Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study

KÖSEOĞLU, FÜSUN B.; Akın, Ceyda; OKEN, OZNUR

Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study

Ceyda AKIN, (Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 4. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara, Türkiye)

Öznur ÖKEN, (Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 4. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara, Türkiye)

FÜSUN B. KÖSEOĞLU (Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, 4. Fizik Tedavi ve Rehabilitasyon Kliniği, Ankara, Türkiye)

Turkish Journal of Rheumatology(.)Archives of Rheumatology

0 0

Yıl: 2010 Cilt: 25 Sayı: 2 Sayfa Aralığı: 50 - 55 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study

Öz:

Amaç: Lateral epikondilit tanısı almış hastalarda ultrason tedavisinin etkinliğini araştırmak ve plasebo ultrason tedavisi ile karşılaştırmaktı.Yöntem ve Gereçler: Çalışmaya, lateral epikondilit tanısı konan 25-62 yaş (ort. yaş 46.7±8.1) arasında 60 hasta (40 kadın ve 20 erkek) dahil edildi. Hastalar randomize olarak 2 gruba ayrıldı: ultrason (US) grubu ve plasebo grubu. Ultrason grubundaki hastalara (n=30) sürekli ultrason; plasebo grubuna (n=30) ise çalışmayan başlığın kullanıldığı ultrason 5 dakika süreyle 3 hafta boyunca toplam 15 seans uygulandı. Tüm hastalara tedavi süresince (3 hafta) gece splinti verildi. Hastalar tedavi başlangıcı, sonu (3. hafta) ve 15 gün sonra (5. hafta ) değerlendirildi. İstirahat ve hareket ağrısı vizüel ağrı skalası (VAS) ile, el sıkma gücü el dinamometresi ile, günlük yaşam aktivite değerlendirmesi Disabilities of the Arm, Shoulder, and Hand (DASH-T) anketi Türkçe versiyonu ile, yaşam kalitesi Short-Form (SF)-36 ölçeği ile değerlendirildi Ayrıca hasta memnuniyeti de sorgulandı. Bulgular: İstirahat ağrısı (VAS); US grubunda hem tedavi sonunda (3. hafta) hem de 15 gün sonraki takipte (5. hafta) tedavi öncesine göre anlamlı düzelmişti, ancak plasebo grubundaki düzelme sadece 3. haftada gözlendi (p<0.01). Hareket ağrısı (VAS) ise US grubunda hem 3. haftada hem de 5. haftada tedavi öncesine göre anlamlı düzelmişti, ancak plasebo grubunda 3. haftadaki anlamlı azalmaya rağmen 5.haftada anlamlı artış gözlendi (p<0.01). El sıkma gücü; her iki grupta da tedavi sonunda ve 5. haftadaki takipte tedavi öncesine göre düzelmişti (p<0.008), ancak tedavi sonu ile 5. hafta arasında fark yoktu . Her iki grup karşılaştırıldığında ise gruplar arasında farklılık saptanmadı (p>0.05). DASH-T skorları açısından iki grup arasında tedavi sonunda ve 15 gün sonraki takipte fark yoktu. Tedavi öncesine göre 3. ve 5. haftalardaki DASH-T'taki değişim, US grubunda plasebo grubuna kıyasla anlamlı yüksekti (p<0.017). Hasta memnuniyeti her iki grupta da tedavi ile artmıştı, ancak US grubunda plasebo grubuna göre anlamlı oranda daha yüksekti (p<0.001). Sonuç: Bu çalışmada, ultrason tedavisinin, lateral epikondilitli hastalarda ağrı, günlük yaşam aktiviteleri ve hasta memnuniyetinde anlamlı düzelme sağladığı gösterilmiştir.

