Rahman M S, Salek A K, Ullah M A
Professor Dr Md Shahidur Rahman, Professor, Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2017 Apr;26(2):306-311.
Lateral epicondylitis or Tennis elbow is very common repetitive stress injury or cumulative trauma disorder among active professionals and tennis players. Local steroid injection can provide quick functional improvement as sought by most of the patients. Therapeutic ultrasound and eccentric exercises can also improve the function. This study was carried out to see the comparative efficacy of these two modalities of treatments in terms of quicker functional improvement and this randomized interventional clinical trial was carried out in a private rehabilitation hospital in Dhaka. Patients attended the authors private chamber from January 2013 to December 2013 with clinical diagnosis of tennis elbow were included. Eighty adult patients diagnosed as lateral epicondylitis or tennis elbow were randomly divided into two groups. Group A received local steroid injection (triamcinolone acetate) and group B received therapeutic ultrasound for two weeks. Both the groups received eccentric exercises and advised to avoid provocative activities like twisting and lifting activities. Pain, tenderness and functional improvements were measured in traditional methods like visual analogue scale (VAS) and tenderness grade 0 to 4. Data were analyzed by SPSS. Most of the patients were female. None of them were tennis player. Younger housewives were common sufferer. Almost all patients in group A had very little or no pain or tenderness and no difficulty in lifting object at one week and two weeks. VAS was 13.62±6.503 and 4.15±5.517 respectively. Group B patients had mild improvement of pain and function at one week and moderate improvement at two weeks. VAS was 52.57±7.80 and 25.57±5.392 respectively. Similarly tenderness' were markedly improved in Group A at one and two weeks. They were 0.68±0.616 and 0.02±0.405 respectively for Group A and 1.60±0.553 and 1.14±0.335 respectively for Group B. Results were statistically significant in both groups at the end of two weeks. Local corticosteroid injections at extensor origin in tennis elbow patients are found to have better relief of pain and tenderness and quicker functional improvement than therapeutic ultrasound treatment. None of the patients were followed up for long term efficacy in either group.
外侧上髁炎或网球肘是活跃的专业人士和网球运动员中非常常见的重复性应力损伤或累积性创伤疾病。局部类固醇注射可以像大多数患者所期望的那样提供快速的功能改善。治疗性超声和离心运动也可以改善功能。本研究旨在观察这两种治疗方式在更快的功能改善方面的比较疗效，并且这项随机干预性临床试验在达卡的一家私立康复医院进行。2013年1月至2013年12月期间，临床诊断为网球肘的患者到作者的私人诊室就诊并被纳入研究。80名被诊断为外侧上髁炎或网球肘的成年患者被随机分为两组。A组接受局部类固醇注射（醋酸曲安奈德），B组接受治疗性超声治疗两周。两组均进行离心运动，并被建议避免如扭转和提举活动等诱发活动。采用视觉模拟评分法（VAS）和0至4级压痛分级等传统方法测量疼痛、压痛和功能改善情况。数据采用SPSS进行分析。大多数患者为女性。他们中没有人是网球运动员。年轻家庭主妇是常见的患者群体。A组几乎所有患者在1周和2周时疼痛或压痛很少或没有，提举物体时没有困难。VAS分别为13.62±6.503和4.15±5.517。B组患者在1周时疼痛和功能有轻度改善，在2周时有中度改善。VAS分别为52.57±7.80和25.57±5.392。同样，A组在1周和2周时压痛明显改善。A组分别为0.68±0.616和0.02±0.405，B组分别为1.60±0.553和1.14±0.335。两周结束时两组结果均具有统计学意义。发现在网球肘患者的伸肌起点处进行局部皮质类固醇注射比治疗性超声治疗在缓解疼痛和压痛以及更快的功能改善方面效果更好。两组均未对患者进行长期疗效随访。
