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ORIJINAL ARAŞTIRMA

Lateral Epikondilit için Ekstrakorporeal Şok Dalga Tedavisinin Başlangıç Zamanlamasının Herhangi Bir Aşamasında: Ağrı, Güç ve Fonksiyon Üzerine Etkisi
Extracorporeal Shock Wave Therapy for Lateral Epicondylitis at Any Stage of Timing of Onset: Effect on Pain, Strength and Function
Received Date : 03 Feb 2021
Accepted Date : 03 May 2021
Available Online : 18 May 2021
Doi: 10.31609/jpmrs.2021-82024 - Makale Dili: EN
J PMR Sci. 2021;24(3):260-6
ÖZET
Amaç: Çalışmanın amacı, lateral epikondilit (LE) tedavisinde kullanılan ekstrakorporeal şok dalgası tedavisinin [extracorporeal shock wave therapy (ESWT)] etkinliğini ortaya koymak ve ağrı süresinin tedavinin başarısına etkisi olup olmadığını belirlemektir. Gereç ve Yöntemler: Çalışmaya LE tanısı ile ESWT ile tedavisi alan 47 hasta dâhil edildi. Hastalar semptomları 3 aydan daha kısa olanlar akut LE grubu (n=12), 3-6 ay arası olanlar subakut LE grubu (n=20) ve 6 aydan daha fazla olanlar kronik LE (n=15) olarak ayrıldı. Sonuç ölçütleri, ağrı için maksimum ve dinlenme vizüel analog skala (VAS), kavrama gücü için kavrama dinamometresi ve kolun işlevselliği için hasta derecelendirmeli tenisçi dirseği değerlendirmesi [patient-rated tennis elbow evaluation (PRTEE)] idi. Tüm hastalar tedavi öncesi, tedavi sonrası ve tedaviden 1 ay sonra değerlendirildi. Bulgular: Tedavi sonrası VAS maksimum, VAS dinlenme ve el kavrama gücü değerlerinde önemli gelişmeler elde edildi ve bu gelişmeler takip değerlendirmelerinde de devam etti. Ek olarak PRTEE değerleri tedaviden sonra önemli ölçüde azaldı. Tedavi sonrası ve takip değerlendirmeleri arasında PRTEE değerlerinde anlamlı bir artış olmasına rağmen takip değerleri tedavi öncesi ile karşılaştırıldığında hâlâ istatistiksel olarak üstündü. Hastalar ağrı süresine göre gruplandırıldığında, VAS, kavrama gücü ve PRTEE puanlarındaki değişikliklerde istatistiksel olarak anlamlı bir fark saptanmadı. Sonuç: ESWT, LE tedavisinde etkili bir tedavi yöntemidir. LE’nin akut, subakut ve kronik evrelerinde de etkili bir tedavi yöntemidir ve bu dönemler arasında istatistiksel olarak fark yoktur.
ABSTRACT
Objective: The aim of this study was to demonstrate the effectiveness of extracorporeal shock wave therapy (ESWT) used in the treatment of lateral epicondylitis (LE) and to determine whether the time since onset of pain has an impact on outcome. Material and Methods: The study included 47 patients who were diagnosed with LE and treated with ESWT. The patients were separated as those who had symptoms for <3 months as the acute LE group (n=12), those who had symptoms for 3-6 months as the subacute LE group (n=20) and those who had symptoms for >6 months as the chronic LE group (n=15). The outcome measures were the maximum and rest visual analog scale (VAS) for pain, grip dynamometer for grip strength and patient-rated tennis elbow evaluation (PRTEE) for functionality of the arm. All patients were evaluated pre-treatment, post-treatment and at 1 month after treatment. Results: Significant improvements were obtained in VAS maximum, VAS rest and hand grip strength values after treatment and these improvements continued in the follow-up evaluations. In addition PRTEE values were significantly decreased after treatment. Although there was a significant increase in the PRTEE values between the post-treatment and follow-up evaluations, follow-up values was still statistically superior compared to pre-treatment. When patients were grouped according to pain duration, no statistically significant difference was determined in the changes in VAS scores, grip strength and PRTEE scores. Conclusion: ESWT is an effective treatment modality in the treatment of LE. It is also an effective treatment method in acute, subacute and chronic stages of LE, and there is no statistically difference between these periods.
