scholarly journals The relative effectiveness of cross friction and Mill's manipulation as compared to cross friction alone in the treatment of lateral epicondylitis (tennis elbow)

2000 ◽  
Author(s):  
◽  
Junaid Shaik
Keyword(s):  
General Population ◽  
Sampling Methods ◽  
Tennis Elbow ◽  
Relative Effectiveness ◽  
Lateral Epicondylitis ◽  
Controlled Study ◽  
Group 2 ◽  
Prospective Controlled Study ◽  
Group 1

The purpose of this study was to determine the relative effectiveness of cross friction combined with Mill's manipulation compared to cross friction alone in the treatment of lateral epicondylitis. This was a prospective, controlled study. The study involved thirty subjects, fifteen randomly allocated into two groups. These patients were selected from the general population by purposive sampling methods. Group 1 received cross friction and Mill's manipulation while Group 2 received cross friction only. Each subject was treated 6 times over a three-week period. Patients were required to return for a one-month follow-up from the date of their last consultation.

scholarly journals Manipulation of the Wrist for Management of Lateral Epicondylitis: A Randomized Pilot Study

2003 ◽  
Vol 83 (7) ◽  
pp. 608-616 ◽  
Author(s):  
Peter AA Struijs ◽  
Pieter-Jan Damen ◽  
Eric WP Bakker ◽  
Leendert Blankevoort ◽  
Willem JJ Assendelft ◽  
...  
Keyword(s):  
Success Rate ◽  
Large Scale ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Control Group ◽  
Muscle Stretching ◽  
Strengthening Exercises ◽  
Group 2 ◽  
Group 1

Abstract Background and Purpose. Lateral epicondylitis (“tennis elbow”) is a common entity. Several nonoperative interventions, with varying success rates, have been described. The aim of this study was to compare the effectiveness of 2 protocols for the management of lateral epicondylitis: (1) manipulation of the wrist and (2) ultrasound, friction massage, and muscle stretching and strengthening exercises. Subjects and Methods. Thirty-one subjects with a history and examination results consistent with lateral epicondylitis participated in the study. The subjects were randomly assigned to either a group that received manipulation of the wrist (group 1) or a group that received ultrasound, friction massage, and muscle stretching and strengthening exercises (group 2). Three subjects were lost to follow-up, leaving 28 subjects for analysis. Follow-up was at 3 and 6 weeks. The primary outcome measure was a global measure of improvement, as assessed on a 6-point scale. Analysis was performed using independent t tests, Mann-Whitney U tests, and Fisher exact tests. Results. Differences were found for 2 outcome measures: success rate at 3 weeks and decrease in pain at 6 weeks. Both findings indicated manipulation was more effective than the other protocol. After 3 weeks of intervention, the success rate in group 1 was 62%, as compared with 20% in group 2. After 6 weeks of intervention, improvement in pain as measured on an 11-point numeric scale was 5.2 (SD=2.4) in group 1, as compared with 3.2 (SD=2.1) in group 2. Discussion and Conclusion. Manipulation of the wrist appeared to be more effective than ultrasound, friction massage, and muscle stretching and strengthening exercises for the management of lateral epicondylitis when there was a short-term follow-up. However, replication of our results is needed in a large-scale randomized clinical trial with a control group and a longer-term follow-up.

scholarly journals A Prospective Controlled Study on Long-Term Outcomes of Facial Lacerations in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Sonja Fontana ◽  
Clemens M. Schiestl ◽  
Markus A. Landolt ◽  
Georg Staubli ◽  
Sara von Salis ◽  
...  
Keyword(s):  
Treatment Time ◽  
Trial Registration ◽  
Long Term Results ◽  
Controlled Study ◽  
Tissue Adhesives ◽  
Scar Assessment ◽  
Group 2 ◽  
Group 1

Background: Although skin adhesives have been used for decades to treat skin lacerations, uncertainty remains about long-term results, and complications.Methods: In this prospective, controlled, single-blinded, observational cohort study, outcomes were assessed by five plastic surgeons with standardized photographs at 6–12 months using a modified Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS); additionally, the POSAS was performed by the patients/caregivers and the physician; pain, requirement of anesthesia, treatment time, costs, complications, and quality of live (QoL) were assessed.Results: A total of 367 patients were enrolled; 230 were included in the main analysis; 96 wounds were closed using tissue adhesives (group 1); 134 were sutured (group 2). Assessment by the independent observers revealed an improved mean modified overall POSAS score in group 1 in comparison with group 2 [2.1, 95% CI [1.97–2.25] vs. 2.5, 95% CI [2.39–2.63]; p < 0.001, d = 0.58] and mean VSS score [1.2, 95% CI [0.981–1.34] vs. 1.6, 95% CI [1.49–1.79], p < 0.001, d = 0.53]. At the early follow-up, dehiscence rate was 12.5% in group 1 and 3.7% in group 2 (p < 0.001); later on, one dehiscence remained per group. Mild impairment of QoL was found at the early follow-up in both groups, with no impairment remaining later on. Duration of treatment and treatment costs were lower in group 1.Conclusion: Both modalities of wound closure yield favorable esthetic results, and complications are rare. Adhesives are more cost-effective, and its application is less time-consuming; therefore, tissue adhesives offer considerable advantages when used appropriately.Trial Registration: Public trial registration was performed at www.ClinicalTrials.gov (Identifier: NCT03080467).