Anahtar Kelime:

Konular: Romatoloji

Lateral Epikondilitli Hastalarda Ultrason Tedavisinin Kısa Dönem Etkinliÿi: Randomize, Tek Kör Plasebo Kontrollü, Prospektif Çalışma

Öz:

Objective: We aimed to assess the effectiveness of ultrasound treatment in patients with lateral epicondylitis and to compare with placebo ultrasound treatment. Materials and Methods: Sixty patients with lateral epicondylitis were included. All of the patients were randomized to two groups as: ultrasound (US) group (n=30) and placebo US group (n=30). Continuous US was applied to the patients in the US group whereas placebo US was applied to those in the placebo group for 5 minutes over three weeks (totally 15 sessions). All patients used a static splint at night for the three weeks. Patients were assessed before the treatment (baseline), at the end of the treatment (3rd week) and after 15 days follow-up (5th week). The following parameters were evaluated: pain with the visual analog scale (VAS), hand grip strength using a hand dynamometer, activities of daily living using the Turkish version of Disabilities of the Arm, Shoulder and Hand (DASH-T) questionnaire, and quality of life using the Short-Form (SF)-36 questionnaires. In addition, patient satisfaction was examined. Results: VAS at rest and during motion had significantly improved in both groups at the end of treatment (3rd week) and in the follow-up (5th week), while improvement in the VAS was observed only in the 3rd week in placebo group (p<0.01). Pain with motion was significantly decreased in the 3rd and 5th weeks in the US group while it was increased in the 5th week in the placebo group (p<0.01). Hand grip strength were improved in the 3rd and 5th weeks in both groups (p<0.008). There was no significant difference between the two groups (p>0.05). No difference between the two groups was found in terms of general DASH-T scores at the end of the treatment and follow-up. However, improvement in DASH scores in the US group at the 3rd and 5th weeks was significantly higher than in the placebo group (p<0.017). Patient satisfaction scores increased in both groups, but satisfaction of patients in the US group was significantly higher than of those in the placebo group (p<0.001). Conclusion: In this study, it was found that US treatment for lateral epicondylitis improved pain and activities of daily living and resulted in high patient satisfaction

Anahtar Kelime:

Konular: Romatoloji

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Finnoff JT. Musculoskeletal problems of the upper limb. In: Braddom RL (ed). Physical Medicine and Rehabilitation WB Saunders Co. Philadelphia 2007: 825-53.
2. Klaiman M, Fink K. Connective tissue injuries of upper limb. In: DeLisa JA, Gans BM (eds): Rehabilitation Mdicine Principles and Practice. J.B.Lipincott Co. Philadelphia 2007: 829-41.
3. Ernst E. Conservative therapy for tennis elbow. Br J Clin Pract. 1992; 46: 55-7.
4. Struijs PAA, Kerkhoffs GMMJ, Assendelft WJJ, Van Dijk CN. Conservative treatment of lateral epicondylitis. Brace versus physical therapy or a combination of both - a randomized clinical trial. Am J Sports Med 2004; 32: 462-9.
5. Walker-Bone K, Palmer KT, Reading I, Coggon G, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum 2004; 5: 642-51.
6. Price DD, McGrath PA, Rafii A, Buckingham B. The validations of visual analogue scales as ratio scale measures for chronic pain and experimental pain. Pain 1983; 17: 45-56.
7. Ertekin C. Ağrının nöroanatomi ve nörofizyolojisi. In: Yegül I (ed). Ağrı ve Tedavisi. İstanbul: Yapım Matbaacılık, 1993: 1-17.
8. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am 1984; 9: 222-6.
9. Dundar P, Fidaner C, Fidaner H, et al. Comparing the Turkish versions of WHOQOL-BREF and SF-36, convergent validity of WHOQOL-BREF and SF-36. Hippokratia 2002; 6: 27-43.
10. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Am J Indust Med 1996; 29: 602-8.
11. Düger T, Yakut E, Öksüz Ç. The reliability and validity of Turkish version of DASH Questionnaire. Physiother Rehabil 2006; 17: 99-107.
12. Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005; 39: 411-22.
13. Tan PK, Lam KS, Tan SK. Results of modified Basworth's operation for persistent and recurrent tennis elbow. Singapore Med J. 1989; 30: 359-62.
14. Özcan E. Lateral epikondilitte değerlendirme ve tedavi. Acta Orthop Traumatol Turc. 1990; 24: 74-6.
15. Moore G. Arthrocentesis technique and intraarticular therapy. In: Kopman W, Moreland L(eds). Arthritis and Allied Conditions. Lippincott WW. Philadelphia 2004: 775-86.
16. Kivi P. The etiology and conservative treatment of humeral epicondylitis. Scand J. Rehab. Med. 1982; 15: 37-41.
17. Hong QN, Durand MJ, Loisel P. Treatment of lateral epicondylitis: where is the evidence? Joint Bone Spine 2004; 71: 369-73.
18. Binder A, Hodge G, Greenwood AM, Hazleman BL, Page-Thomas DP. Is therapeutic ultrasound effective in treating soft tissue lesions? Br Med J 1985; 290: 512-4.
19. Haker E, Lundeberg T. Pulsed ultrasound treatment in lateral epicondylalgia. Scand J Rehabil Med 1991; 23: 115-8.
20. Trudel D, Duley J, Zastrow I, Kerr EW, Davidson R, MacDermid JC. Rehabilitation for patients with lateral epicondylitis. J Hand Ther 2004; 17: 243-66.
21. D'Vaz AP, Ostor AJ, Speed CA, Jenner JR, Bradley M. Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial. Rheumatology 2006; 45: 566-70.
22. Walther M, Kirschner S, Koenig A, Barthel T, Gohlke F. Biomechanical evaluation of braces used for treatment of epicondylitis. J Shoulder Elbow Surg 2002; 11: 265-70.