REFERENCES
  1. Runge, F. Zur genese und behandlung des schreibekrampfes. Berl Klin Wochenschr, 1873;10(1):245-8.
  2. Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol. 1974;3:145-53. [Crossref]  [PubMed] 
  3. Stasinopoulos D, Johnson MI. Cyriax physiotherapy for tennis elbow/lateral epicondylitis. Br J Sports Med. 2004;38:675-7. [Crossref]  [PubMed]  [PMC] 
  4. Wuori JL, Overend TJ, Kramer JF, et al. Strength and pain measures associated with lateral epicondylitis bracing. Arch Phys Med Rehabil. 1998;79:832-7. [Crossref]  [PubMed] 
  5. Nirschl RP. Elbow tendinosis/tennis elbow. Clin Sports Med. 1992;11:851-70. [Crossref]  [PubMed] 
  6. Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Med. 1999;28:375-80. [Crossref]  [PubMed] 
  7. Lai WC, Erickson BJ, Mlynarek RA, et al. Chronic lateral epicondylitis: challenges and solutions. Open Access J Sports Med. 2018;9:243-51. [Crossref]  [PubMed]  [PMC] 
  8. Bhabra G, Wang A, Ebert JR, et al. Lateral elbow tendinopathy: development of a pathophysiology-based treatment algorithm. Orthop J Sports Med. 2016;4:2325967116670635. [Crossref]  [PubMed]  [PMC] 
  9. Thiel M. Application of shock waves in medicine. Clin Orthop Relat Res. 2001;(387):18-21. [Crossref]  [PubMed] 
  10. Yao G, Chen J, Duan Y, et al. Efficacy of extracorporeal shock wave therapy for lateral epicondylitis: A systematic review and meta- analysis. Biomed Res Int. 2020;2020:20 64781. [Crossref]  [PubMed]  [PMC] 
  11. Speed CA, Nichols D, Richards C, et al. Extracorporeal shock wave therapy for lateral epicondylitis--a double blind randomised controlled trial. J Orthop Res. 2002;20:895-8. [Crossref]  [PubMed] 
  12. Chung B, Wiley JP. Effectiveness of extracorporeal shock wave therapy in the treatment of previously untreated lateral epicondylitis: a randomized controlled trial. Am J Sports Med. 2004;32:1660-7. [Crossref]  [PubMed] 
  13. Köksal İ, Güler O, Mahiroğulları M, et al. Comparison of extracorporeal shock wave therapy in acute and chronic lateral epicondylitis. Acta Orthop Traumatol Turc. 2015;49:465-70. [Crossref]  [PubMed] 
  14. Helbig K, Herbert C, Schostok T, et al. Correlations between the duration of pain and the success of shock wave therapy. Clin Orthop Relat Res. 2001;(387):68-71. [Crossref]  [PubMed] 
  15. Chung B, Wiley JP, Rose MS. Long-term effectiveness of extracorporeal shockwave therapy in the treatment of previously untreated lateral epicondylitis. Clin J Sport Med. 2005;15:305-12. [Crossref]  [PubMed] 
  16. Stania M, Krol B, Franek A, et al. A comparative study of the efficacy of radial and focused shock wave therapy for tennis elbow depending on symptom duration. Arch Med Sci. 2009;1:1-10. [Link] 
  17. Behrens SB, Deren ME, Matson AP, et al. A review of modern management of lateral epicondylitis. Phys Sportsmed. 2012;40:34-40. [Crossref]  [PubMed] 
  18. Overend TJ, Wuori-Fearn JL, Kramer JF, MacDermid JC. Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis. J Hand Ther. 1999;12:31-7. [Crossref]  [PubMed] 
  19. Altan L, Ercan I, Konur S. Reliability and validity of Turkish version of the patient rated tennis elbow evaluation. Rheumatol Int. 2010; 30:1049-54. [Crossref]  [PubMed] 
  20. Akkurt S, Yılmaz A, Saka T. A comparison of extracorporeal shock wave therapy, physiotherapy, and local steroid injection in treatment of lateral epicondylitis. Turk J Phys Med Rehabil. 2016;1:37-44. [Crossref] 
  21. Yalvaç B, Mesci N, Geler Külcü D, et al. Comparison of ultrasound and extracorporeal shock wave therapy in lateral epicondylosis. Acta Orthop Traumatol Turc. 2018;52:357-62. [Crossref]  [PubMed]  [PMC] 
  22. Aydın A, Atiç R. Comparison of extracorporeal shock-wave therapy and wrist-extensor splint application in the treatment of lateral epicondylitis: A prospective randomized controlled study. J Pain Res. 2018;11:1459-67. [Crossref]  [PubMed]  [PMC] 
  23. Radwan YA, ElSobhi G, Badawy WS, et al. Resistant tennis elbow: shock-wave therapy versus percutaneous tenotomy. Int Orthop. 2008;32:671-7. [Crossref]  [PubMed]  [PMC] 
  24. Richter D, Ekkernkamp A, Muhr G. Die extrakorporale Stosswellentherapie--ein alternatives Konzept zur Behandlung der Epicondylitis humeri radialis? [Extracorporeal shock wave therapy--an alternative concept for the treatment of epicondylitis of the humerus and radius?]. Orthopade. 1995;24:303-6. German. [PubMed] 
  25. Rompe JD, Hopf C, Küllmer K, et al. Low-energy extracorporal shock wave therapy for persistent tennis elbow. Int Orthop. 1996;20:23-7. [Crossref]  [PubMed] 
  26. Reilly JM, Bluman E, Tenforde AS. Effect of shockwave treatment for management of upper and lower extremity musculoskeletal conditions: A narrative review. PM R. 2018;10:1385-1403. [Crossref]  [PubMed] 
  27. Bayram K, Yesil H, Dogan E. Efficacy of extracorporeal shock wave therapy in the treatment of lateral epicondylitis. North Clin Istanb. 2014;1:33-8. [Crossref]  [PubMed]  [PMC] 
  28. Khan KM, Cook JL, Taunton JE, et al. Overuse tendinosis, not tendinitis part 1: A new paradigm for a difficult clinical problem. Phys Sportsmed. 2000;28:38-48. [Crossref]  [PubMed] 
  29. Haake M, Böddeker IR, Decker T, et al. Side-effects of extracorporeal shock wave therapy (ESWT) in the treatment of tennis elbow. Arch Orthop Trauma Surg. 2002;122:222-8. [Crossref]  [PubMed]