Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.
J Orthop Sports Phys Ther. 2013 Jun;43(6):368-78. doi: 10.2519/jospt.2013.4411. Epub 2013 Mar 18.
Single-cohort descriptive and correlational study.
To investigate the relationships between tendon pathology, biomechanical measures, and self-reported pain and function in individuals with chronic lateral epicondylosis.
Lateral epicondylosis has a multifactorial etiology and its pathophysiology is not well understood. Consequently, treatment remains challenging, and lateral epicondylosis is prone to recurrence. While tendon pathology, pain system changes, and motor impairments due to lateral epicondylosis are considered related, their relationships have not been thoroughly investigated.
Twenty-six participants with either unilateral (n = 11) or bilateral (n = 15) chronic lateral epicondylosis participated in this study. Biomechanical measures (grip strength, rate of force development, and electromechanical delay) and measures of tendon pathology (magnetic resonance imaging and ultrasound) and self-reported pain and function (Patient-Rated Tennis Elbow Evaluation) were performed. Partial Spearman correlations, adjusting for covariates (age, gender, weight, and height), were used to evaluate the relationship between self-reported pain, function, and biomechanical and tendon pathology measures.
Statistically significant correlations between biomechanical measures and the Patient-Rated Tennis Elbow Evaluation ranged in magnitude from 0.44 to 0.68 (P<.05); however, no significant correlation was observed between tendon pathology (magnetic resonance imaging and ultrasound) measures and the Patient-Rated Tennis Elbow Evaluation (r = -0.02 to 0.31, P>.05). Rate of force development had a stronger correlation (r = 0.54-0.68, P<.05) with self-reported function score than with grip strength (r = 0.35-0.47, P<.05) or electromechanical delay (r = 0.5, P<.05).
Biomechanical measures (pain-free grip strength, rate of force development, electromechanical delay) have the potential to be used as outcome measures to monitor progress in lateral epicondylosis. In comparison, the imaging measures (magnetic resonance imaging and ultrasound) were useful for visualizing the pathophysiology of lateral epicondylosis. However, the severity of the pathophysiology was not related to pain and function, indicating that imaging measures may not provide the best clinical assessment.
单队列描述性和相关性研究。
研究慢性肱骨外上髁炎患者的肌腱病理、生物力学测量值与自报疼痛和功能之间的关系。
肱骨外上髁炎的病因复杂，其病理生理学尚不清楚。因此，治疗仍然具有挑战性，且该病易于复发。虽然肱骨外上髁炎的肌腱病变、疼痛系统变化和运动障碍被认为是相关的，但它们之间的关系尚未得到充分研究。
本研究纳入了 26 名单侧（n=11）或双侧（n=15）慢性肱骨外上髁炎患者。对生物力学测量值（握力、肌力发展速率和机电延迟）、肌腱病变测量值（磁共振成像和超声）以及自报疼痛和功能（患者网球肘评估）进行了评估。采用偏Spearman 相关分析，校正了协变量（年龄、性别、体重和身高），以评估自报疼痛、功能与生物力学和肌腱病变测量值之间的关系。
生物力学测量值与患者网球肘评估之间的相关性具有统计学意义，其大小范围为 0.44 至 0.68（P<.05）；然而，肌腱病变（磁共振成像和超声）测量值与患者网球肘评估之间无显著相关性（r = -0.02 至 0.31，P>.05）。肌力发展速率与自报功能评分的相关性更强（r = 0.54-0.68，P<.05），而与握力（r = 0.35-0.47，P<.05）或机电延迟（r = 0.5，P<.05）的相关性较弱。
生物力学测量值（无痛握力、肌力发展速率、机电延迟）有可能作为监测肱骨外上髁炎进展的结果测量值。相比之下，影像学测量值（磁共振成像和超声）有助于观察肱骨外上髁炎的病理生理学变化。然而，病理生理学的严重程度与疼痛和功能无关，这表明影像学测量值可能无法提供最佳的临床评估。