scholarly journals Randomized controlled study of proximal fibular osteotomy (PFO) with or without trabeculotomy in early osteoarthritis (OA) knee

2022 ◽  
Vol 7 (2) ◽  
pp. 82-86
Author(s):  
Syed Tariq Mahmood ◽  
Shubham Jain ◽  
Mrudul Shah ◽  
Harish Rao ◽  
Ravi Mehrotra ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Early Osteoarthritis ◽  
Fibular Osteotomy ◽  
Osteoarthritis Of Knee ◽  
Randomized Controlled ◽  
Group 2 ◽  
Group 1

This study was conducted to evaluate and compare the clinical and functional outcome of OA knee patients treated with proximal fibular osteotomy with or without trabeculotomy.This was a randomized controlled study amongst patients of osteoarthritis knee for a period of 1 year on patients with early osteoarthritis of knee. All patients were randomly allocated into two groups; group 1 patients were managed using PFO with trabeculotomy whereas group 2 patients were managed with proximal fibular osteotomy alone. All the patients were followed up post operatively at 15 days and at 2, 6 and 12 months post operatively. At each follow up patients were assessed for presence of Pain using Visual analogue scale. Also functional outcome was assessed using WOMAC.In present study, patients of two groups were comparable in their base line characters (p>0.05). Post operatively, mean VAS score and WOMAC score improved significantly in both the groups, the improvement was significantly higher in group 1 as compared to group 2 at all the follow up (p<0.05).Proximal fibular osteotomy with or without trabeculotomy can be used effectively as a promising tool for management of cases with early osteoarthritis of knee. It is safe, effective, and cost effective surgical technique for pain relief and improving functional outcome. PFO with trabeculotomy yields better results in terms of clinical as well as functional outcome as compared to PFO without trabeculotomy.

Extension block technique for mallet fractures: a comparison of one and two dorsal pins

2016 ◽  
Vol 41 (7) ◽  
pp. 701-706 ◽  
Author(s):  
U. Akgun ◽  
T. Bulut ◽  
E. C. Zengin ◽  
M. Tahta ◽  
M. Sener
Keyword(s):  
Controlled Study ◽  
Randomized Controlled ◽  
Outcome Scores ◽  
Level 3 ◽  
The Mean ◽  
Group 2 ◽  
Mean Time ◽  
Extensor Lag ◽  
Group 1

The aim of this study was to compare the clinical and radiological outcomes of one or two dorsal pins for extension blocking of mallet fractures. We treated 36 mallet fractures with the extension block technique. A single pin was used in 19 fractures (Group 1) and two pins in 17 fractures (Group 2). The mean age was 33.6 years and the mean follow-up time was 12.2 months. All patients were assessed by the Crawford outcome score. Extensor lag and other complications were noted. All fractures united with a mean time of 6.0 weeks (4–9) in Group 1, and 6.1 weeks (4–7) in Group 2. We obtained 74% and 71% excellent and good outcome scores in Group 1 and in Group 2, respectively. The final extension lag was 6° in Group 1, and 7° in Group 2. No difference was found between the two groups in terms of clinical outcomes, radiological values and complications. Level 3 non-randomized controlled study.

