Dissertations / Theses: 'Tennis elbow'

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Verhaar, Johannes Albertus Nicolaas. "Tennis elbow." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 1992. http://arno.unimaas.nl/show.cgi?fid=5721.

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Stickney, David. "(Non-surgical) epicondylitis rehabilitation a systematic review /." Morgantown, W. Va. : [West Virginia University Libraries], 2008. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5727.

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Zeisig, Eva. "Tennis elbow : sonographic findings and intratendinous injection treatment." Doctoral thesis, Umeå universitet, Idrottsmedicin, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1857.

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Tennis elbow (TE) is a relatively common painful condition affecting the upper extremity. The aetiology is not known, but TE is most often seen in middle aged individuals using repetitive and forceful gripping at work or recreational activities, and is referred to overuse injuries. The pathogenesis is not known, but there are so-called degenerative changes in the wrist- and finger-extensor muscle origin (common extensor origin - CEO). The pain mechanisms involved have not been scientifically clarified. The studies in the present thesis aimed to 1) evaluate the structure and blood flow using ultrasound (US) and colour Doppler (CD) examinations of the CEO in patients with TE, and in pain-free elbows, 2) evaluate the clinical effects of US- and CD-guided intratendinous injection treatment with the sclerosing substance polidocanol, 3) evaluate the long term (2 years) effects of injection treatment on the tendon structure and blood flow, and 4) investigate if there is a local production of sympathetic and parasympathetic signal substances in non-neural cells in the CEO. Structural tendon changes and high blood flow was found in the CEO in patients with TE, but not in pain-free controls. Remaining structural changes and additional bone spur formation at the lateral epicondyle, but not high blood flow, were seen 2 years after successful injection treatment. In a randomised double-blind study, US- and CD-guided intratendinous injection treatment with sclerosing polidocanol or the local anaesthetic lidocaine combined with epinephrine, targeting the region with high blood flow, was found to reduce pain and increase grip strength in patients with TE. There were no differences in the outcome between the two treatment groups. A local production of catecholamines, but not acetylcholine, was found in fibroblasts in the CEO, in patients with TE. This thesis presents results showing US and CD examinations to be useful methods to diagnose TE, and to evaluate structure and blood flow in the CEO after treatment. US- and CD-guided injection treatment targeting high blood flow in the region with structural changes can reduce pain symptoms in patients with TE. The localised high blood flow, and local production of catecholamines in the tendon cells in the CEO, might be involved in the pain mechanisms.

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Rossi, Jeremy. "Analyse biomécanique de l'interface main-raquette lors de la pratique du tennis : applications à l'étude du tennis elbow." Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM4074.

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Le tennis elbow est une pathologie fréquente affectant le membre supérieur. Cette pathologie s'observe également dans un large éventail d'activités manuelles allant de la manipulation d'outils de maçonnerie à la manipulation d'une souris d'ordinateur. Malgré son prévalence élevée, les mécanismes sous-jacents au développement du tennis elbow demeurent paradoxalement largement méconnus et n'offrent pas de consensus scientifique. Toutefois, les outils, les instruments ou les objets manipulés, formant une interface avec la main, sont soupçonnés d'être en partie responsables de l'apparition de cette affection. Cependant, le manque de moyens d'investigation biomécanique sur la main ramène cette assertion au statut d'hypothèse. Dans ce travail de thèse, l'idée que les caractéristiques physiques de la raquette (i.e. taille et forme du manche ; inertie de la raquette) puissent avoir une influence sur le risque d'apparition du tennis elbow a été testée. Pour cela, nous avons mené une démarche structurée en trois étapes. Tout d'abord, une approche expérimentale contrôlée nous a permis de quantifier les efforts exercés au niveau de l'interface main-manche lorsque l'on serre simplement ce dernier. Pour cela, un instrument de mesure des forces a été développé (i.e. ergomètre à 6 poutres couplé à une nappe de pression Tekscan). Cela nous a permis de définir une taille et une forme de manche optimale pour les forces de serrage. Dans un second temps, ce manche optimal (i.e. de section circulaire et de périmètre égal à 17,9% de la longueur de la main) a été testé au cours de frappes de tennis
Lateral epicondylalgia (LE) have been reported to occur at least once in a range of 40% to 50% of tennis players and in a large number of workers using hand tools. Despite high prevalence, the mechanisms underlying the development of tennis elbow are paradoxically misunderstood and suffer from a lack of scientific consensus. The characteristics of the handled tools (e.g. the grip size and the shape) are believed to be partly responsible for the occurrence of these disorders. However, the available material and technique for investigation and the proceedings studies did not gave evidence for this hypothesis. In this work, the idea that the size and shape of a tennis racket handle can affect the risk of developing tennis elbow was tested in three main steps. First, a controlled experimental approach was performed in order to quantify the forces exerted at the interface hand / handle when squeezing simply a handle. A special force ergometer has been developed to measure the forces at the hand/handle interface. This study enabled us to define an optimal size and shape (i.e. circular perimeter equal to 18% of the length of the hand) to perform a maximal squeezing force. In a second step, the optimal handle was tested during tennis strokes. Our results show that with and without fatigue, the grip force was lower for the optimal handle compared to bigger or smaller handle. Finally, in a last step, a biomechanical model of the hand was used to assess the impact of the tennis racket grip size on the forces applied on muscles affected by tennis elbow during a simulation. Our results suggest that the optimal grip size reduces muscle tensions of hand extensor muscle

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Poltawski, Leon. "Microcurrent therapy in the management of chronic tennis elbow." Thesis, University of Hertfordshire, 2011. http://hdl.handle.net/2299/5466.

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Microcurrent therapy (MCT) involves the application of sub-sensory electric current and can promote tissue repair, possibly by mimicking endogenous electrical cues for healing. It has been used successfully to treat recalcitrant bone fractures and skin ulcers, but its effects on other forms of tissue have received little attention. This study aimed to investigate the potential of MCT to promote healing and alleviate symptoms in a selected soft connective tissue disorder. A systematic review of human studies involving MCT for soft connective tissue damage was conducted. A survey of 93 musculoskeletal physiotherapists was used to help select a common, recalcitrant disorder to treat with microcurrent in a clinical trial. Novel sonographic scales to quantify tendon structural abnormality and tissue healing were developed, and their measurement properties evaluated along with several clinical and patient-rated outcome measures. Two preliminary clinical trials, involving 62 people with the selected disorder – chronic tennis elbow - were conducted, comparing four different types of microcurrent applied daily for 3 weeks. The review found fair quality evidence that certain forms of MCT can relieve symptoms, and low quality evidence that they can promote healing, in several soft connective tissue disorders, including those affecting tendons. Optimal treatment parameters are unknown. In the survey, clinicians identified frozen shoulder, plantar fasciitis and tennis elbow as particularly problematic, and tennis elbow was selected for treatment in the trials. The sonographic scales of hyperaemia had fair-to-good inter-rater and test-retest reliability. Minimum Detectable Change values are calculated for the sonographic scales and for pain-free grip strength measurements. The trials suggest that monophasic microcurrent of peak amplitude 50 µA applied for 35 hours was most effective in symptom alleviation, with a 93% treatment success rate three months after treatment. By final assessment, pain-free grip strength increased by 31% (95%CI:5,57%), pain measured on a multiple-item questionnaire reduced by 27% (95%CI:16,38%) and patient-rated functional disability by 26% (95%CI:14,28%). MCT with a current amplitude of 500 µA was significantly less effective, and varying the waveform appeared less important in determining outcomes. Differences between groups were non-significant on several measurs, though there was a risk of type II error in the tests used. No significant differences between any groups were seen in sonographic assessments, although consistent patterns in bloodflow chage suggested that MCT may modulate hyperaemia levels. Higher baseline hyperaemia was associated with sustained falls in hyperaemia levels after treatment, and with improved clinical outcome. MCT’s analgesic effect does not rely on sensory stimulation, and further investigation of its influence on tendinous blood flow and vascularity, or on the local biochemical milieu, may help elucidate its mechanism of action. On the basis of this investigation, a fully-powered controlled clinical trial is justified. A protocol, combining MCT with an exercise programme, is proposed.

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Qutishat, Dania. "Balance and response time in patients with chronic tennis elbow." Thesis, Sheffield Hallam University, 2011. http://shura.shu.ac.uk/20786/.

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Tennis elbow is a common condition that is easy to diagnose however, the optimal approach to management is still an area of considerable debate with limited evidence to support current practice. This is due to the ambiguous nature of its aetiology and pathology, which remain poorly understood. Bilateral sensorimotor deficits in the upper limb have been found in patients with unilateral tennis elbow, as they had slower response time and slower speed of movement. Research suggests that these patients could also have generalised sensorimotor deficits due to peripheral and central sensitisation. However, only bilateral sensorimotor deficits have been investigated suggesting that research is warranted to investigate the generalised sensorimotor deficits in patients with chronic tennis elbow. Therefore, it is the intention of this research to provide new knowledge in the area of sensorimotor function in these patients. This PhD programme consisted of two phases, the first phase involved healthy participants (n=22) and the second phase involved patients with chronic tennis elbow (n=11). This study was quasi experimental and investigated sensorimotor function by measuring balance and response time of the upper and lower limbs. The outcome measure for balance was time to boundary (TtB) in the anterio-posterior (ap) and medio-lateral (ml) directions. For the response time, the outcome measures were 1-choice response time and 2-choice response time. The test-retest reliability was assessed for these outcome measures using the intraclass correlation coefficient (ICC) and the standard error of measurement and yielded good to excellent reliability estimates. Following descriptive analysis and tests for normality and homogeneity of variance, the data was analysed using a mixed design ANOVA. Results showed that patients with chronic tennis elbow have more balance instability when compared to healthy participants as they were closer to reach their stability boundary in the anterioposterior direction. The findings of this research add new knowledge to the field of sensorimotor function in patients with chronic tennis elbow and enhance the understanding of this condition between health professionals.

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Paulsson, Olivia. "Heat detection in precurser of tennis elbow and other joint injuries." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-281875.

