Department of Physiotherapy and Rehabilitation, Istanbul University, Institute of Health Sciences, Istanbul, Turkey.
Division of Physiotherapy and Rehabilitation, Istanbul University, Faculty of Health Sciences, Istanbul, Turkey.
J Hand Ther. 2019 Oct-Dec;32(4):417-425. doi: 10.1016/j.jht.2018.01.002. Epub 2018 Feb 13.
Randomized parallel group trial.
Various treatment options for lateral epicondylosis have been reported in the literature.
We aimed to compare the effectiveness of low-level laser therapy (LLLT), phonophoresis, and iontophoresis in terms of pain, function, and grip strength.
This study that comprised 37 patients with lateral epicondylosis was planned as a prospective randomized parallel group trial. Twelve participants were randomized to the LLLT group, 12 to the phonophoresis group, and 13 to the iontophoresis group. The Visual Analog Scale (VAS), pressure algometer, the Patient-Rated Tennis Elbow Evaluation, and grip strength dynamometer were used to measure outcomes. The measurements were performed at baseline and at the end of 15 sessions.
Investigation of the pain scores revealed that all VAS scores were improved in both the laser and iontophoresis groups (VAS at rest: P = .015, effect size (ES) = 1.49 and P = .016, ES = 0.58, respectively; VAS during activity: P = .008, ES = 1.05 and P = .008, ES = 1.16, respectively; VAS at night: P = .013, ES = 1.01 and P = .016, ES = 0.72, respectively). Only advance in function and grip strength was associated with the iontophoresis group (Patient-Rated Tennis Elbow Evaluation P = .006, ES = 0.78; grip strength with elbow extension P = .011, ES = 1.03; with elbow flexion P = .003, ES = 0.52).
The most effective approach could not be highlighted among the existing studies in the literature as they were applied in combination with other therapies.
In our study, we observed that LLLT provides a benefit only for pain, whereas iontophoresis is beneficial for both pain and function. If the effect size is evaluated, LLLT is more influential than iontophoresis for decreasing pain. However, when we compared phonophoresis and iontophoresis in terms of effectiveness, we found that iontophoresis has better effects for pain, function, and grip strength.
随机平行分组试验。
文献中报道了各种治疗外侧肱骨上髁炎的方法。
我们旨在比较低水平激光治疗(LLLT)、超声透药疗法和离子电渗疗法在疼痛、功能和握力方面的疗效。
这项研究纳入了 37 名外侧肱骨上髁炎患者,计划采用前瞻性随机平行分组试验设计。12 名参与者被随机分配到 LLLT 组、12 名到超声透药疗法组、13 名到离子电渗疗法组。采用视觉模拟评分(VAS)、压力测力计、患者自评网球肘评估和握力测力计来测量结果。在基线和 15 次治疗结束时进行测量。
疼痛评分的研究结果表明,激光和离子电渗疗法组的所有 VAS 评分均有所改善(休息时 VAS:P=0.015,效应量(ES)=1.49;活动时 VAS:P=0.016,ES=0.58;夜间 VAS:P=0.013,ES=1.01)。只有功能和握力的改善与离子电渗疗法组相关(患者自评网球肘评估 P=0.006,ES=0.78;伸肘握力 P=0.011,ES=1.03;屈肘握力 P=0.003,ES=0.52)。
由于这些研究与其他治疗方法联合应用,因此无法在现有文献中突出强调哪种方法最有效。
在我们的研究中,我们观察到 LLLT 仅对疼痛有效,而离子电渗疗法对疼痛和功能均有益。如果评估效应量,LLLT 对减轻疼痛的影响大于离子电渗疗法。然而,当我们比较超声透药疗法和离子电渗疗法的疗效时,发现离子电渗疗法在疼痛、功能和握力方面的效果更好。