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Medicina dello Sport 2003 June;56(2):103-13


language: Italian

Role of the eccentric exercise in the functional reeducation of lateral epicondylitis: a randomised controlled clinical trial

Selvanetti A. 1, Barrucci A. 1, ntonaci A. 1, Martinez P. 1, Marra S. 1, Necozione S. 2

1 Azienda Ospedaliera “Complesso Ospedaliero S. Giovanni-Addolorata-Calvary”, UOC di Medicina Fisica e Riabilitazione, Centro di Riabilitazione “Medical Corner”, Roma; 2 Dipartimento di Medicina Interna e Sanità Pubblica, Università degli Studi dell’Aquila, L’Aquila


Aim. The literature about the conservative treatment of lateral epicondylitis shows that there are a lot of treatments, but reliable study protocols are lacking. During recent years the eccentric training regimen of the overuse tendinopathies has been reported as helpful and successful. This study shows personal experience of the authors in lateral epicondylitis (mean duration of symptomatology: 6,7 months) with a non-operative treatment including PNF (Proprioceptive Neuromuscular Facilitation) stretching, eccentric training of the wrist extensors and education.
Methods. In a double-blinded randomized controlled study, 62 patients were randomly allocated to 2 treatment groups.Group C (control; n = 29) underwent sham ultrasound and counseling, while group E (eccentric; n = 33) was treated with a contract-relax stretching program, eccentric exercises and counseling. All the patients were allowed to use an orthotic device in painful activities that could not be stopped.
Results. Before and after treatment, the results were evaluated using the scoring system proposed by Ko. At the final follow up of 11 months (range 6-14) Ko and Verhaar scoring systems, and a subjective assessment were also used. At the end of the treatment period, group E showed statistically significant improvements in Ko’s items, and after 11 months the successful results (excellent/good according to the Verhaar score) were 76% versus only 3% among patients of group C. The early improvements (4 week-period) of group C, as stated by Ko’s score, have not been maintained at the final follow-up.
Conclusions. In a short-term follow-up, an eccentric exercise regimen seems more effective than placebo in treating lateral epicondylitis, reducing pain and improving patient’s function.

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