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Background: Joint injuries are a complex matter. Due to the low blood flow to the tendons and ligaments, they take months or even years to heal; some fail to heal. This can be devastating for the elite athlete as well as for the labour worker or everyday person. Today, the devices that can detect an upcoming inflammation or injury, cost 15 000 US dollars and more. A cheaper technology would increase the access. This project is investigating the possibility to detect an upcoming inflammation through measuring the local skin temperature. Method: A model of an arm was built in Comsol Multiphysics, where a tennis elbow (lateral epicondylitis) was simulated through local temperature increase. Clinical tests were pursued on two healthy subjects, in order to gain knowledge on how the skin temperature behaves on healthy subjects. Results: At an internal temperature increase in the LE of 0.25 K, a temperature difference on the skin of 0.18 K was detected in the model. The clinical tests on healthy subjects indicated a correlation between the temperatures on and around the elbow joint. Discussion: The model results does not include any error sources, such as deviation in room temperature and factors affecting the subject´s body temperature, such as time of day, eating and exercising routines. The clinical tests show a pattern of the temperature distribution on and around the elbow joint, in healthy subjects. The fact that a pattern is present, is a presumption enabling to find deviations, caused by upcoming inflammation. Conclusion: The model is indicating that a local temperature increase in the LE is detectable at the skin surface. The clinical test indicates that the noise in the temperature data of a healthy person, is small enough to enable to detect a local temperature deviation. At a local skin temperature increase of more than 0.5 K, the results are indicating that the deviation is detectable. Analysing the model data, 0.5 K in skin temperature increase would mean a local temperature increase at the LE of approximately 0.7 K. This is before the stage of inflammation according to literature, which occurs at an increase of 1.5 to 2.2 K. Further studies would be interesting to make, in purpose of developing an affordable device that can detect if an inflammation is about to occur, and thereby enable the subject to stop the course. A prototype should be developed in order to make tests on more subjects. The equine industry is also a target group – the prototype may therefore be developed to fit both humans and horses.
Bakgrund: Ledskador är komplicerade. På grund av det låga blodflödet till senor och ligament, tar de månader eller år att läka; visa skador läker aldrig helt. Det här kan vara förödande för såväl elitatleter som arbetande och gemene man. Tekniker idag som kan detektera uppkommande inflammation eller skada, kostar 15 000 US dollar och mer. En billigare teknik skulle ha en större tillgänglighet. Det här projektet undersöker möjligheten att detektera en uppkommande inflammation genom att mäta den lokala skintemperaturen. Metod: En modell av en arm byggdes i Comsol Multiphysics, där en tennisarmbåge (lateral epikondylit) simulerades genom en lokal temperaturökning. Kliniska tester utfördes på två friska subjekt, för att skapa en bil av hur skintemperaturen varierar på friska personer. Resultat: Vid en inner temperaturökning om 0,25 K i LE, uppmättes en temperaturökning på huden om 0,18 K i modellen. De kliniska testerna på friska subjekt indikerade att en korrelation finns mellan temperaturerna på och runt armbågsleden. Diskussion: Resultat från modellen saknar felkällor, som exempelvis variation av rumstemperatur och andra faktorer som påverkar subjektets kroppstemperatur, som tid på dagen, mat- och träningsrutiner.De kliniska testerna uppvisar ett mönster av temperaturdistributionen hos friska subjekt på och runt armbågsleden. Att ett mönster finns, banar väg för att hitta avvikelser, som orsakas av uppkommande inflammation. Slutsats: Modellen indikerar att en lokal temperaturökning i LE är mätbar på huden. Det kliniska testet indikerar att bruset i temperaturdistributionen hos ett friskt subjekt, är litet nog för att möjliggöra detektion av en lokal temperaturavvikelse. Vid en lokal ökning av hudtemperatur med mer än 0,5 K, indikerar resultaten att avvikelsen är detekterbar. Vid analys av modellresultaten, innebär 0,5 K hudtemperatursökning en temperaturökningi LE om ungefär 0,7 K. Det är innan inflammation har brutit ut, som sker vid en ökning om 1,5 till 2,2 K. Vidare studier är intresssant att göra, i ändamål att utveckla en prisvärd produkt som kan detektera om en inflammation är på väg, och därigenom göra det möjligt för subjektet att stoppa förloppet. En prototyp behöver utvecklas för att kunna utföra tester på fler subjekt. Utöver människor, är hästindustrin en målgrupp – prototypen bör därför utvecklas för att passa båda grupperna.

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Binder, Allan Ivan. "Painful stiff shoulder (frozen shoulder) and soft tissue rheumatism in the upper limb." Doctoral thesis, University of Cape Town, 1985. http://hdl.handle.net/11427/25848.

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Campbell, Brian Jude Weimar Wendi Hannah. "Wrist extension counter-moment force effects on muscle activity of the ECR with gripping implications for lateral epicondylagia /." Auburn, Ala., 2006. http://repo.lib.auburn.edu/Send%206-15-07/CAMPBELL_BRIAN_6.pdf.

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Peterson, Magnus. "Chronic Tennis Elbow : Aspects on Pathogenesis and Treatment in a Soft Tissue Pain Condition." Doctoral thesis, Uppsala universitet, Allmänmedicin och klinisk epidemiologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-160051.

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Objectives: To study the treatment practice of chronic tennis elbow (TE) among general practitioners (GPs) and physiotherapists (PTs), the effects of a simple, graded home exercise regime versus expectation, the effects of eccentric versus concentric exercise, and the involvement of the substance P – NK1 receptor system in the peripheral, painful tissue of chronic TE patients by positron emission tomography (PET). Materials and methods: A postal survey regarding therapeutic methods used in patients with chronic TE was sent to 129 GPs and 77 PTs, 81 subjects with chronic TE were randomly and blindly assigned to either an exercise group or a wait list group, 120 subjects were randomly assigned to either eccentric or concentric exercise and ten subjects were examined by PET and the NK1 specific radioligand [11C]GR205171. Results: High proportions of GPs and PTs used ergonomic counselling and stretching in the treatment of chronic TE. The majority of GPs prescribed passive anti-inflammatory measures such as sick leave and anti-inflammatory medication. Many PTs prescribed dynamic, particularly eccentric, exercise. Graded dynamic exercise according to a simple low-cost protocol, has better effect on pain than a wait-and-see attitude. Adjusted for outcome affecting variables, eccentric graded exercise has quicker effect than concentric graded exercise. During PET scan with the NK1 specific radioligand [11C]GR205171, voxel volume and signal intensity of this volume was significantly higher in the affected than the unaffected arm in subjects with unilateral chronic TE. Conclusions: GPs and PTs used many treatments to a similar extent but differed regarding the use of exercise. Chronic TE responds favourably to graded dynamic exercise aimed specifically at the painful tissue. The exercise should stress the eccentric work phase. The substance P – NK1 receptor system seems to play a part in the peripheral, painful tissue of a chronic, soft tissue pain condition such as chronic TE.
Epi-X

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Lowe, Katherine Audrey. "The test retest reliability, construct validity, and responsiveness of the Tennis Elbow Function Scale." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0021/MQ47060.pdf.

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Glynn, Jonathan A. "An investigation of elbow loading in one-handed tennis backhand groundstrokes using computer simulation." Thesis, Loughborough University, 2007. https://dspace.lboro.ac.uk/2134/8051.

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A 3D subject-specific computer simulation model of a ball-racket system linked to an upper-limb and torso was developed to investigate factors which may result in adverse loading at the elbow during one-handed backhand groundstrokes. Rigid hand, forearm, upper-arm and torso segments were driven by joint angle time histories obtained from backhand performances. Wobbling mass segments were incorporated to represent soft tissue motion. The upper-limb model was attached to a forward dynamics model of the racket-ball system using spring-dampers at the thenar and hypothenar eminences of the hand. The racket frame was represented using two rigid bodies with two torsional spring-dampers to allow motion in and out of the racket plane. The stringbed was represented by nine point masses connected using elastic springs. A point mass representation of the tennis ball allowed normal and oblique impacts at the nine locations on the stringbed. Inertia parameters for the elite tennis player and the rackets and visco-elastic parameters for the rackets and ball were determined from independent experimental tests. Visco-elastic parameters for the hand and wobbling masses were determined within the matching process of six backhand trials. Excellent agreement between performance and matching simulations was obtained with a mean RMS difference of 1.3% based on racket kinematics, outbound ball velocity and time of ball contact. Simulation results suggest that the inertia and stiffness parameters of the racket frame and the stringbed tension have a relatively small influence on elbow loading within current design ranges. In contrast, the off-centre ball impact simulations resulted in an 11% increase in peak internal elbow joint force, a 22% increase in peak pronation-supination net torque and a 19% increase in peak elbow-flexion extension net torque around the elbow joint. This research suggests that racket frame vibration is an unlikely mechanism for tennis elbow and that an accumulation of peak loads from off-centre hits is a more likely cause.

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Savage, Nicholas James, and nicolasshu709@hotmail com. "Vibration absorption in the tennis grip and the effects on racquet dynamics." RMIT University. Aerospace, Mechanical and Manufacturing Engineering, 2007. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080522.153134.

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The modern game of tennis has changed in recent years as a result of lightweight, stiffer racquets. The evolution of the tennis racquet, with respect to both design and materials, has increased the speed of the game but also the levels of stress placed on the player's bodies. Many believe that injuries such as lateral epicondylitis (tennis elbow) are caused and aggravated by the absorption of racquet energy by the player, in the form of shock and vibration. This thesis presents an experimental investigation into the absorption of racquet vibration to the player's hand and forearm. Quantification of the tennis grip has been achieved in this research using different experimental techniques to analyse different aspects of the tennis grip. Grip pressure distribution profiles during impact have been established using both pressure sensitive film and real-time data acquisition methods. Quantification of grip tightness during impact, together with gripping times, has also been quantified using a strain gauge cantilever system manufactured specifically for this research. The experimental data acquired in this research has provided the base for grip pressure distribution profiles to be established for three stroke types (e.g. Forehand, service and the problematic backhand). The profiles depict the distribution of pressure in the tennis grip in relation to the ball impact, in the time domain. Based on these grip profiles, the research hypothesises hand movements in an attempt to establish muscle contractions (and moreover locations of vibration absorption) specific to stroke types. The research investigates the absorption of racquet vibrations by the player's hand in the time domain. Filtering of accelerometer data allows for the isolation of specific frequencies of interest (i.e. below 200Hz). Logarithmic decrement of racquet vibration has been calculated and related to the grip pressure distributions in the time domain, and the relationship between grip pressure and vibration damping has been modelled. The correlation between grip pressure and the logarithmic decrement has been show to be significant (p less than 0.005) and non-linear. The relationship between the tennis grip and the damping of racquet vibrations has been found to be dependant on both grip pressure and the proximity of grip pressure application in proximity to the handle node. Grip pressure applied to the racquet close to the handle node has a greater damping effect than a similar pressure further away. In addition to these key research findings, the effectiveness of a piezoelectric racquet damping system is also investigated. A comprehensive modal analysis of two tennis racquets is given with further ball impact tests. The ball impact tests showed that the damping system has a 28% difference in racquet vibrations during freely suspended grip conditions. However, under hand-held grip conditions the inclusion of grip damping into the system provides a much greater damping entity (880% greater). Therefore, the effect of the piezoelectric system was deemed to be negligible.

