Department of Physiotherapy, University of Seville, Avicena Street, 41009 Seville, Spain.
Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain.
Int J Environ Res Public Health. 2021 May 3;18(9):4877. doi: 10.3390/ijerph18094877.
The aim was to analyze effects of a percutaneous neuromodulation (PNM) treatment on the radial nerve, regarding pain, functionality, electrophysiologic excitability, and morphology, in patients with chronic lateral epicondylalgia (LE).
Twenty-four patients with chronic unilateral elbow pain were recruited for this preliminary study and were divided into two groups: control (n = 12) and PNM group (n = 12). The subjects in the PNM group received percutaneous peripheral neurostimulation with an acupuncture needle that was located next to the nerve with ultrasound guidance. Pain using a numerical rating scale (NRS), functional ability using patient-rated tennis elbow evaluation (PRTEE), radial nerve cross-sectional area measured by ultrasound, and chronaxie and accommodation index (AI) measured by the strength-duration curve were evaluated.
Both groups showed no differences in the baseline measurements (all = 0.001). However, at the end of the treatment, there were significant differences between groups since only the PNM group significantly improved their values compared to their baseline values: level of pain and cross-sectional area (CSA) values showed a significant decrease while the PRTEE scores showed a significant improvement. Then, regarding AI, the PNM group showed significant improvement for the electrophysiologic nerve excitability pattern, reporting normal function in all radial nerves after treatment ( = 0.001). However, chronaxie values always reported similar values with no differences between groups ( >0.05); Conclusion: Ultrasound-PNM technique may be an interesting therapeutic tool for the treatment of chronic LE due to the improvement in the level of pain, functionality, nerve morphology, and excitability in this population.
分析经皮神经调节（PNM）治疗对慢性肘外侧痛（LE）患者桡神经的疼痛、功能、电生理兴奋性和形态的影响。
本初步研究共招募了 24 例慢性单侧肘部疼痛患者，并将其分为两组：对照组（n = 12）和 PNM 组（n = 12）。PNM 组患者在超声引导下将针灸针置于神经旁进行经皮外周神经刺激。采用数字评分量表（NRS）评估疼痛，采用患者自评网球肘评估（PRTEE）评估功能能力，采用超声测量桡神经横截面积，采用强度-时间曲线测量时值和适应指数（AI）。
两组基线测量值均无差异（均 P > 0.05）。然而，在治疗结束时，两组之间存在显著差异，因为只有 PNM 组与基线值相比，其值显著改善：疼痛水平和横截面积（CSA）值显著降低，而 PRTEE 评分显著提高。然后，对于 AI，PNM 组的电生理神经兴奋性模式显示出显著改善，治疗后所有桡神经均报告正常功能（ P < 0.001）。然而，时值始终报告相似的值，两组之间无差异（ P > 0.05）；结论：超声-PNM 技术可能是治疗慢性 LE 的一种有趣的治疗工具，因为它可以改善该人群的疼痛水平、功能、神经形态和兴奋性。
