Comparison of combined isotonic and deep friction soft tissue techniques on pain and function in patients with chronic lateral epicondylitis: Patient with chronic lateral epicondylitis

Aleena  Bashir; Sana  Hafeez; Khurram  Sarfraz; Anum  Bashir; Samra  Anwar; Farwa  Asad

doi:10.54393/pbmj.v5i2.276

Authors

Aleena Bashir Clinical Physiotherapist Mednic Clinic
Sana Hafeez Riphah College of Rehabilitation and Allied Health Sciences, Lahore
Khurram Sarfraz Riphah College of Rehabilitation and Allied Health Sciences, Lahore
Anum Bashir Clinical Physiotherapist Mednic Clinic
Samra Anwar Manual Therapist Johar Hospital Lahore
Farwa Asad Clinical Physiotherapist Jinnah Hospital

DOI:

https://doi.org/10.54393/pbmj.v5i2.276

Keywords:

Lateral epicondylitis, deep friction soft tissue technique, combined isotonic technique.

Abstract

To determine the effects of combined isotonic and deep friction soft tissue techniques on pain and function in patient with chronic lateral epicondylitis. Study Design: Quasi Experimental study. Place and Duration of study: Data was collected from Mednic clinic and services hospital Lahore, for 6 months of duration after the approval of synopsis. Method: Quasi Experimental study was conducted on twenty-two patients of chronic lateral epicondylitis. Participants were allocated to either combined isotonic technique group and deep friction soft tissue technique group, both groups were treated for 12 sessions in 4 weeks. NPRS and PRTEE scale were used to measure the treatment effect before and after treatment of 3 session per week, total 12 sessions in 4 weeks to each participant. Data was analyzed by SPSS 21. Results: Total participants 22 were classified into two groups, Group A (combined isotonic technique) and Group B (deep friction soft tissue technique group). Minimum age was 30, maximum age was 46, mean age 37 and standard deviation was ±4.93. The significance was greater than 0.05 which mean the data is normally distributed as the value of Shapiro wilk test for NPRS .88 and for PTREE was .208, therefore parametric test (paired and independent T test) was applied. The significance values for all statistical tests were set to 0.05. Paired sample T test for NPRS mean difference reading for group A was 2.63 ±.9244 and group B was 1.09 ±.3015 and for PRTEE mean difference for group A was 14.09 ±7.8288 and group B was 5.81 ±3.945 showed that although in both group changes were significant but difference of mean was greater in Combined isotonic technique group. Independent T test comparison of mean score of NPRS and PRTEE between Group A and Group B showed that there was significant difference in value, pretreatment NPRS mean difference was .011 and post treatment NPRS score was 1.54. pretreatment PRTEE mean difference was 1.90 and post treatment NPRS score was 6.36 so combined isotonic technique showed greater mean difference after treatment. Conclusion: The study concluded that combined isotonic exercises group showed better results than deep friction soft tissue technique group for improvement of pain and functional disability in lateral epicondylitis patients

References

Lai WC, Erickson BJ, Mlynarek RA, Wang D. Chronic lateral epicondylitis: challenges and solutions. Open access journal of sports medicine. 2018;9:243.

https://doi.org/10.2147/OAJSM.S160974

Jobe FW, Ciccotti MG. Lateral and medial epicondylitis of the elbow. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 1994;2(1):1-8.

https://doi.org/10.5435/00124635-199401000-00001

Haahr J, Andersen J. Physical and psychosocial risk factors for lateral epicondylitis: a population based case-referent study. Occupational and environmental medicine. 2003;60(5):322-9.

https://doi.org/10.1136/oem.60.5.322

Levin D, Nazarian LN, Miller TT, O'Kane PL, Feld RI, Parker L, et al. Lateral epicondylitis of the elbow: US findings. Radiology. 2005;237(1):230-4.

https://doi.org/10.1148/radiol.2371040784

Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. American journal of epidemiology. 2006;164(11):1065-74.

https://doi.org/10.1093/aje/kwj325

Tang H, Fan H, Chen J, Yang M, Yi X, Dai G, et al. Acupuncture for lateral epicondylitis: a systematic review. Evidence-based complementary and alternative medicine. 2015;2015.

https://doi.org/10.1155/2015/861849

Salib PI. Treatment of lateral epicondylitis: try it, what do you lose? Journal of surgical orthopaedic advances. 2004;13(1):49.