Iontophoretic Administration of Dexamethasone Sodium Phosphate for Acute Epicondylitis: A Randomized, Double-Blinded, Placebo-Controlled Study

2003 ◽  
Vol 31 (2) ◽  
pp. 189-195 ◽  
Author(s):  
◽  
Robert P. Nirschl ◽  
Dennis M. Rodin ◽  
Derek H. Ochiai ◽  
Craig Maartmann-Moe
Keyword(s):  
Sodium Phosphate ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Placebo Treatment ◽  
Controlled Study ◽  
Global Improvement ◽  
Dexamethasone Sodium Phosphate ◽  
The Difference ◽  
Double Blinded

Background: A better treatment modality is needed to control the pain of medial or lateral epicondylitis (tennis elbow). Hypothesis: Dermal iontophoretic administration of dexamethasone sodium phosphate will be significantly more effective in controlling pain than a placebo in patients with medial or lateral elbow epicondylitis. Study Design: Randomized, double-blinded, placebo-controlled study. Methods: On six occasions, 1 to 3 days apart within 15 days, 199 patients with elbow epicondylitis received 40 mA-minutes of either active or placebo treatment. Results: Dexamethasone produced a significant 23-mm improvement on the 100-mm patient visual analog scale ratings, compared with 14 mm for placebo at 2 days and 24 mm compared with 19 mm at 1 month. More patients treated with dexamethasone than those treated with placebo scored moderate or better on the investigator's global improvement scale (52% versus 33%) at 2 days, but the difference was not significant at 1 month (54% versus 49%). Investigator-rated pain and tenderness scores favored dexamethasone over placebo at 2 days. Patients completing six treatments in 10 days or less had better results than those treated over a longer period. Conclusions: Iontophoresis treatment was well tolerated by most patients and was effective in reducing symptoms of epicondylitis at short-term follow-up.

ROLE OF LOCAL CORTICOSTEROID INJECTION VS THERAPEUTIC ULTRASOUND REGARDING IMPROVEMENT IN PAIN FREE GRIP STRENGTH OF TENNIS ELBOW PATIENTS

2021 ◽  
pp. 76-77
Author(s):  
Pradip Kumar Mallick ◽  
Ushnish Mukherjee
Keyword(s):  
Grip Strength ◽  
Steroid Injection ◽  
Tennis Elbow ◽  
Corticosteroid Injection ◽  
Initial Period ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Local Steroid Injection ◽  
Group 2 ◽  
Group 1

Background: Tennis elbow or Lateral epicondylitis is now a days a well known condition with mixed etiopathogenesis of inammation and microtear resulting in decreased hand grip strength. Among the various treatment options, therapeutic ultrasound and local steroid injection are commonly used in managing these patients, but comparative effectiveness of these two treatment procedures are often debated. To compare the efcacy of local cortic Aim of Study: osteroid injection versus therapeutic ultrasound in terms of improvement in painfree grip strength(PFGS) of affected upper limb. This i Method: nterventional study was conducted on 56 patients of both sexes within the age group of 18-60 years with unilateral Tennis elbow. They were randomly divided in two groups of same number(28 in each group)- Group-1: managed with local injection of steroid (methylprednisolone-10mg, single dose) with 2% of 0.5 ml lignocaine and Group-2 : managed with Therapeutic Ultrasound. Improvement of PFGS was assessed by hand held Dynamometer. Data collected at 0 week (Visit-1 or Pre-initiation), 3weeks (Visit-2 ), 6 weeks (Visit-3), 12 weeks (Visit-4). For PFGS score, in both Group-1 and Group-2, there Result: was signicant increase in subsequent visits (p<0.05). The mean PFGS score of Group-1 was signicantly higher than that of Group-2 in visit2(p<0.01), but in visit-3(p>0.05) & visit-4(p>0.05) there was no statistically signicant difference noted. Local Steroid injection & Conclusion: therapeutic ultrasound both are effective in improving PFGS. Though Local steroid injection is more effective in initial period, but in subsequent followups, the difference was statistically insignicant.

COMPARISON OF CORTICOSTEROID INJECTION WITH THERAPEUTIC ULTRASOUND FOR PAIN MANAGEMENT IN LATERAL EPICONDYLITIS

2021 ◽  
pp. 67-68
Author(s):  
Pradip kumar Mallick ◽  
Ushnish Mukherjee
Keyword(s):  
Pain Management ◽  
Pain Score ◽  
Steroid Injection ◽  
Corticosteroid Injection ◽  
Therapeutic Ultrasound ◽  
Lateral Epicondylitis ◽  
Local Steroid Injection ◽  
Group 2 ◽  
Group 1