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Niemelä, Jonna. "Effekten av excentrisk träning vid epikondyalgi-en systematisk litteraturstudie." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-412249.

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Bakgrund: Tendinopati är en vanlig diagnos hos patienter inom primärvården, en av de vanligare formerna av tendinopati är epikondyalgi. Det är oklart vad som är den mest effektiva behandlingen för epikondyalgi. Studier har visat lovande resultat av enbart excentrisk träning (ET) samt som del av kombinationsbehandling. Det var därför relevant att kartlägga vilken effekt excentrisk träning har vid epikondyalgi. Syfte: Kartlägga och sammanställa aktuell forskning gällande evidensen för effekten av ET på smärta och funktion vid epikondyalgi. Metod: En systematisk litteraturstudie. Litteratursökning genomfördes i databaserna PubMed, Cinahl, Web of Science samt Scopus. Åtta artiklar inkluderades. Dessa kvalitétsgranskades enligt PEDro, varefter den sammanvägda evidensen bedömdes enligt GRADE. Resultat: De inkluderade studiernas kvalité enligt PEDro varierade från medelhög till hög. Begränsat vetenskapligt underlag för att ET inte minskar smärta vid lateral epikondyalgi (LE). Otillräckligt vetenskapligt underlag för att ET ökar funktion vid LE. Otillräckligt vetenskapligt underlag för en jämförelse av ET i olika former eller som del av kombinationsbehandling. Inga resultat för medial epikondyalgi framkom. Slutsats: ET har inte någon effekt på smärta vid LE. Det finns otillräcklig vetenskaplig grund för effekten på funktion vid LE. Interventionerna, i studierna som jämförde ET i olika former eller utvärderade kombinationsbehandlingar, skilde sig åt vilket gjorde att sammanvägningen av dessa resultat inte var möjlig. Vidare forskning behövs för att kunna fastställa effekterna av excentrisk träning vid epikondyalgi.
Background: Tendinopathy is a common diagnosis in primary care, a common form of tendinopathy is epicondylalgia. However, the most effective treatment for epicondylalgia is undetermined. Studies have shown promising results in regard to eccentric training (ET) as a stand-alone treatment as well as adjunct to other treatments. It is therefore relevant to map the effect of ET for patients with epicondylalgia. Objective: Map and compile current evidence on the effect of ET on pain and function for patients with epicondylalgia. Methods: A systematic review. A search was conducted in the PubMed, Cinahl, Web of Science and Scopus database. Eight articles were included. These were assessed for quality according to the PEDro scale and the evidence was assessed according to GRADE. Results: The quality of the included studies ranged from medium to high. Limited evidence showed that ET does not reduce pain for patients with lateral epicondylalgia, LE. Insufficient evidence showed that ET improves function. The evidence on the comparison of ET in different forms or in combination with other treatments was insufficient. No results emerged for medial epicondylalgia. Conclusion: ET does not reduce pain for patients with LE. There is insufficient evidence on the effect of ET on function for patients with LE. Studies comparing different forms of ET alone or in combination with other treatments have used different interventions, preventing the aggregation of results. Further research is needed to determine the effects of ET for patient with epicondylalgia.

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Tonks, Jeanette Heloise. "Evaluation of short-term conservative treatment in patients with tennis elbow (lateral epicondylitis) : a prospective randomised, assessor-blinded trial." Thesis, University of Central Lancashire, 2012. http://clok.uclan.ac.uk/6791/.

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The complexity of the pathophysiology of tennis elbow is reflected by the lack of consensus on management and remains a therapeutic challenge. This study was a prospective randomised, assessor-blinded trial. 64 patients with tennis elbow referred by their GP to either the physiotherapy, orthopaedic or MSK CAT services, subject to eligibility criteria, were randomised into one of 3 treatment arms: injection, ultrasound or exercise, to which the assessor remained blinded. The outcome measures of thermal difference, median frequency (MDF), patient-rated tennis elbow evaluation questionnaire (PRTEE), pain-free grip strength (PFG) and patient preference were assessed twice at baseline, at 10 days, 6 weeks and 6 months and analysed as an intention to treat analysis. In the short term of 6 weeks injection was the most effective treatment demonstrating both statistically significant and minimum clinically important differences (MCID) for PFG and PRTEE in comparison to ultrasound and exercise. Patients had a strong preference for injection and a strong aversion for exercise. No statistically significant differences were found between ultrasound and exercise although a MCID was found in favour of ultrasound for thermal difference and MDF at 10 days. In to the long term of 6 months, although this was on a limited subgroup, no statistically significant differences were found between any of the groups. A MCID was found in favour of ultrasound for MDF and a MCID was found in favour of exercise over injection for all aspects of PRTEE and over ultrasound for PRTEE pain only. This research supports the superior effectiveness of injection in the short term of 6 weeks and should be advocated for patients who present early with severe limiting pain and have important short term goals, although patients need to be warned that a 1/3rd will have a recurrence of symptoms within 6 months. In contrast, for those patients who present with moderate to low pain physiotherapy including exercise and/ or ultrasound should be advocated. Thermal difference is a sensitive outcome measure for tennis elbow. Continuous 3 MHz therapeutic ultrasound at 2W/cm2 for 5 minutes utilises thermal effects which optimise the healing process and demonstrate an accumulative effect of ultrasound in to the long term. Further research on the effectiveness of a combination of injection with physiotherapy is required.

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Vandi, Matteo. "Diagnosi differenziale nel dolore laterale di gomito come strumento di valutazione fisioterapica: una scoping review." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amslaurea.unibo.it/21893/.

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Background: il dolore laterale di gomito (LEP) è una problematica muscolo-scheletrica che interessa la componente epicondiloidea degli estensori di polso e dita. Movimenti ripetitivi di flesso-estensione e prono-supinazione del gomito, sollevamenti di carichi pesanti e frequenti estensioni di polso contro resistenza contribuiscono all’insorgere della patologia, portando a una riduzione della partecipazione durante le attività di vita quotidiana. Obiettivo: L’obiettivo della scoping review è quello di raccogliere informazioni in letteratura riguardanti la diagnosi differenziale nel dolore laterale di gomito al fine di fornire strumenti utili a discriminare tutte quelle che possono essere le problematiche e patologie associate per poi programmare un piano terapeutico mirato ed efficace. Metodi: la ricerca è avvenuta consultando banche dati disponibili online quali PubMed, PEDro e Cochrane Library e tramite ricerca manuale bibliografica. Sono stati analizzati articoli che trattano la diagnosi differenziale nel LEP di qualsiasi tipologia, in lingua inglese e riguardanti il genere umano. Risultati: sono stati inseriti 26 articoli rispondenti ai criteri di eleggibilità, di cui 16 revisioni, 3 studi diagnostici, 1 studio comparativo, 1 studio terapeutico e 5 Case Report. È stato creato un diagramma di flusso per descrivere le fasi del processo di ricerca, mentre il contenuto dei singoli articoli è stato schematizzato in una tabella sinottica. Conclusioni: ad oggi eseguire una corretta diagnosi differenziale in presenza di LEP risulta complicato. Tante sono le patologie che possono essere causa di questa problematica e molte di queste risultano difficili da discriminare fra loro. In letteratura non sono presenti un cluster di test e un algoritmo decisionale validati e affidabili che permettano di inquadrare meglio un soggetto con LEP. L’imaging rappresenta uno strumento utile per la diagnosi differenziale, ma allo stesso tempo non deve sostituire il giudizio clinico.

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Lucado, Ann M. "Characteristics of the upper extremity in female recreational tennis players with and without lateral epicondylalgia." Thesis, NSUWorks, 2010. https://nsuworks.nova.edu/hpd_pt_stuetd/5.

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Problem Statement: A paucity of research exists describing the relationship between lateral epicondylalgia (LE) and upper extremity (UE) strength, range of motion or joint characteristics, between the shoulder, elbow and wrist despite the close kinetic relationship. The primary purpose of this study was to describe these characteristics of the UE in female tennis players and a control group. Methods: This was a descriptive study of three groups: sample of active adult females with no elbow pain (control), non-symptomatic tennis players (NSTP), and symptomatic tennis players (STP) with LE. A convenience sample of three groups, 21 women each was recruited. A questionnaire was completed by each participant and a screening procedure was performed to confirm group assignment and gather tennis specific information. The dependent variables were collected at a one-time session for the dominant extremity of each subject and included UE passive motion, mean UE adjusted strength values, strength ratios, elbow carrying angle, posterior shoulder tightness, anterior glenohumeral joint (GHJ) laxity and shoulder impingement tests. Results: The STP group demonstrated significantly greater passive forearm pronation, higher internal/external rotation strength ratios, increased frequency of anterior GHJ hyperlaxity and positive Hawkins-Kennedy test results. Grip strength taken in elbow extension was significantly weaker in the STP group compared with the NSTP and control groups. The strength ratio of the upper/lower trapezius was significantly greater in the STP compared to NSTP group, but was not significantly different from the control group. The STP group demonstrated a trend toward greater passive motion in elbow hyperextension and supination, and a higher wrist flexion/extension ratio that did not reach statistical significance. Both tennis player groups demonstrated limited passive wrist flexion and shoulder internal rotation when compared to controls. No significant differences were found in tennis playing factors between the groups. Conclusion: Impairments in strength, range of motion, or motor control are hypothesized to contribute to the altered kinematics of the UE and may potentially lead to LE in recreational tennis players. Recognizing risk factors a priori may provide a framework to guide the physical evaluation, treatment plan and preventative techniques for the tennis player exhibiting symptoms of LE.

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Pinheiro, Miguel Oliveira Dias Pinto. "Intervenção da fisioterapia na epicondilite lateral: uma revisão bibliográfica." Bachelor's thesis, [s.n.], 2020. http://hdl.handle.net/10284/9145.

