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Cited by 103Tendon Structure and TreatmentShoulder Injury and TreatmentMusculoskeletal pain and rehabilitation

A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)

Peterson, Magnus, Butler, Stephen, Eriksson, Margaretha, Svärdsudd, Kurt·2014·Clinical Rehabilitation
DOI 10.1177/0269215514527595
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Abstract

OBJECTIVE: To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow. DESIGN: Randomized controlled trial. SETTING: Primary care in Uppsala County, Sweden. SUBJECTS: A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement. INTERVENTION: Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load. MAIN MEASURES: Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months. RESULTS: The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures. CONCLUSION: Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.

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  • Disability levels at the end of the program (12.56, 95% CI 10.25; 14.87) were within the ranges reported in previous studies (9-23 points).

    “Disability levels at the end of this program (12.56, 95% CI 10.25; 14.87) were within the ranges reported in previous studies (9–23 points), using either QuickDASH, DASH or the Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) [74,75,78,79].”

    From Digital Rehabilitation for Elbow Pain Musculoskeletal Conditions: A Prospective Longitudinal Cohort Study (2022) · cites this paper as [79]

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Authors
Peterson, M., Butler, S., Eriksson, M., & Svärdsudd, K.
Affiliations
  • Uppsala University (SE)
  • Uppsala University Hospital (SE)
ORCID
Venue
Clinical Rehabilitation
Publisher
SAGE Publications
Published
2014-03-14
Volume
28
Issue
9
Pages
862-872
ISSN
  • 0269-2155 (ISSN-L)
  • 1477-0873
DOI
10.1177/0269215514527595
OpenAlex
W2137651312
Cited by
103
References
36
Citations by year
2026: 3 · 2025: 6 · 2024: 10 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 9 · 2019: 5 · 2018: 14 · 2017: 11 · 2016: 8 · 2015: 7 · 2014: 1
FWCI
9.37
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Clinical Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
  • Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
lateral epicondylitis, eccentric exercise, concentric exercise, graded exercise, home-based exercise, analgesia, muscle strength, quality of life, elbow function
MeSH terms
Exercise Therapy, Female, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Sweden, Tennis Elbow, Pain Management

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