Alizadehkhaiyat Omid, Fisher Anthony C, Kemp Graham J, Frostick Simon P
Musculoskeletal Science Research Group, Royal Liverpool University Hospital, Liverpool, UK.
Clin J Pain. 2007 Jul-Aug;23(6):482-9. doi: 10.1097/AJP.0b013e31805f70fa.
First to compare pain and functional disability in tennis elbow (TE) patients with healthy controls. Second, to evaluate the relationship between the 2 major psychologic factors (anxiety and depression) and TE.
Sixteen TE patients were recruited from 46 consecutive attendees at an upper limb clinic: inclusion criteria were lateral epicondyle tenderness, pain with resisted wrist and middle finger extension and at least 3 months localized lateral elbow pain. Sixteen healthy controls with no upper limb problem were recruited from students and staff. Participants were given 4 questionnaires, together with instructions for completion: Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, Patient-Rated Wrist Evaluation Questionnaire, and Hospital Anxiety and Depression Scale. The independent t test was used to compare the total and subscale scores between the groups.
Significantly higher scores were found in TE for pain and function subscales and also total score for Disabilities of the Arm, Shoulder, and Hand, Patient-Rated Forearm Evaluation Questionnaire, and Patient-Rated Wrist Evaluation Questionnaire. For Hospital Anxiety and Depression Scale, both anxiety and depression subscales (P<0.001) and the total score (P<0.01) were significantly higher in TE. According to the anxiety and depression subscales, 55% and 36% of patients, respectively, were classified as probable cases (score >11).
TE patients showed markedly increased pain and functional disability. Significantly elevated levels of depression and anxiety pointed out the importance of psychologic assessment in TE patients. In the development of supportive and treatment strategies, we suggest the combination of "upper limb" and "psychologic" assessment tools.
首先比较网球肘（TE）患者与健康对照者的疼痛和功能障碍情况。其次，评估两大心理因素（焦虑和抑郁）与网球肘之间的关系。
从一家上肢诊所连续就诊的46名患者中招募了16名网球肘患者：纳入标准为外侧髁压痛、抗阻腕关节和中指伸展时疼痛以及至少3个月的局限性外侧肘部疼痛。从学生和工作人员中招募了16名无上肢问题的健康对照者。参与者收到4份问卷以及填写说明：《手臂、肩部和手部功能障碍问卷》、《患者自评前臂评估问卷》、《患者自评腕关节评估问卷》和《医院焦虑抑郁量表》。采用独立t检验比较两组之间的总分和子量表得分。
网球肘患者在疼痛和功能子量表以及《手臂、肩部和手部功能障碍问卷》、《患者自评前臂评估问卷》和《患者自评腕关节评估问卷》的总分上得分显著更高。对于《医院焦虑抑郁量表》，网球肘患者的焦虑和抑郁子量表（P<0.001）以及总分（P<0.01）均显著更高。根据焦虑和抑郁子量表，分别有55%和36%的患者被归类为可能病例（得分>11）。
网球肘患者的疼痛和功能障碍明显增加。抑郁和焦虑水平显著升高表明对网球肘患者进行心理评估的重要性。在制定支持性和治疗策略时，我们建议结合“上肢”和“心理”评估工具。