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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciado em Fisioterapia
Perceber as diversas abordagens terapêuticas na epicondilite e quais aquelas em que se obtém melhores resultados. Metodologia: As bases de dados utilizados para a realização da pesquisa no âmbito deste trabalho foram a PubMed e Scielo. A classificação metodológica dos artigos selecionados para esta revisão foi feita através da escala PEDro. Resultados: Esta revisão inclui 7 artigos abrangendo um total de 251 intervenientes. Dentro das modalidades terapêuticas investigadas nos artigos selecionados estavam presentes exercícios específicos sob supervisão, terapia de vibração, ultrassom pulsátil de baixa intensidade, técnica de Maitland, libertação miofascial, Massagem Transversal Profunda e aplicação de KinesioTape. Conclusão: Tendo por base a análise dos referidos estudos, a abordagem do fisioterapeuta na epicondilite deve ser abrangente na escolha das modalidades terapêuticas, uma vez que se obtém resultados positivos, nomeadamente na diminuição da dor e aumento da função, através de vários tratamentos.
To understand the different therapeutic approaches in patients with lateral epicondylitis and which of them produce the better outcomes. Methodology: The databases used to carry out the research in the scope of this work were PubMed and Scielo. The methodological classification of the articles selected for this review was made using the PEDro scale. Results: This review includes 7 articles covering a total of 251 stakeholders. Within the therapeutic modalities investigated in the selected articles, specific exercises under supervision, vibration therapy, low intensity pulsatile ultrasound, Maitland technique, myofascial release, Deep Friction Massage and application of KinesioTape. Conclusion: Based on the analysis of the aforementioned studies, the physiotherapist’s approach in lateral epicondylitis should embrace multiple therapeutic modalities, since there are positive outcomes, namely decrease in pain and increase in function, through various treatments.
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Palaniswamy, Vijayakumar. "Ultrasound-observed tendon abnormalities in lateral epicondylalgia: Exploring associations with neurosensory and clinical outcomes." Thesis, Griffith University, 2018. http://hdl.handle.net/10072/380988.

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Background Lateral epicondylalgia (LE) also known as tennis elbow is an overuse tendinopathy of the common extensor tendon at the lateral elbow causing persistent pain and disability. Current pathophysiological models have highlighted that local tendon structural abnormalities and sensory system changes are key factors associated with LE, however, the exact nature of the inter-relationship between these pathophysiological characteristics is largely unknown. In particular, there are notable knowledge gaps on the inter-relationship between local tendon pathology, sensory system changes and their relative contribution to pain and disability in LE. It is important to evaluate the inter-relationship between these pathophysiological factors to model the mechanisms underpinning the clinical presentation and recovery profile in people with LE. While the mechanism underlying the pathogenesis of persistent pain necessitates further exploration, it is equally important to determine the optimal treatment for improving tendon structure and sensory function in LE. Conservative treatments such as manual therapy/exercise and prolotherapy injections have been recognised as potentially effective treatment options for improving pain and function in LE. However, the effects of prolotherapy injections and manual therapy/exercise used, either singly or in combination, on improving tendon structural and sensory abnormalities are largely unknown. Furthermore, it is not clear whether the baseline presence of tendon abnormalities can influence the short- and long-term outcomes of prolotherapy injections and manual therapy/exercise in LE. The aims of this dissertation were (i) to explore the inter-relationship between tendon structural abnormalities, sensory abnormalities and clinical outcomes over time; (ii) investigate the effectiveness of prolotherapy injections, manual therapy/exercise, both singly and in combination in improving tendon structural and sensory abnormalities over time; and (iii) examine the prognostic indicators of short- and long-term outcomes of these interventions for LE. Methods The sample for the thesis was 120 participants with a clinical diagnosis of lateral epicondylalgia, aged 18 to 70 years who enrolled in a single-blinded randomised clinical trial (RCT) of prolotherapy injections and manual therapy/exercise used singly and in combination with a 52-week follow-up. Ultrasound (US) examination, Quantitative Sensory Testing and clinical assessments (e.g., Patient-Reported Tennis Elbow Evaluation; PRTEE) were performed at baseline and at 6, 12, 26 and 52 weeks follow-up. The five studies of the current thesis studies include: 1) an inter-rater reliability study of scoring tendon structural abnormalities from static and dynamic US images by a non-radiologist using a composite scale score; 2) a cross-sectional study investigating the association between tendon structural abnormalities, sensory and clinical characteristics; 3) an RCT assessing the comparative effectiveness of prolotherapy injections and manual therapy/exercise in improving tendon structural and clinical outcomes over time; 4) an RCT investigating the effects of prolotherapy injections and manual therapy/exercise in improving sensory outcomes over time; and 5) a study investigating prognostic factors associated with short- and long-term clinical outcomes following prolotherapy injections and manual therapy/exercise in LE. Results The results of this thesis demonstrate that i) the composite US scoring method has good inter-and intra-rater reliability in grading tendon abnormalities in LE ii) US described tendon structural abnormalities has minimal association with sensory system changes iii) prolotherapy injections and manual therapy/exercise are effective in improving tendon structure, sensory and pain and function over time, with no significant differences between treatment conditions. Also, tendon structural abnormalities assessed using composite US score was significantly associated with pain and disability (PRTEE) at 6, 12, 26 and 52 weeks following interventions. iv) the baseline presence of tendon structural abnormalities was associated with PRTEE at 12 and 52 weeks. Discussion Findings for the US image rating scale used in the study support the reliability of non-experienced US observer for grading tendon abnormalities in LE. Given the poor vascular supply to the common extensor tendon, the presence of neovascularity can be considered a weak clinical indicator of cold hyperalgesia. Individuals exhibiting tendon thickness on the US images reported poor vibration detection threshold. Adding prolotherapy injections with manual therapy/exercises is beneficial in improving tendon and sensory abnormalities in LE. US evaluation of tendon abnormalities using a composite score can be a useful method for predicting treatment outcomes for LE.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School Allied Health Sciences
Griffith Health
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Bancale, Giulia. "L’Efficacia del Kinesio Tape nel Trattamento dell'Epicondilite Laterale: una Revisione Sistematica della Letteratura." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2021. http://amslaurea.unibo.it/24552/.

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Background. L’epicondilite laterale è la patologia del gomito più comune. Le evidenze suggeriscono che la causa possa essere infiammatoria o degenerativa. Vengono colpiti i tendini degli estensori di polso che si inseriscono sull’epicondilo laterale causando dolore e limitazione funzionale. Il Kinesio Tape (KT) è uno dei metodi conservativi a cui si può ricorre per il trattamento della patologia. Obiettivi. Valutare l’efficacia del KT in termini di miglioramento del dolore, della funzionalità e della qualità di vita nei pazienti affetti da epicondilite laterale. Disegno dello studio. Revisione Sistematica costruita seguendo il PRISMA Statement. Criteri di eleggibilità. Studi Trial Clinici Randomizzati con partecipanti affetti da epicondilite laterale trattati esclusivamente con KT. Fonti di ricerca. Le banche dati utilizzate sono state: PubMed, PEDro e CINAHAL. Risultati. Gli studi inclusi sono stati 5. In tutti, il KT ha prodotto miglioramenti; tuttavia, si sono osservati miglioramenti significativi a tutti gli outcome solo nei due studi in cui veniva eseguito il follow up a distanza di alcune settimane, rispetto agli studi in cui veniva eseguito subito dopo la fine del trattamento o dopo qualche giorno. Inoltre, nei tre studi che hanno eseguito il follow up a breve distanza dalla fine del trattamento e che confrontavano il trattamento con KT al placebo, non si sono osservati miglioramenti significativi a favore del KT. Conclusioni. Gli studi inclusi nella revisione non hanno dimostrato un chiaro beneficio in favore del KT, se non per i due studi che hanno eseguito il follow up a distanza di alcune settimane. È dunque necessario condurre ulteriori indagini includendo follow up a maggior distanza dalla fine del trattamento, con lo scopo di osservare meglio i miglioramenti significativi che si sono ottenuti nei due studi sopracitati che utilizzavano tali tempistiche; infine, sarebbe opportuno avere anche un gruppo di controllo con cui poi confrontare i risultati.

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Pínola, Livia Nahas. "Validade e confiabilidade do teste de comprometimento funcional da mão, pescoço, ombro e braço - FIT-HaNSA em pacientes com epicondiloalgia lateral do cotovelo." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-06012017-113926/.

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Introdução: A epicondiloalgia lateral (EL) é caracterizada por uma desordem musculoesquelética envolvendo o tendão extensor comum originado no epicôndilo lateral. O Teste de Comprometimento Funcional da Mão, Pescoço, Ombro e Braço - FIT-HaNSA foi desenvolvido para analisar o desempenho durante três tarefas que realizam atividades repetitivas de elevação do membro superior, além de posturas sustentadas em pacientes com disfunção no ombro, medida em até 300 segundos. O objetivo deste estudo foi avaliar a confiabilidade e a validade do teste FIT-HaNSA em pacientes com EL do cotovelo, bem como avaliar as estratégias biomecânicas utilizadas pelo membro superior durante a execução deste teste. Método: Uma versão brasileira do dispositivo do teste foi desenvolvida. Foram incluídos 10 voluntários destros assintomáticos e 20 pacientes com EL. Para a análise da confiabilidade foi utilizado o Coeficiente de Correlação Intraclasse (CCI) por meio do SPSS, com um intervalo de confiança de 95% e para a análise da validade de construto, o Coeficiente de Correlação de Spearman por meio do Software Mini Tab®. Foram coletados dados de preensão palmar, limiar doloroso e questionário DASH. Para a coleta dos dados eletromiográficos foi utilizado o equipamento da marca Delsys® (Trigno® Wireless Systems). A preparação da pele seguiu as recomendações do Projeto SENIAM. Os eletrodos foram posicionados em músculos do tronco, costas, braço e antebraço. Para a análise cinemática foi utilizado o software de imagens 3D (Vicon Motion Systems Ltd®), composto por 8 câmeras infravermelho que captaram o movimento de 16 marcadores reflexivos passivos. Os dados eletromiográficos e cinemáticos foram adquiridos de forma sincronizada e simultânea e o processamento dos sinais foi realizado off-line no Matlab®. Foi utilizada análise de variância (ANOVA) e pos hoc de Bonferroni (p<=0.05). Resultados: A média do tempo das tarefas 1, 2 e 3 foram respectivamente, 300s, 297s e 268s para o grupo assintomático e 249s, 141s e 264s para o grupo paciente. O teste apresentou entre excelente e boa confiabilidade teste reteste para o grupo assintomático para as tarefas 1, 2 e 3 respectivamente, 0,99 (0,91 - 0,99), 0,89 (0,02 - 0,98) e 0,95 (0,54 - 0,99) e para o grupo pacientes, excelente confiabilidade para as tarefas 1 e 2 respectivamente 0,98 (0,82 - 0,99) e 0,92 (0,29 - 0,99) e não aceitável para a tarefa 3 0,60 (-2,76 - 0,95), sem alteração do padrão doloroso após o teste. Apresentou correlação moderada entre o score médio do teste e a dor (r=0,67), assim como a força de preensão (r=0,56) e fraca correlação do teste com o questionário DASH (r=- 0,42). O músculo extensor ulnar do carpo esteve bastante ativo durante a realização das três tarefas. Conclusão: A versão adaptada do FIT-HaNSA-Br mostrou ser válida e reprodutível para pacientes com EL. A principal estratégia biomecânica foi a maior ativação do extensor ulnar do carpo com maior ADM de desvio ulnar ao realizar preensão com deslocamento de carga. Esta ferramenta pode ser utilizada como uma variável de desfecho em estudos clínicos para verificar a efetividade dos recursos fisioterapêuticos no tratamento conservador da EL do cotovelo.
Introduction: The lateral epicondylalgia (LE) is characterized by a musculoskeletal disorder involving the common extensor tendon which is originated at the lateral epicondyle. The Functional Impairment Test-Hand, and Neck/ Shoulder/Arm - FIT-HANSA was developed to analyze the performance during three tasks that perform repetitive activities of the upper limb elevation, and sustained postures, in patients with dysfunction in the shoulder, measured up to 300 seconds. The aim of this study was to evaluate the reliability and validity of FIT-HANSA in patients with LE and evaluate the biomechanical strategies used by the upper limb during the execution of this test. Method: A Brazilian version of FIT-HANSA device has been developed. The study included 10 healthy volunteers and 20 patients with LE. For the analysis of reliability we used the intraclass correlation coefficient (ICC) with a confidence interval (CI) of 95%, using the SPSS. For the analysis of the construct validity, the Spearman\'s correlation coefficient (r) was calculated in Software Mini Tab®. They were collected handgrip data, pain threshold and questionnaire DASH. Electromyographic data was collected using a Delsys® (Trigno® Wireless Systems) equipment. The preparation of skin followed the recommendations of SENIAM Project. The electrodes were placed in the trunk muscles, back, arm and forearm. For kinematic analysis we used a software for 3D image analysis (Vicon Motion Systems Ltd ®), composed of 8 infrared cameras, which capture the movement through 16 reflective markers. Kinematic and electromyographic data were acquired synchronized and simultaneously via Vicon Nexus® Software and signal processing was performed offline in Matlab® software. Statistical analysis was performed by means of analysis of variance (ANOVA) and post hoc Bonferroni (p <= 0.05). Results: The average time of the tasks 1, 2 and 3 were, respectively, 300s, 297s e 268s for the asymptomatic group and 249s, 141s e 264s for the patient group. The test showed between excellent and good test-retest reliability for the asymptomatic group for the tasks 1, 2 and 3 respectively 0.99 (0.91 to 0.99) and 0.89 (0.02 to 0.98) and 0.95 (0.54 to 0.99), and the group patients, excellent reliability for tasks 1 and 2 respectively, 0.98 (0.82 to 0.99) and 0.92 (0.29 to 0.99) and not acceptable for the task 3 0.60 (-2.76 to 0.95), without changing the painful pattern after the test. Moderate correlation was found between the average score of the test and pain (r = 0.67) and grip strength (r = 0.56) and weak correlation between the test and DASH questionnaire (r = -0.42). The long extensor Carpi ulnaris muscle was significantly active during the course of the three tasks. Conclusion: The adapted version of the FIT-HANSA-Br showed to be valid and reproducible for patients with LE. The main biomechanical strategy was greater activation of the extensor carpi ulnaris muscle with more ulnar deviation performed to hold the load-displacement. This tool can be used as an outcome variable in clinical studies to assess the effectiveness of physical therapy resources in the conservative treatment of LE.