Uygur E, Aktaş B, Özkut A, Erinc S, Yilmazoglu EG. Dry needling in lateral epicondylitis: a prospective controlled study. International orthopaedics. 2017;41(11):2321-5.

https://doi.org/10.1007/s00264-017-3604-1

Ko J-Y, Chen H-S, Chen L-M. Treatment of lateral epicondylitis of the elbow with shock waves. Clinical Orthopaedics and Related Research (1976-2007). 2001;387:60-7.

https://doi.org/10.1097/00003086-200106000-00008

Reyhan AC, Sindel D, Dereli EE. The effects of Mulligan's mobilization with movement technique in patients with lateral epicondylitis. Journal of back and musculoskeletal rehabilitation. 2020;33(1):99-107.

https://doi.org/10.3233/BMR-181135

Joshua Ezhil Selvan J. Comparision of the Effectiveness of Bracing [COUNT'R-Force Forearm Brace] Vs. Tapping [MACDONALD] in Patients with Lateral Epicondylitis: Nandha College of Physiotherapy, Erode; 2012.

Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Medicine. 1999;28(5):375-80.

https://doi.org/10.2165/00007256-199928050-00006

Hong QN, Durand M-J, Loisel P. Treatment of lateral epicondylitis: where is the evidence? Joint Bone Spine. 2004;71(5):369-73.

https://doi.org/10.1016/j.jbspin.2003.05.002

Saroja G, Aseer PAL, Venkata Sai P. Diagnostic accuracy of provocative tests in lateral epicondylitis. Int J Physiother Res. 2014;2(6):815-23.

https://doi.org/10.16965/ijpr.2014.699

Walton MJ, Mackie K, Fallon M, Butler R, Breidahl W, Zheng MH, et al. The reliability and validity of magnetic resonance imaging in the assessment of chronic lateral epicondylitis. The Journal of hand surgery. 2011;36(3):475-9.

https://doi.org/10.1016/j.jhsa.2010.11.040

VCIII D, Grimmer K, Milanese S, Kumar S. The sensitivity of the provocation tests in replicating pain on the lateral elbow area of participants with lateral epicondylalgia. J Case Rep Clin Res Stud. 2014;1(1):1.

Yi R, Bratchenko WW, Tan V. Deep friction massage versus steroid injection in the treatment of lateral epicondylitis. Hand. 2018;13(1):56-9.

https://doi.org/10.1177/1558944717692088

Kim B-R, Yi D-H, Yim J-E. Effect of the combined isotonic technique for proprioceptive neuromuscular facilitation and taping on pain and grip strength in patients with lateral epicondylitis: a randomized clinical trial. Journal of exercise rehabilitation. 2019;15(2):316.

https://doi.org/10.12965/jer.1938078.039

Cho Y-T, Hsu W-Y, Lin L-F, Lin Y-N. Kinesio taping reduces elbow pain during resisted wrist extension in patients with chronic lateral epicondylitis: a randomized, double-blinded, cross-over study. BMC musculoskeletal disorders. 2018;19(1):1-8.

https://doi.org/10.1186/s12891-018-2118-3

Puri J, Ahmed N. EFFECTS OF DEEP FRICTION MASSAGE ON TENDINITIS (LATERAL EPICONDYLITIS) IN COMPARISON TO ULTRASOUND THERAPY. Pakistan Journal of Rehabilitation. 2014;3(2):36-40.

https://doi.org/10.36283/pjr.zu.3.2/008