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The predictive value of the extensor grip test for the effectiveness of bracing for tennis elbow |
Struijs PA, Assendelft WJ, Kerkhoffs GM, Souer S, van Dijk CN |
The American Journal of Sports Medicine 2005 Dec;33(12):1905-1909 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Tennis elbow is a common complaint. Several treatment strategies, such as corticosteroid injections and physical therapy and braces, have been described. HYPOTHESIS: The extensor grip test has predictive value in assessing the effectiveness of bracing in tennis elbow. STUDY DESIGN: Cohort study (prognosis); level of evidence, 1. METHODS: Patients with tennis elbow complaints were randomized into 3 groups: brace only, physical therapy, and combination brace and physical therapy. The extensor grip test was performed before randomization on all patients. Outcome measures at 6-week follow-up were success rate, severity of complaints, pain, disability, inconvenience during daily life, and satisfaction. RESULTS: In the brace-only group, significant differences were identified between patients with a positive test result and patients with a negative test result for 3 outcome measures. The success rate in the test-negative group was 23% (5/22) compared to 47% (21/45) in the test-positive group. Mean decrease in pain was 23 (95% confidence interval, -3 to 49) in the test-positive group compared to 11 (95% confidence interval, -6 to 28) in the test-negative group, and mean satisfaction in the test-positive group was 71 (95% confidence interval, 48 to 94) compared to 51 (95% confidence interval, 24 to 78) in the test-negative group. In the physical therapy and combination groups, no differences were identified between test-positive and test-negative patients. CONCLUSION: The extensor grip test seems valuable as a predictive factor for the effectiveness of bracing as treatment for tennis elbow over the short term.
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