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Wulff, Monica. "Lateral epikondylalgia : evidens för stötvågsbehandling för smärtreducering och förbättrad handgreppsstyrka." Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-2819.

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Syfte Syftet med föreliggande studie var att försöka klargöra om stötvågsbehandling har någon effekt på smärta och handgreppstyrka hos patienter med lateral epikondylalgia. Frågeställningar 1. Har stötvågsbehandling någon effekt på smärta hos patienter med lateral epikondylalgia, i så fall vilken? 2. Har stötvågsbehandling någon effekt på handgreppsstyrka hos patienter med lateral epikondylalgia, i så fall vilken? Metod Sökning av litteratur utfördes i PubMed, Cochrane, Cinahl och PEDro. Detta resulterade i 14 artiklar, som granskades och bedömdes enligt PEDro Scale. Poängbedömningen utifrån PEDro Scale omsattes till Statens Beredning för medicinsk Utrednings (SBU) mall för bevisvärde. Utifrån artiklarnas sammantagna bevisvärde bestämdes evidensnivån enligt SBU:s fyra nivåer. Resultat Enligt GRADE-systemet förelåg det ett starkt vetenskapligt belägg för att stötvågsbehandling har en smärtlindrande effekt vid lateral epikondylalgia. Studier av likartad vetenskaplig kvalitet påvisar motsägande resultat avseende om stötvågsbehandling är bättre än placebo, kortison eller tenotomi. Detta innebär att det vetenskapliga underlaget är otillräckligt och att mer forskning behövs. Enligt GRADE-systemet förelåg det ett starkt vetenskapligt belägg för att stötvågsbehandling leder till förbättrad handgreppsstyrka vid lateral epikondylalgia. Vidare förelåg det ett starkt vetenskapligt belägg för att stötvågsbehandling inte är bättre än någon annan behandling gällande ökning av handgreppsstyrka vid lateral epikondylalgia. Slutsats Stötvågsbehandling har en smärtlindrande effekt hos patienter med lateral epikondylalgia. Det finns dock ingen evidens för att stötvågsbehandling är bättre ur smärthänseende än någon annan behandling såsom placebo, kortison eller tenotomi. Stötvågsbehandling leder till förbättrad handgreppsstyrka men är inte bättre än placebo, kortison eller tenotomi på att öka handgreppsstyrkan hos patienter med lateral epikondylalgia.
Aim The aim of the present study was to try to find out whether shock wave therapy has any effect on pain and grip strength in patients with lateral epicondylitis. Objectives 1. Does shock wave therapy reduce pain in patients with lateral epicondylitis? 2. Does shock wave therapy improve grip strength in patients with lateral epicondylitis? Method A literature review was performed in the databases PubMed, Cochrane, Cinahl and PEDro. Fourteen articles were found and critically reviewed. These articles were scored according to the PEDro scale and the scores were translated into a scale of evidence by the Statens Beredning för medicinsk Utredning (SBU) and the level of evidence was determined based on the four different grades presented by the SBU. Results According to the GRADE-system there was a strong scientific evidence for a reduction of pain using shock wave therapy in patients with lateral epicondylitis. Contradictory results whether shock wave therapy was better than placebo, corticosteoroid injection or tenotomy have been reported in studies of similar scientific quality. This means that more research is needed in this field. According to the GRADE-system there was a strong scientific evidence for an improvement of grip strength using shock wave therapy. Furthermore, there was a strong scientific evidence for that shock wave is not better than any other therapy in terms of improving grip strength in patients with lateral epicondylitis. Conclusion Shock wave therapy reduces pain in patients with lateral epicondylitis. There is, however, no evidence for shock wave therapy to be superior to any other treatment such as placebo, corticosteoroid injection or tenotomy. Shock wave therapy improves grip strenght but is not better than placebo, corticoidsteroid injection or tenotomy in increasing grip strength in patients with lateral epicondylitis.

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Sitts, Colette. "Acupuncture treatment of tennis elbow." 2005. http://www.ocomlibrary.org/images/PDF/studentpapers/colettesitts.pdf.

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Shaik, Junaid. "The relative effectiveness of cross friction and Mill's manipulation as compared to cross friction alone in the treatment of lateral epicondylitis (tennis elbow)." Thesis, 2000. http://hdl.handle.net/10321/2682.

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Thesis submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic at Technikon Natal, 2000.
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.
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Marquis, Janay. "The relative effectiveness of dry needling the extensor muscles of the forearm as an adjunct to cross friction massage in the treatment of lateral epicondylitis." Thesis, 2002. http://hdl.handle.net/10321/286.

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Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2002. 113 leaves
Lateral epicondylitis is the most common cause of chronic lateral elbow pain in adults (Bowen et al. 2001:642). No uniform treatment regime is available for lateral epicondylitis, although most authors do agree that treatment should begin with a conservative approach before progressing to more complex and invasive therapies (Kamien 1990:174). The purpose of this study was to investigate the relative effectiveness of dry needling myofascial trigger points of the forearm extensor muscles as an adjunct to cross friction massage, in the treatment of lateral epicondylitis.

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Roodt, Bradley Scott. "The efficacy of manipulation of the elbow joint in patients suffering from lateral epicondylitis." Thesis, 2001. http://hdl.handle.net/10321/1951.

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A dissertation proposal presented in the partial fulfilment of the requirement for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001.
The purpose of this investigation was to perform a placebo controlled, randomised clinical study to determine the efficacy of manipulative therapy of the elbow, based on motion palpation findings, in the treatment of lateral epicondylitis . Forty patients participated in the study, all of who underwent a case history, physical examination, and elbow regional examination. They were then randomly assigned to one of the two groups, so that twenty patients received manipulative therapy of the elbow, and the remainder of the patients received detuned ultrasound. All patients received 6 treatments over a 3-week period, with subjective and objective data being collected before the first, third and sixth treatments. The short-form McGill pain questionnaire and the NRS101 questionnaire where used to monitor each patients subjective response, while algometer and dynamometer readings were taken to provide objective data. Motion palpation of the symptomatic elbow was performed on all patients before treatments 1,3, and 6. Examination of the statistical data reveals that there was no significant difference in improvement between the two groups, ie. manipulative therapy of the elbow was found to be no more
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Shih-tsung, Chang, and 張世聰. "The Influence of Tennis Racket Striking Impact to Elbow." Thesis, 1998. http://ndltd.ncl.edu.tw/handle/87882157031896424575.

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碩士
國立體育學院
運動教練研究所
86
There are three purposes for this study, first, to test the effect of grip force for racket vibration using a mobile-joint-fixture to simulate the human forearm. Second, to analyze the discrepancy of impact between forehand and backhand strike, one-hand backhand and two-hand backhand strike, as well as wearing and without tennis elbow brace. Third, to test the correlation between elbow impact vibration and elbow flexion, wrist flexion, wrist radial deviation as well as the circumference of forearm. The results of this study showed that the elbow vibration was decreased when the grip pressure of forearm simulator was below 10kg/cm2. But when the grip pressure was over 12.5kg/cm2, the vibration started to increase. The results of subject test showed that elbow vibration with forehand strike was larger than backhand strike, the vibration with two-hand backhand strike was significantly larger than one-hand backhand strike, wearing elbow brace could not reduce the elbow impact vibration for forehand strike, but the anterior posterior impact vibration was significantly reduced by wearing elbow brace for backhand strike. The vibration of elbow significantly correlated with the angle of elbow flexion, wrist flexion, wrist radial deviation, and the circumference of forearm. The negative correlation between the circumference of forearm and elbow vibration indicated that the muscle and soft tissue have damping effect for the elbow vibration. Based on the results of this study, increase the muscle of forearm or wearing elbow brace can reduce the elbow injury from vibration. And it also could prevent the injury by striking the ball with appropriate wrist and elbow position.

