Peterson Magnus, Butler Stephen, Eriksson Margaretha, Svärdsudd Kurt
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
Department of Surgical Sciences/Anesthesiology and Intensive Care Medicine, Uppsala University Hospital, Uppsala, Sweden.
Clin Rehabil. 2014 Sep;28(9):862-72. doi: 10.1177/0269215514527595. Epub 2014 Mar 14.
To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.
Randomized controlled trial.
Primary care in Uppsala County, Sweden.
A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement.
Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load.
Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months.
The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures.
Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.
分析离心运动与向心渐进性运动对慢性网球肘的治疗效果。
随机对照试验。
瑞典乌普萨拉郡的初级医疗保健机构。
从初级医疗保健机构及通过广告招募了120名患网球肘超过三个月的受试者。
离心运动组（n = 60）或向心运动组（n = 60），通过每天在家中降低或举起重物进行运动，持续三个月，负荷逐渐增加。
在基线以及1、2、3、6和12个月后评估肌肉收缩和肌肉伸展时的疼痛以及力量。在基线以及3、6和12个月后评估功能和生活质量。
离心运动组疼痛缓解更快，在肌肉收缩和伸展过程中，在所有疼痛减轻水平上，平均反应率高10%（分别为p < 0.0001和p = 0.006）。从两个月起，Cox分析发现显著差异（风险比0.78，95%置信区间（CI）0.63 - 0.96，p < 0.02）。这意味着离心运动组与向心运动组相比，绝对疼痛减轻了10%，需治疗人数为10。离心运动组的肌肉力量增加也比向心运动组更大（p < 0.02）。这些差异在整个随访期持续存在。两组在功能或生活质量测量方面无显著差异。
与向心渐进性运动相比，离心渐进性运动能更有效地减轻慢性网球肘的疼痛并增加肌肉力量。
