Sensorimotor Deficits Remain Despite Resolution of Symptoms Using Conservative Treatment in Patients With Tennis Elbow: A Randomized Controlled Trial

Abstract

Bisset LM, Coppieters MW, Vicenzino B. Sensorimotor deficits remain despite resolution of symptoms using conservative treatment in patients with tennis elbow: a randomized controlled trial. Objectives To evaluate the time course of sensorimotor deficits in lateral epicondylalgia (LE; tennis elbow) and how these deficits may be influenced by common conservative treatments. Design Single-blind randomized controlled trial. Setting University laboratory, Australia. Participants A total of 198 participants with unilateral LE of a minimum 6 weeks duration and normative data from a group of 40 healthy participants. Interventions Participants with LE were randomly assigned to physical therapy, corticosteroid injection, or a wait-and-see approach with ergonomic advice. Main Outcome Measures Upper-limb reaction time (simple, 1-choice and 2-choice reaction time) and speed of movement were assessed at baseline and 6 and 52 weeks of follow-up. Results Patients with LE exhibited delayed reaction times (P<.001) and slower movement speeds (P<.001) for both the affected and unaffected arm at baseline, compared with normative data. Despite some improvement over time, significant bilateral deficits remained compared with healthy participants, with no significant differences between the affected and unaffected arm. Overall, there was no significant difference between the 3 treatment groups over time. Conclusions Sensorimotor deficits remain relatively unchanged over time and are present bilaterally in patients with unilateral LE. Treatment did not influence the time course of the sensorimotor deficits. This prompts conjecture as to the relationship and clinical relevance of sensorimotor deficits in LE. It should be noted that treatment evaluated in this study did not specifically target sensorimotor function, and further investigation into the significance of sensorimotor deficits in patients with LE is required.