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Chiang, Jinn Yen, and 江勁彥. "The Influence to the Forearm Electromyography Activity and Elbow Vibration by Wearing Different Tennis Elbow Braces." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/00811086907871090027.

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碩士
國立體育學院
教練研究所
87
The Influence to the Forearm Electromyography Activity and Elbow Vibration by Wearing Different Tennis Elbow Braces Abstract The aims of the present study were to compare the elite tennis player(ETP) and amateur tennis player(ATP): (1) the difference on muscle electromyography(EMG) while striking, (2) the difference on racket, wrist and elbow vibration while striking, (3) the relationship among all the parameters. The results of study showed that: on the follow-through phase(FTP) of forehand(FH) with or without brace, the reaction of EMG of wrist extensor muscle(WEM) on ATP is higher than ETP. On backhand(BH) with or without brace, the vibration of prepare phase(PP)and FTP on racket, wrist and elbow is higher in ATP. The vibration of racket on BH is higher than FH on PP and FTP with or without brace on ETP. The vibration of wrist and elbow on FH is higher than BH on PP and FTP with or without brace on ATP. Most of the parameters are correlated for the ETP including the muscle range(MR) and grip force(GF), training yesrs(TY) and age, EMG of forehand flexor muscle(FFM) without brace on PP and wrist vibration, EMG of backhand flexor muscle(BFM) without brace on PP and (EMG) of forehand flexor muscle (FFM)without brace on (PP), EMG of BFM without brace on FTP and EMG of FFM without brace on FTP. And for ATP, the MR and GF, TY and age, wrist vibration and GF, elbow vibration and wrist racket vibration are correlated. Both of the ETP wrist flexor and extensor muscle appeared co-contraction on FH and BH PP, but the ATP didn''t. From the results of the study, we could know that wearing tennis brace and increase forearm muscle strength can reduce vibration, and the co-contraction of muscle can prevent the occurrence of tennis elbow. Keyword: Tennis elbow, Brace, Electromyography, Vibration.

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Du, Coudray Nicolette Bourgault. "An investigation into the role of muscle imbalances within the wrist flexor and extensor muscle groups as an associated factor in the presentation of lateral epicondylitis." Thesis, 2006. http://hdl.handle.net/10321/343.

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Thesis (M.Tech.:Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. xiii, 84 leaves, Annexures A-J.
Many studies have been done investigating the role that muscle imbalances play in causing injury to the body, for example the knee and the shoulder. It has been found that keeping muscle balances around a joint play an important role in protecting the soft tissue structures. There is a need to further investigate the effect of muscle imbalances in the upper limb. Additionally, according to the literature, as yet no effective treatment protocol or a specific cause has been found for lateral epicondylitis making it a troubling condition for practitioners to treat and a disabling condition for patients to live with. Therefore, this research aimed at investigating whether muscle imbalances are associated with the aetiology of lateral epicondylitis. If an association was found, people involved in predisposing activities could improve the imbalance to avoid the condition, thereby minimizing time spent away from work and sport. Also, a more effective and efficient management protocol for the painful condition could be attained. The objectives of this study included: 1) assessing the peak torque (using the Cybex Orthotron II) and muscle activity (using surface electromyography) of the wrist flexor and extensor muscle groups of asymptomatic subjects; 2) assessing the peak torque (using the Cybex Orthotron II) and muscle activity (using surface electromyography) of the wrist flexor and extensor muscle groups of symptomatic subjects and 3) to integrate this information, compare the two groups and subgroups and statistically analyse the difference between them.

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Enomoto, Kaori. "Kinematic and electromyographic analysis of backhand strokes in tennis players with and without lateral elbow pain." Thesis, 1996. http://hdl.handle.net/1957/34235.

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Despite dramatic changes in tennis equipment and technique, more than 30% of recreational tennis players suffer from lateral elbow pain ("tennis elbow"). Certain kinematic and electromyographic characteristics in backhand strokes have been implicated as major factors responsible for lateral elbow pain. From a local tennis club, 22 recreational players who were rated 3.0 to 5.0 skill level (intermediate to advanced) by United States Tennis Association criteria participated in this study. Either one-handed or two-handed backhand ground stroke techniques were used by the subjects according to their preference. Half of the subjects for each technique had lateral elbow pain related to playing tennis. Four groups (one-handed and two-handed technique with and without elbow pain) were analyzed in terms of kinematic and electromyographic characteristics. A three-dimensional kinematic analysis was performed using data obtained with 60 Hz videography. Electromyographic data were collected using a telemetered electromyography (EMG) system at 100 Hz through surface electrodes.
Graduation date: 1997

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31

Gomes, César António dos Reis. "O tennis elbow e a sua relação com a técnica de esquerda." Master's thesis, 2014. http://hdl.handle.net/10400.5/7358.

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Mestrado em Treino Desportivo
Existem atividades de vida diária que solicitam a articulação do cotovelo nos seus eixos de movimento. A prática do ténis exige movimentos do braço com grandes amplitudes e acelerações provocando sobrecargas funcionais, que podem favorecer o aparecimento de lesões. O “Tennis Elbow”, ou Epicondilite, consiste num processo inflamatório, que afeta os tendões dos músculos extensores da mão e que têm origem no cotovelo (epicôndilo). Nesta tese, com base na caracterização de alguns dos fatores intrínsecos e extrínsecos e através de um questionário realizado a jogadores de ténis, procurámos saber como é que a técnica de esquerda, “backhand”, está associada à lesão. No final, na análise dos dados e discussão dos resultados serão apontados caminhos futuros de investigação da referida lesão aplicada ao ténis.

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Haswell, Garrick David. "The efficacy of dry needling in patients suffering from lateral epicondylitis." Thesis, 2002. http://hdl.handle.net/10321/1802.

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A dissertation proposal presented in partial fulfilment of the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2002.
Lateral epicondylitis is a relatively common disorder affecting approximately one third of the nearly thirty-two million tennis players worldwide. It usually presents as a chronic disorder that follows a remitting relapsing course, and as such represents a challenge to manage. At present the scientific literature does not favour any particular treatment modality and as such well designed placebo studies are required to assess the efficacy of the various modalities of treatment, with a long term view of establishing an effective treatment protocol to manage lateral epicondylitis. The purpose of this study was to determine the efficacy of dry needling the posterior distal muscles of the upper extremity as a treatment for lateral epicondylitis. Sixty patients were included in the study. They all under went a case history, physical examination and an elbow regional examination. They were then randomly allocated into the experimental or control groups. The thirty patients in the experimental group received dry needling while the thirty included in the control group received placebo or 'sham' needling. All participants in the study received three treatments over a nine-day period with subjective and objective measurements being taken before the 1st. 2nd, and 3rd treatments, with a 4th being taken after the third treatment. Examination of the statistical data revealed that a significant improvement in the experimental group versus the control group in terms of both subjective
M

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Hughes, Nicholla Maray. "The effects of elbow manipulation combined with dry needling compared to manipulation combined with cross friction in the treatment of lateral epicondylits." Thesis, 2011. http://hdl.handle.net/10210/3728.

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M.Tech.
Purpose: Lateral epicondylitis has been identified as one of the most common conditions affecting the upper limb. The exact pathophysiology of this condition is still under investigation; however it is believed to be an overuse injury which affects the common extensor tendon at the tenoperiosteal and/or the musculotendonous junctions. Despite the frequent occurrence of lateral epicondylitis and its considerable symptoms there is little scientific evidence to support the effectiveness of any treatment methods. As yet one treatment method has not been proved more effective than the other. The purpose of this comparative study was to determine whether manipulation combined with dry needling of the common extensor tendon and extensor muscle belly of the forearm, was more effective than cross friction of the common extensor tendon combined with manipulation with regards to a decrease in pain and an increase in pressure pain threshold. Method: This study consisted of 32 participants between the ages of 18 – 40. Possible participants were examined and accepted according to the inclusion and exclusion criteria. Once accepted the participants were assigned into two groups each consisting of equal amounts of males and females. The first group received manipulation of their elbow combined with dry needling of their common extensor tendon and extensor muscle belly of their forearm. The second group also received manipulation of their elbow but this was combined with cross friction of their common extensor tendon. Procedure: Each participant received six treatment sessions and one follow up session. Objective data and subjective data was taken at the beginning of the first, fourth and seventh session. Objective data consisted of algometer readings that were taken on the common extensor tendon, the lateral epicondyle of the humerus and the extensor muscle belly. The subjective data collected was in the form of the Numerical Pain Rating Scale and the short form of the McGill Pain Questionnaire. The manipulation of the elbow was then administered based on the restrictions identified during motion palpation. This was followed by either dry needling of the common extensor tendon and the extensor muscle belly of the forearm or cross v friction of the common extensor tendon. The information collected was analysed by means of Friedman and Wilcoxon Signed Rank tests.Results: Statistically significant improvements in all measurements were noted over the course of the treatments for all participants in both groups. However there was no statistically significant difference between the improvements of the dry needling group compared to that of the cross friction group. Conclusion: The results illustrate the effectiveness of the individual treatments over the treatment period. However it is still inconclusive whether one treatment method is more effective than the other. As this study was directed to a small group of participants, accurate conclusions could not be formulated to prove the effectiveness of one treatment method over that of another. Due to the insignificant findings obtained in this study, further studies need to be performed to determine which method of treatment is most effective when treating lateral epicondylitis.

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Hsieh, Wen-Yih, and 謝文逸. "Biomechanical Effects of Elbow Brace on Tennis Players Using Single-handed Backhand Strokes." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/35841535250556864032.

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碩士
國立體育學院
運動傷害防護研究所
93
Purpose: The purposes of this study were to compare the differences of the following factors in tennis players using single-handed backhand stroke with and without brace by 4, 8cm distal to lateral epicondyle: (1). maximal muscle activities, (2) range of motion (ROM) among the trunk, shoulder, elbow and wrist, and (3). relative joint positions opposed to neutral positions among the trunk, shoulder, elbow and wrist when each tested muscle achieves maximal contract. Methods: The subjects were ten collegiate tennis players. Surface electrodes were placed on six forearm muscles. Twelve strokes among three tested conditions were recorded on high-speed camera and synchronized with electromyographic signals. Results: The results showed that no significant differences were found on maximal muscle activities, ROM and relative positions of the trunk, shoulder, elbow and wrist among three tested conditions. Ball velocities and maximal muscle activities of Extensor Carpi Radialis (ECR) and Flexor Carpi Radialis (FCR) were correlated, p=0.000 and 0.025 respectively. The correlation appeared to be negative on ECR and positive on FCR, r2=0.062 and 0.015 respectively. Conclusion: The correlation between ball velocities and muscle activities of ECR and FCR might relate to the wrist stability, since they were the major stabilizers of the wrist during backhand strokes. From the consistence of muscle activities, ROM and relative positions of joints, they made no differences between bracing at different position and non-bracing. The effects of braces do not seem to be obvious for the expert tennis players.

