E. J., Jaglal, S. B., Davis, A. M., Tomlinson, G., & Verrier, M. C. (2004). Factors Associated with Prognosis of Lateral Epicondylitis After 8 Weeks of Physical Therapy. Archives of Physical Medicine and Rehabilitation, 85(2), 308–318 Doi:10.1016/s0003-9993(03)00480-5.
• Weber, C., Thai, V., Neuheuser, K., Groover, K., & Christ, O. (2015). Efficacy of Physical Therapy for the Treatment of Lateral Epicondylitis: A Meta-Analysis. BMC Musculoskeletal Disorders, 16, 223. Doi:10.1186/s12891-015-0665-4
• Wen, D. Y., Schultz, B. J., Schaal, B., Graham, S. T., & Kim, B. S. (2011). Eccentric Strengthening for Chronic Lateral Epicondylosis: A Prospective Randomized Study. Sports Health, 3(6), 500–503. Doi: 10.1177/1941738111409690