A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis)
Open accessAbstract
BACKGROUND: Chronic tennis elbow (lateral epicondylosis) is a common disorder. Like other chronic soft-tissue pain conditions it is often difficult to treat successfully. The effects of exercise have been discussed, but no convincing evidence has been put forward so far, and a simple protocol for exercise is lacking. AIMS OF THE STUDY: This study is a randomized, controlled, clinical trial of the effect of exercise versus expectation (wait-list) on pain, muscle strength, function, and quality of life in patients with long-standing lateral epicondylosis. METHODS: Eighty-one subjects with tennis elbow lasting for more than 3 months were randomly allocated to an exercise group (n = 40) or a reference group (n = 41). The exercise group performed daily exercise, with weekly load increase, for 3 months. The reference group was wait-listed, but otherwise followed in the same way. Outcome measures were pain during maximum voluntary muscle contraction (Cozen's test) and pain during maximum muscle elongation with a load (modified Empty-can-test); muscle strength was measured with a Chatillon MSE 100 hand-held dynamometer, and the Disability of the Arm, Shoulder and Hand (DASH) and the Gothenburg Quality of Life questionnaires. RESULTS: The exercise group had greater and faster regression of pain, both during muscle contraction and muscle elongation, than the reference group (p = 0.0005 and p = 0.0016, respectively). There was a non-significant muscle strength difference between the groups, but no differences regarding DASH scores or quality of life measures. CONCLUSIONS: Exercise appears to be superior to expectation in reducing pain in chronic lateral epicondylosis.
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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 [78]
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Flagged first, then by citations
Research works printed but not linked: 2
- [1]Verhaar JA Tennis elbow [PhD thesis] The Netherlands Maastricht University 1992
- [46]Alkner B Effects of unloading and resistance exercise on skeletal muscle function, size and composition in man [PhD thesis] Department of Physiology and Pharmacology, Section for Muscle and Exercise Physiology, Karolinska Institute 2005 Stockholm, Sweden
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Physiotherapy management of lateral epicondylalgia
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“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].”
MethodInfluential
- Authors
- Peterson, M., Butler, S., Eriksson, M., & Svärdsudd, K.
- Affiliations
- Uppsala University (SE)
- Uppsala University Hospital (SE)
- Venue
- Upsala Journal of Medical Sciences
- Publisher
- Uppsala Medical Society
- Published
- 2011-11
- Volume
- 116
- Issue
- 4
- Pages
- 269-279
- ISSN
- 0300-9734 (ISSN-L)
- 2000-1967
- PMC
- PMC3207303
- OpenAlex
- W2087338752
- Cited by
- 78
- References
- 48
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 12 · 2014: 5 · 2013: 7 · 2012: 5
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Upsala Journal of Medical Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Vetenskapsrådet (K2005-27X-15293-01A)
- Uppsala Universitet
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Health Sciences › Medicine › Rehabilitation › Elbow and Forearm Trauma Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- lateral epicondylitis, exercise therapy, waitlist control, analgesia, muscle strength, functional disability, quality of life, empty can test, hand dynamometry, DASH questionnaire
- MeSH terms
- Adult, Chronic Disease, Female, Humans, Male, Middle Aged, Pain Measurement, Tennis Elbow, Exercise, Linear Models
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