APA	Akın C, OKEN O, KÖSEOĞLU F (2010). Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. , 50 - 55.
Chicago	Akın Ceyda,OKEN OZNUR,KÖSEOĞLU FÜSUN B. Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. (2010): 50 - 55.
MLA	Akın Ceyda,OKEN OZNUR,KÖSEOĞLU FÜSUN B. Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. , 2010, ss.50 - 55.
AMA	Akın C,OKEN O,KÖSEOĞLU F Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. . 2010; 50 - 55.
Vancouver	Akın C,OKEN O,KÖSEOĞLU F Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. . 2010; 50 - 55.
IEEE	Akın C,OKEN O,KÖSEOĞLU F "Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study." , ss.50 - 55, 2010.
ISNAD	Akın, Ceyda vd. "Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study". (2010), 50-55.

APA	Akın C, OKEN O, KÖSEOĞLU F (2010). Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. Turkish Journal of Rheumatology(.)Archives of Rheumatology, 25(2), 50 - 55.
Chicago	Akın Ceyda,OKEN OZNUR,KÖSEOĞLU FÜSUN B. Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. Turkish Journal of Rheumatology(.)Archives of Rheumatology 25, no.2 (2010): 50 - 55.
MLA	Akın Ceyda,OKEN OZNUR,KÖSEOĞLU FÜSUN B. Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. Turkish Journal of Rheumatology(.)Archives of Rheumatology, vol.25, no.2, 2010, ss.50 - 55.
AMA	Akın C,OKEN O,KÖSEOĞLU F Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2010; 25(2): 50 - 55.
Vancouver	Akın C,OKEN O,KÖSEOĞLU F Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study. Turkish Journal of Rheumatology(.)Archives of Rheumatology. 2010; 25(2): 50 - 55.
IEEE	Akın C,OKEN O,KÖSEOĞLU F "Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study." Turkish Journal of Rheumatology(.)Archives of Rheumatology, 25, ss.50 - 55, 2010.
ISNAD	Akın, Ceyda vd. "Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study". Turkish Journal of Rheumatology(.)Archives of Rheumatology 25/2 (2010), 50-55.