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Chan, Yu-Wun, and 詹毓文. "The effects of elastic taping on sensorimotor control in individuals with tennis elbow." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/28pprq.

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碩士
國立陽明大學
物理治療暨輔助科技學系
105
Background Tennis elbow (TE) is a common upper-extremity musculoskeletal disorder with 8.5% recurrent rate within 1.5 years. Several studies showed that clinical symptoms are not only related to local tissue damage but also the alteration of the nervous system. Clinical features include pain, decreased grip strength, sensorimotor deficit and functional limitation. Common treatments mainly focus on pain relief and muscle strength training. However, previous studies showed that sensorimotor deficit persists despite that resolution of pain relief and strength improvement along with treatments. Sensorimotor deficits could disturb functional ability due to poor gripping mechanism, poor hand-arm coordination and muscle fatigue. Elastic taping is used as a treatment option for musculoskeletal problems in recent years. Some researchers suggested that elastic taping provides sensory input and helps sensorimotor deficit in several kinds of patient populations. However, the effects of elastic taping on sensorimotor control, grip strength, pain and functional ability in TE patients remain unclear, and more direct evidence of sensorimotor integration with elastic taping is needed. Corticomuscular coherence (CMC) indicates the functional connectivity between cortical activity and contralateral muscle during voluntary movements. It’s used to help monitor sensorimotor integration in our study. Purpose There were two aims in this study. First one was to determine whether elastic taping is feasible for improving sensorimotor control, grip strength, pain and functional ability in TE patients. Second, to discuss how elastic taping modulates sensorimotor control by observing functional outcomes and CMC with and without elastic taping. Methods This was an experimental study composed of 2 parts of crossover trials. 12 healthy and 12 TE patients were recruited. Primary outcome for each part was sensorimotor control. Secondary outcome was grip strength. Subjects were measured under 2 conditions: (1) without taping; (2) with elastic taping. In part 2, pain and functional ability were also recorded as secondary outcomes using Patient-rated Tennis Elbow Evaluation Questionnaire in TE patients. Statistic Wilcoxon signed-rank test was used to compare outcomes between conditions. Spearman's rank correlation coefficient was used to find out the relationship between CMC and sensorimotor control. Significant level is set at 0.05. Results After taping, joint position sense matching error significantly decreased and the steadiness of joint position significantly increased in both groups. No significant relationship between sensorimotor control and CMC was observed. Discussion and conclusion In this present study, we conclude that elastic taping improve joint position sense and joint stability during isometric contraction of wrist extensor. However, other related outcome wasn’t change significantly such as reaction time, force sense, CMC, grip strength, pain and functions in patients. This might because of the small sample size and insufficient sensory input. Further research is needed to find out the mechanism of elastic taping on sensorimotor system.

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Oehley, Darryl Bruce Somerset. "The efficacy of a local action transcutaneous flurbiprofen patch, in the treatment of lateral epicondylitis." Thesis, 2002. http://hdl.handle.net/10321/292.

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Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2002 xii, 90 leaves
The purpose of this study was to determine the relative efficacy of topical flurbiprofen in the form of a local action transcutaneous patch (LAT), in the treatment of lateral epicondylitis.

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Chang, Ting-Jen, and 張庭禎. "Using Taguchi Methods with Absolute Voltage Time Histogram to Construct Diagnostic Model of Tennis Elbow." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/6beswr.

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碩士
國立高雄應用科技大學
電子工程系碩士班
102
Purpose: Using Taguchi method to select the variables from the absolute voltage time histogram and equivalent uniform voltage to build tennis elbow predictive models. Materials and methods: In this study, seventy-eight subjects were tested tennis elbow EMG signal data, and if the visual analog scale over than grade 3 means the subject will be defined Suffering by tennis elbow, we use the absolute voltage time histogram to quantify the EMG data and calculated equivalent uniform voltage, which can able to build tennis elbow predictive models. The parameter n which can affect the model result was start from-10 to 10. Using Taguchi method to select the parameter n by observation Signal-to-noise ratio and pick out the biggest n value of Signal-to-noise ratio. We used logistic regression models, Probit prediction model and fuzzy theory to build prediction models and finally, three methods will be compared. Results: This study the selected the parameter n from -10 to 10 for chose the best n to build tennis elbow predictive models. In the first experiment, the Taguchi method is found when n value is 3, and the second experiment of Taguchi method was selected the n value is 2.3. We using when n is 2.3 to calculated equivalent uniform voltage to build prediction models. Logistic regression models, Probit prediction model and fuzzy theory all passed the test. Tennis elbow prediction models of logistic regression model has the AUC value of 0.86, Probit tennis elbow prediction model has the AUC value of 0.87, the fuzzy theory has the AUC is 0.95. Conclusions: The parameter n of equivalent uniform voltage is a very important factor of tennis elbow prediction model. At three prediction models, fuzzy theory has the best predictive effect.

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Lin, Yu-Ching, and 林裕晴. "Comparison between Type A Botulinum Toxin Injection and Corticosteroid Injection in the Treatment of Tennis Elbow." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/88433211739389283916.

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碩士
國立成功大學
環境醫學研究所
94
Tennis elbow (humeral lateral epicondylitis) is a common painful elbow disorder that has a direct impact on the affected worker’s productivity and quality of life. Steroid injection is one of the few methods proven to have short-term efficacy in treating tennis elbow, but its potential adverse effects lead to a low acceptance rate. Botulinum toxin injection into the extensor carpi radialis brevis can cause temporary muscle weakness and might facilitate the auto-repair mechanism in tennis elbow. Some preliminary studies suggested that type A botulinum toxin injection is effective in treating tennis elbow. The objective of this study is to compare botulinum toxin injection with corticosteroid injection in treating tennis elbow. We recruited patients of tennis elbow and assigned them randomly to receive type A botulinum toxin or corticosteroid injection. The treatment outcomes, including visual analogue scale (VAS), WHO Quality of Life-BREF (WHOQOL-BREF) Taiwan Version questionnaire, and grip strength, were assessed at the baseline and 4 weeks, 8 weeks, and 12 weeks after the treatment by an investigator blind to the drug assignment. Sixteen patients with 19 elbows affected by humeral lateral epicondylitis were enrolled into the trial, but one patient lost to follow-up, leading to 8 elbows receiving botulinum toxin injection and 9 elbows receiving corticosteroid injection in the final comparison. The demographic data between the two groups did not differ. We found steroid was superior to type A botulinum toxin in treating tennis elbow at week 4, while the grip strength decreased significantly in the botulinum toxin group at 4 and 8 weeks after injection without improvement in pain. In conclusion, type A botulinum toxin injection into extensor carpi radialis brevis is not as effective as steroid injection in relieving the pain caused by tennis elbow, and it is associated with weakness in finger and wrist extension.

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Flanders, Megan. "The clinical effectiveness of therapeutic exercises alone and in combination with orthotic bracing in the treatment of lateral epicondylalgia." Thesis, 2012. http://hdl.handle.net/10321/719.

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Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012.
Lateral epicondylalgia (L.E) is a common diagnosis in elbow pathology. The aetiology is poorly understood but it is generally accepted to be as a result of repetitive microtrauma, affecting the proximal end of the extensor carpi radialis brevis tendon. Elbow bracing and exercise modification are often utilised by sufferers in order to reduce symptoms. In addition, there have been multiple treatment regimes used in practice to treat L.E, but none has stood out as being more effective than another. Thus, the aim of this study was to investigate the relative clinical effectiveness of therapeutic exercises alone and in combination with orthotic bracing, in terms of subjective and objective clinical findings. Methods This stratified, quantitative, prospective clinical trial consisted of two equal groups (n=15) diagnosed with L.E. Group One consisted of a strengthening and stretching programme alone, and Group Two consisted of a combination of the same programme and an orthotic brace. The participants performed the programme daily at home for six weeks, and the brace was worn throughout the day for six weeks. Each participant was assessed before, during and after the programme, in terms of subjective and objective clinical data which was then statistically analysed using SPSS version 18. Repeated measures ANOVA testing was also used to compare the outcomes between the groups over the time points. Results Both groups showed significant statistical improvement in terms of all the outcome measures. The groups also showed a clinically significant improvement for all the outcome measures except pressure pain threshold where Group Two showed clinically significant improvement over Group One. v Conclusion The results show that there was negligible benefit when combining an orthotic brace with therapeutic exercises as opposed to performing the therapeutic exercises alone.

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Gouws, Karien. "A Biokinetic approach to the prevention and rehabilitation of shoulder injuries in Tennis Players." Thesis, 2006. http://hdl.handle.net/2263/29207.

