Dokuz Eylul University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Izmir, Turkey.
Dokuz Eylul University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Izmir, Turkey.
Arch Phys Med Rehabil. 2024 Apr;105(4):655-663. doi: 10.1016/j.apmr.2023.12.010. Epub 2023 Dec 30.
This study compares the clinical and ultrasonographic efficacy of 2 splint types, the lateral epicondylitis band (LEB) and the wrist extensor splint (WES), for treatment of lateral epicondylitis (LE).
Randomized controlled single-blind trial.
Outpatient clinic.
159 participants diagnosed with unilateral LE based on clinical and ultrasonographic findings, and 2-12 weeks from symptom onset, were included (N=159).
One group received joint-protection education-only (wait-and-see), while the other 2 groups were fit with splints: one the LEB and the other the WES. Both splint groups received joint-protection education.
The primary outcome measure was the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire. Secondary outcome measures were the Visual Analog Scale (VAS) for pain, hand grip strength by dynamometry, algometric measurements, patient satisfaction, and selected ultrasonographic parameters (maximum tendon thickness measurements (MTTM) in the capitellar-radiocapitellar region and total ultrasonography scale score [TUSS]). All outcomes were assessed at baseline, 3-weeks, and 6-weeks post intervention initiation.
Participants' mean age was 46.85±8.63 years. Of the participants, 40.88% (n=65) were male and 59.12% (n=94) were female. The baseline median (1Q-3Q) values of PRTEE-total scores were 58.5 (51-68) for the LEB, 63.5 (56.25-70.25) for the WES and 57 (48-68) for the education-only groups. At 6-weeks, the PRTEE-total scores had decreased by 44 points for those randomized to the LEB, 46 points to the WES and 7 points in the education-only groups(P<.001). While the LEB and WES approaches were superior to the wait-and-see approach in algometric measurements, VAS, and PRTEE scores (P<.05), no significant changes were found in MTTM and TUSS values. The LEB group was superior to the WES group in hand grip strength and patient satisfaction (P<.05).
Using either splint for 6 weeks can be considered effective for the relief of pain and increased functionality in persons with subacute LE, although the LEB had a more positive effect on grip strength and patient satisfaction than the WES.
本研究比较了两种夹板类型，外侧肱骨带（LEB）和腕伸肌夹板（WES），治疗外侧肱骨炎（LE）的临床和超声疗效。
随机对照单盲试验。
门诊。
根据临床和超声检查结果，159 名单侧 LE 患者（N=159），症状出现 2-12 周。
一组接受关节保护教育（观察等待），另一组 2 组患者佩戴夹板：一种是 LEB，另一种是 WES。两组夹板患者均接受关节保护教育。
主要观察指标为患者网球肘评估（PRTEE）问卷。次要观察指标为疼痛的视觉模拟量表（VAS）、握力测力计、压痛计测量、患者满意度和选定的超声参数（髁状突-桡骨突区域的最大肌腱厚度测量值（MTTM）和总超声评分[TUSS]）。所有结果均在基线、3 周和 6 周干预开始后进行评估。
参与者的平均年龄为 46.85±8.63 岁。参与者中，40.88%（n=65）为男性，59.12%（n=94）为女性。LEB 的 PRTEE 总分中位数（1Q-3Q）值为 58.5（51-68），WES 为 63.5（56.25-70.25），教育仅为 57（48-68）组。在 6 周时，随机分配到 LEB 组的患者 PRTEE 总分下降 44 分，WES 组下降 46 分，教育仅为 7 分（P<.001）。LEB 和 WES 方法在压痛计测量、VAS 和 PRTEE 评分方面优于观察等待方法（P<.05），但 MTTM 和 TUSS 值无明显变化。LEB 组在握力和患者满意度方面优于 WES 组（P<.05）。
使用这两种夹板 6 周均可有效缓解亚急性 LE 患者的疼痛和提高功能，尽管 LEB 对握力和患者满意度的影响比 WES 更积极。
