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Clinical and ultrasonographic effectiveness of two different splints used for the treatment of lateral epicondylitis: a prospective randomized controlled study
Songur K, Demir ZD, Baysan C, Dilek B
Archives of Physical Medicine and Rehabilitation 2024 Apr;105(4):655-663
clinical trial
7/10 [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: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: This study compares the clinical and ultrasonographic efficacy of two splint types, the lateral epicondylitis band (LEB) and the wrist extensor splint (WES), for treatment of lateral epicondylitis (LE). DESIGN: Randomized controlled single-blind trial. SETTING: Outpatient clinic. PARTICIPANTS: 159 participants diagnosed with unilateral LE based on clinical and ultrasonographic findings, and 2 to 12 weeks from symptom onset, were included. INTERVENTIONS: One group received joint-protection education-only (wait-and-see) while the other two groups were fit with splints: one the LEB and the other the WES. Both splint groups received joint-protection education. MAIN OUTCOME MEASURES: The primary outcome measure was the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire. Secondary outcome measures were the Visual Analog Scale (VAS) for pain, hand grip strength by dynamometry, algometric measurements, patient satisfaction, and selected ultrasonographic parameters (maximum tendon thickness measurements (MTTM) in the capitellar-radiocapitellar region and total ultrasonography scale score (TUSS)). All outcomes were assessed at baseline, 3-weeks, and 6-weeks post intervention initiation. RESULTS: Participants' mean age was 46.85 +/- 8.63 years. 40.88%(n = 65) were male and 59.12%(n = 94) were female. The baseline median (1Q to 3Q) values of PRTEE-total scores were 58.5 (51 to 68) for the LEB, 63.5 (56.25 to 70.25) for the WES and 57 (48 to 68) for the education-only groups. At 6-weeks, the PRTEE-total scores had decreased by 44 points for those randomized to the LEB, 46 points to the WES and 7 points in the education-only groups (p < 0.001). While the LEB and WES approaches were superior to the wait-and-see approach in algometric measurements, VAS, and PRTEE scores (p < 0.05), no significant changes were found in MTTM and TUSS values. The LEB group was superior to the WES group in hand grip strength and patient satisfaction (p < 0.05). CONCLUSION: Using either splint for 6 weeks can be considered effective for the relief of pain and increased functionality in persons with subacute LE, although the LEB had a more positive effect on grip strength and patient satisfaction than the WES.

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