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Sports scientists and trainers generally agree that the multidimensional training in tennis should start during early childhood in order to ultimately reach a professional playing standard. Evidence suggests that motor skills, including power, strength, agility, speed and explosive power, as well as mental strength and a highly developed neuromuscular coordinating ability are strongly correlated with the level of tournament performance. Turner&Dent (1996) found that 27% of all tennis injuries in junior players occur in the shoulder region. The shoulder girdle is prone to injury because of its ability to maximally accelerate and decelerate the arm while the arm maintains it maintains precise control over the racquet at ball contact. The purpose of this study was to determine whether the occurrence of shoulder injuries could be minimized in tennis players by following a specific exercise programme, focusing on the shoulder girdle. A total of 42 tennis players participated in this study. They were all aged between 14 and 18 years. Both males and females were used for the purpose of this study. All the players were training at the SA Tennis Performance Centre and the International Tennis Federation at the University of Pretoria. They were all elite tennis players practising daily and scheduled for standard major tournaments throughout the year. Each subject completed a questionnaire of his or her tennis and medical history. The players were then divided into a control group and an experimental group. Both groups completed a series of physical scientific tests, consisting of posture analysis, body composition, flexibility, functional strength of the upper body; and isokinetic power and endurance of the shoulder muscles. These tests were executed every 3 months over a 9-month period and the results of each battery of tests were used to adjust and upgrade the new programmes. The experimental group did specific preventative shoulder exercises 5 times a week in addition to their usual gymnasium programme twice a week, while the control group followed a normal strengthening programme twice a week. A medical doctor immediately evaluated any muscle stresses or pains throughout the year. At the end of the year the data was compared to determine the difference in injury occurrence between the two groups. There was a significant difference (p<0.05) in the distribution of the lean body mass with the Lean body mass at T1 being lower than the Lean body mass at T3 in the control group. In the experimental group the fat percentage showed a significant decrease (p<0.05) from T1 to T3. The distribution of the muscle percentage at T1 was significantly different (p<0.05) from the distribution of the muscle percentage at T3 in the experimental group with the muscle percentage at T1 being lower than the muscle percentage at T3. There was a significant difference between the control and experimental group for 1RM bench press (p<0.05) with the 1RM bench press measurements at T3 being lower for the control group than for the experimental group. Also, the 1RM bench press at T1 was lower than the 1RM bench press at T3 in the experimental group. The experimental group showed a significant increase from T1 to T3, peaking at T3 with the 1RM bench press. Results of the tests done to determine isokinetic muscle strength showed that a statistical significant correlation (p<0.05) was found with regard to the strength of the internal rotators of the non-dominant shoulder at T3, with the experimental group having a higher measurement than the control group. The internal rotators and external rotators of both the dominant and non-dominant shoulders were lower at T1 than at T3 in the experimental group (p<0.05). The external rotators of the non-dominant shoulder at T1 were lower than the external rotators of the non-dominant shoulder at T3 in the control group. Results of the tests done to determine flexibility showed a statistically significant difference with the internal rotators and external rotators of the dominant as well as the non-dominant shoulders being lower at T1 than at T3 in the experimental group. Also, the external rotators of the non-dominant shoulder of the control group were lower at T1 than at T3. Results of the tests done to determine posture showed that in the control group, 54.5% of the players had scoliosis at T1 as opposed to 40.9% at T3. In the experimental group 55% had scoliosis at T1 compared to the 30% at T3. In the experimental group, 55% of the players’ shoulder heights were not level at T1, compared to 30% at T3. 63.6% of the control group’s non-dominant shoulders were higher than the dominant shoulder at T1, compared to the 40.9% of subjects at T3. Among the subjects in the experimental group, 50% had a higher non-dominant shoulder and 5% a higher dominant shoulder at T1, compared to 25% and 5% respectively in the control group, at T3. Results of the tests done to determine the occurrence of injuries, showed that the subjects with no injuries in the control group stayed stable from T1 (54.5%) to T2 (54.5%) whereafter it increased to 59.1% at T3. The experimental group stayed stable from T1 (55.0%) to T2 (55.0%) where after it increased to 85% at T3. In the control group the percentage grade 1 and 2 injuries was 13.6% at T1, increasing to 18.2% at T2, and decreasing to 13.6% at T3. In the experimental group 15% of the subjects had grade 1 injuries at T1. This percentage increased to 30% at T2 where after it decreased to 15% at T3 again. The percentage of subjects with grade 2 injuries in the experimental group remained stable at 10.0% from T1 to T2. None of the subjects had grade 2 injuries at T3. In the control group 9% had grade 3 injuries at T1, with none at T2 and T3. In the experimental group the percentage of subjects with grade 3 injuries remained stable at 5.0% from T1 to T2. None of the subjects had grade 3 injuries at T3. In the control group 4.5% of subjects had grade 4 injuries at T1. This stayed more or less stable at T2 (4.6%) and increased to 9.1% at T3. In the experimental group 10.0% had grade 4 injuries at T1. None of the subjects had grade 4 injuries at either T2 or T3. In the control group 4.5% had grade 5 injuries at T1, none had it at T2, and 4.5% had it at T3. In the experimental group none of the subjects had grade 5 injuries at T1, T2 or T3. In the control group none of the subjects had grade 6 injuries at T1 or T3. At T2, however, 4.6% had grade 6 injuries. In the experimental group 5.0% of the subjects had grade 6 injuries at T1 and none had this type of injury at T2 or T3. In conclusion, the results indicate that a specifically designed exercise programme can help to diminish the risk of shoulder injuries in tennis players. It can also improve bi-lateral muscle strength in opposing muscle groups which are used in tennis.
Thesis (DPhil)--University of Pretoria, 2007.
Biokinetics, Sport and Leisure Sciences
unrestricted

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(9798281), Caitlin Hill. "Understanding the effects of therapeutic tape in individuals with lateral elbow tendinopathy." Thesis, 2021. https://figshare.com/articles/thesis/Understanding_the_effects_of_therapeutic_tape_in_individuals_with_lateral_elbow_tendinopathy/19185116.

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Lateral elbow tendinopathy (LET) is a common musculoskeletal condition associated with elbow pain during gripping. The pathophysiology of LET involves degenerative changes of the extensor carpi radialis brevis tendon, pain system changes within the peripheral and the central nervous system, and motor impairments, such as altered muscle activity and wrist angle during gripping. One treatment option for LET is therapeutic tape, which has the potential to deload underlying musculotendinous tissue, or alter pain via tactile stimulation of the skin. However, the evidence for tape as a treatment for LET is yet to be synthesised. Additionally, the ways in which healthcare practitioners seek information about, and apply tape for LET, is unclear; highlighting a gap in the translation between research and clinical practice. A new type of tape, called biomechanical tape, is thought to deload underlying musculotendinous tissue. However, no studies have investigated the effectiveness of biomechanical tape on pain and function in individuals with LET. Therefore, this thesis aims to comprehensively review the current literature for the use of tape in LET, explore how and why practitioners are using therapeutic tape to treat LET, and examine whether biomechanical tape can be used to immediately improve pain and function for individuals with LET. Study 1 is a systematic review of the effects of therapeutic tape, as a standalone intervention, for LET. This review identified only eight studies, most at a high risk of bias, that investigated the effects of tape compared to a control or baseline condition. This review supports the use of diamond deloading rigid tape to immediately improve pain and grip strength in individuals with LET, while evidence for the effects of kinesiotape is conflicting. This study also confirms a lack of research examining the effects of biomechanical tape for LET. Study 2 reports the results of an anonymous survey of Australian healthcare practitioners regarding their use of tape for LET. The majority of respondents were physiotherapists, with most working in private practice. The survey found that approximately half of the respondents use a wide range of tape techniques to treat LET. Most respondents apply tape to reduce pain during occupational tasks, sport, or hobbies. Justification for tape use is largely based on experience and patient preference, with information regarding tape mostly gained from professional development courses. Together, Studies 1 and 2 demonstrate that while there is a paucity of high-quality literature regarding the use of tape for LET, it is a popular treatment option. Study 3 examined the between- and within-session reliability of measures commonly used in LET research, pain-free grip strength and pressure pain threshold. This study shows that while using a single trial and the mean of three trials of both outcomes demonstrates good to excellent reliability, the mean of three trials is recommended due to lower measurement error. This study also provides minimum detectable change scores for both between- and within-session study designs. Study 4 reports the clinical outcome measures of pain-free grip strength and pressure pain threshold from a single-blind, randomised crossover trial comparing the effects of biomechanical tape to a control tape and no tape condition. The study was designed to test the immediate effects, and the effects following a short exercise circuit that loaded the wrist extensors. There were no significant differences in pain-free grip strength or pressure pain threshold either immediately or following the exercise circuit. There was variability in the direction and magnitude of individual responses, which suggests that subgroup analysis within future treatment studies is warranted. Study 5 reports on muscle activity and wrist extension angle, measured during a submaximal gripping task in the randomised crossover trial, to explore potential mechanistic effects of biomechanical tape. This study observed several small, significant reductions in the percentage of maximal voluntary contraction for extensor digitorum communis and extensor carpi ulnaris, no significant changes for extensor carpi radialis brevis or longus, and no significant changes in wrist extension angle. While the observed decreases in muscle activity may not be large or consistent enough to be clinically significant on their own, these findings imply that there is a potential deloading effect of biomechanical tape. Overall, this thesis has found that while high-quality research investigating the effects of therapeutic tape in LET is lacking, use of tape is common, and practitioners rely on their own experience and patient preference to decide whether to use tape to treat LET. While biomechanical tape did not have a consistent, immediate effect on pain and function in a group of individuals with LET, there may be a small deloading effect, indicated by a reduction in muscle activity of some of the wrist extensors, that could benefit a subgroup of individuals. Based on these findings, future research exploring the characteristics of responders and non-responders is required to determine whether there is a role for biomechanical tape for individuals with LET.

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Rosenmüllerová, Lenka. "Objektivizace využití kineziotapingu k ovlivnění svalového napětí při epikondylitidě." Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-337071.

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Title The objectification of using of kinesio taping to influence a muscle tone in epicondylitis. Objectives The aim of this master thesis is to find an effect of inhibitive kinesiotape application to muscle tone of hypertonic m. extensor digitorum communis and to pain of lateral epicondyl in lateral epicondylitis. Method The master thesis is divided to theoretical part and empirical research, which is based on the first part. The evaluation of m. extensor digitorum communis tension after kinesiotape application is provided by myotonometry method. The measurement is performed in 5 tested persons before and after two-day kinesio tape application. The questionaire Numeric pain rating scale helps to find a change of pain before and after kinesio tape application and then the dependence of pain to muscle tone change. Results The myotonometer measurement found a decrease of m. extensor digitorum communis tension for 4 from 5 tested persons after two-day application. The pain of lateral epicondyl was reduced for all probands. Keywords lateral epicondylitis, tennis elbow, muscle tone, kinesio taping, myotonometer

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Sanni, Modinat. "MUSCLES ACTIVATIONS DURING "SHOULDER MOUNT" POLE ACROBATIC EXERCISE." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-347414.

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Author: Bc. Modinat Sanni Supervisor: Ing. Miroslav Vilímek, PhD Title: MUSCLES ACTIVATION DURING "SHOULDER MOUNT"POLE ACROBATIC EXERCISE Purpose: This study is an empirical - theoretical study presents the literature review regarding to the topic of the shoulder function anatomy, kinesiology, biomechanics, non-traumatic injuries of the shoulder and their prevention by using the available literatures. Further, the study also compares by surface electromyography the amplitudes, shapes and durations of myoelectric signals of m. latissimus dorsi, m. pectoralis maior, m. biceps brachii, m. infraspinatus and m. supraspinatus of dominant shoulder in two healthy individuals during acrobatic exercise on vertical pole known as "Shoulder Mount". The purpose was monitor the changes in two different conditions; i.e. kinesiotape and elbow brace and compare with the control condition for the reason of finding out their ability to affect the myoelectric activities of selected muscles. Further, the Shoulder Mount exercise had recorded by six Qualisys cameras for motion analyses. Methods and materials: The potentially eligible scientific articles perform a search of studies on the topic of kinesiotapes and tennis elbow brace as measured by EMG mainly on myoelectric activity of the shoulder complex were seared from...

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Dissertations / Theses on the topic 'Tennis elbow'

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