Background: Lateral epicondylitis is the most common presentation of lateral elbow pain and quite disabling entity in Musculoskeletal rehabilitation. Among the various treatment options, therapeutic ultrasound and local steroid injection are commonly used for managing pain in these patients, but comparative effectiveness of these two treatment procedures are often debated. Aim of Study: To evaluate the efcacy of local corticosteroid injection versus therapeutic ultrasound regarding pain reduction in patients with Lateral epicondylitis. Method:This interventional study was conducted on 56 patients of both sexes within the age group of 18-60 years with unilateral Lateral epicondylitis. They were randomly divided in two groups of same number(28 in each group)- Group-1: managed with local injection of steroid (methylprednisolone-10mg, single dose) with 2% of 0.5 ml lignocaine and Group-2 : managed with Therapeutic Ultrasound. Improvement of pain was assessed in 0-10 visual st analogue scale(VAS). Data collected at 0 week (Visit-1 or Pre-initiation), 3weeks (Visit-2 or 1 Follow up), 6 weeks (Visit-3), 12 weeks (Visit-4). Result: For VAS(pain) score, in both Group-1 and Group-2, there was signicant decrease in subsequent visits (p<0.05). The mean VAS(pain) score of Group-1 was signicantly lower than that of Group-2 in visit -2(p<0.01), visit-3(p<0.01) & visit-4(p<0.05) indicating better outcome in Group-1. Conclusion: Both Local Steroid injection (methylprednisolone) & therapeutic ultrasound are effective in pain management of lateral epicondylitis but Local steroid injection is more effective mostly in early follow up period.

scholarly journals Tennis elbow brace and wrist cock-up splint in the management of tennis elbow: a comparative study

2020 ◽  
Vol 6 (4) ◽  
pp. 813
Author(s):  
Sandeep Gavhale ◽  
Harshit Dave ◽  
Hitesh Rohra ◽  
Vipul D. Shet ◽  
Ganesh Aher ◽  
...  
Keyword(s):  
Tennis Elbow ◽  
Symptomatic Relief ◽  
Lateral Epicondylitis ◽  
Post Treatment ◽  
Wrist Extension ◽  
Proper Patient Selection ◽  
Group 3 ◽  
Pre Treatment ◽  
Group 2 ◽  
Group 1

<p class="abstract"><strong>Background:</strong> The purpose of our study was to compare the efficacy of a wrist splint with a forearm counterforce strap brace in the management of tennis elbow.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted between January and December 2018 comprising of 75 patients suffering from lateral epicondylitis managed conservatively with splints. Patients were randomized into three treatment groups, group 1 received tennis elbow forearm brace, group 2 received wrist extension splint, group 3 received both tennis elbow forearm brace and wrist extension splint. The patient-rated tennis elbow evaluation (PRTEE) score and visual analogue scale (VAS) scores were calculated at 0, 3 and 6 weeks of the treatment.<strong></strong></p><p class="abstract"><strong>Results:</strong> Mean difference of pre-treatment and post-treatment PRTEE score was significant in all three groups and was maximum for group 3 patients (32.42) followed by group 2 patients (27.04) followed by group 1 patients (20.06). Pre-treatment and post-treatment VAS score difference was maximum for group 3 patients.</p><p class="abstract"><strong>Conclusions:</strong> Significant symptomatic relief can be achieved in patients with tennis elbow by using either tennis elbow forearm brace or wrist extension splint or both. Provided proper patient selection and compliance, wrist extension splint achieves better symptomatic relief and functional outcome as compared to tennis elbow brace.</p>

Standardized Tendon Fenestration with Injection of Autologous Blood for Treatment of Lateral Epicondylitis

2020 ◽  
Author(s):  
Chul Ki Goorens ◽  
Pascal Wernaers ◽  
Joost Dewaele
Keyword(s):  
Tennis Elbow ◽  
Autologous Blood ◽  
Lateral Epicondylitis ◽  
Pain Scale ◽  
Short Term ◽  
Shockwave Therapy ◽  
Other Substances ◽  
Injured Tendon ◽  
Satisfaction Rates

AbstractLateral epicondylitis (LE) of the elbow is often treated with conservative methods. Several techniques including injections with different substances are widely performed. No standardization exists. This prospective study describes the results of the short-term follow-up of 56 patients with mean age 48 years (range: 30–68 years) treated with the Instant Tennis Elbow Cure Medical device, which fenestrates the injured tendon in a standardized way through a holder of 12 small needles. Depth and position of the needles are determined beforehand by ultrasonography. Unprepared autologous blood was injected through the holder in the tendon. Visual analog pain scale (VAS) decreased significantly in rest by 61% and during activity by 47% after 6 weeks. VAS decreased significantly in rest by 79% and during activity by 66% after 3 months. VAS did not remain significantly different after 6 months. Satisfaction rates were 71% after 6 weeks and 82% after 6 months. This suggests that the therapeutical effect sustains and in some cases increases over time. Patient Related Tennis Elbow Evaluation score ameliorated after 3 months by 71%. Comparative studies are needed to confirm this effect versus other techniques as physiotherapy, shockwave therapy, and injections with other substances.

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

Sign in / Sign up

Export Citation Format

Share Document