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  • Unsupervised Isometric Exercise versus Wait-and-See for Lateral Elbow Tendinopathy

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    Coombes247643-Accepted.pdf (1.841Mb)
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    Accepted Manuscript (AM)
    Author(s)
    Vuvan, Viana
    Vicenzino, Bill
    Mellor, Rebecca
    Heales, Luke James
    Coombes, Brooke Kaye
    Griffith University Author(s)
    Coombes, Brooke K.
    Year published
    2019
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    Abstract
    PURPOSE: This study aimed to investigate the effect of unsupervised isometric exercise compared to a wait-and-see approach on pain, disability, global improvement and pain-free grip strength in individuals with lateral elbow tendinopathy (LET). METHODS: Forty participants with unilateral LET of at least 6 weeks' duration were randomised to either wait-and-see (N=19) or a single supervised instruction session by a physiotherapist, followed by an 8-week unsupervised daily program of progressive isometric exercise (N=21). Primary outcomes were Patient-Rated Tennis Elbow Evaluation (PRTEE), global rating of change on a 6-point ...
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    PURPOSE: This study aimed to investigate the effect of unsupervised isometric exercise compared to a wait-and-see approach on pain, disability, global improvement and pain-free grip strength in individuals with lateral elbow tendinopathy (LET). METHODS: Forty participants with unilateral LET of at least 6 weeks' duration were randomised to either wait-and-see (N=19) or a single supervised instruction session by a physiotherapist, followed by an 8-week unsupervised daily program of progressive isometric exercise (N=21). Primary outcomes were Patient-Rated Tennis Elbow Evaluation (PRTEE), global rating of change on a 6-point scale (GROC, dichotomised to success and no success) and pain-free grip strength at 8 weeks. Secondary outcomes were resting and worst pain on an 11-point numerical rating scale (NRS), and thermal and pressure pain thresholds as a measure of pain sensitivity. RESULTS: Thirty-nine (98%) participants completed 8-week measurements. The exercise group had lower PRTEE scores compared to wait-and-see at 8 weeks (standardised mean difference (SMD) -0.92, 95% CI -1.58 to -0.26). No group differences were found for success on GROC (29% exercise vs 26% wait-and-see (risk difference 2.3%, 95% CI -24.5 to 29.1)), or pain-free grip strength (SMD -0.33, 95% CI -0.97 to 0.30). No differences were observed for all secondary outcomes except for worst pain, which was moderately lower in the exercise group (SMD -0.80, 95% CI -1.45 to -0.14).Unsupervised isometric exercise was effective in improving pain and disability, but not perceived rating of change and pain-free grip strength when compared to wait-and-see at 8 weeks. With only one out of the three primary outcomes being significantly different following isometric exercises, it is doubtful if this form of exercise is efficacious as a sole treatment.
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    Journal Title
    Medicine and Science in Sports and Exercise
    DOI
    https://doi.org/10.1249/MSS.0000000000002128
    Copyright Statement
    © 2019 LWW. This is a non-final version of an article published in final form in AIDS, 2019. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version
    Subject
    Sports science and exercise
    Medical physiology
    Health services and systems
    Public health
    Publication URI
    http://hdl.handle.net/10072/388264
    Collection
    • Journal articles

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