Yıl: 2021 Cilt: 67 Sayı: 1 Sayfa Aralığı: 99 - 106 Metin Dili: İngilizce DOI: 10.5606/tftrd.2021.4789 İndeks Tarihi: 01-06-2022

Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study

Öz:
Objectives: The aim of this study was to investigate the efficacy of continuous and pulsed ultrasound therapies in lateral epicondylitis. Patients and methods: A total of 51 patients (18 males, 33 females; mean age: 46.52±6.16 years; range, 27 to 64 years) who were diagnosed with lateral epicondylitis between February 2013 and October 2014 were included. The patients were randomized to either continuous ultrasound (n=17), pulsed ultrasound (n=17), or placebo (n=17) groups. First group received 10 sessions of continuous ultrasound therapy. The second group received 10 sessions of pulsed ultrasound therapy in a ratio of 1:4. The third group received 10 sessions of placebo treatment. The pain levels of the patients were evaluated using Visual Analog Scale (VAS). The muscle strength was evaluated using a dynamometer. For functional evaluation, Duruöz’s Hand Index (DHI) and Patient-Rated Tennis Elbow Evaluation (PRTEE) scales were used. Assessments were made at baseline, at the end of therapy, and one month after therapy. The thickness of the common extensor tendon was also measured using ultrasonic imaging at baseline and at the end of therapy. Results: At the end of the study, there was a statistically significant improvement in the rest and activation VAS scores, and DHI and PRTEE scores in both continuous and pulsed ultrasound therapy groups, compared to placebo (p<0.05). However, no superiority was found between the continuous and pulsed ultrasound therapy groups (p>0.05). A statistically significant reduction in the common extensor tendon thickness was found only in the pulsed ultrasound therapy group (p<0.05). Conclusion: Our study results show that both continuous and pulsed ultrasound applications are effective in the treatment of lateral epicondylitis.
Anahtar Kelime:

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  • 1. Waugh EJ, Jaglal SB, Davis AM, Tomlinson G, Verrier MC. Factors associated with prognosis of lateral epicondylitis after 8 weeks of physical therapy. Arch Phys Med Rehabil 2004;85:308-18.
  • 2. Vaquero-Picado A, Barco R, Antuña SA. Lateral epicondylitis of the elbow. EFORT Open Rev 2017;1:391-7.
  • 3. Martinez-Silvestrini JA, Newcomer KL, Gay RE, Schaefer MP, Kortebein P, Arendt KW. Chronic lateral epicondylitis: comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther 2005;18:411-9.
  • 4. Mandiroğlu S, Bal A, Gurçay E, Cakcı A. Comparison of the effects of non-steroidal anti-inflammatory drugs, steroid injection and physical therapy in lateral epicondylitis. Turk J Phys Med Rehab 2007;53:104-7.
  • 5. 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 Rehab 2016;1:37-44.
  • 6. Howitt SD. Lateral epicondylosis: a case study of conservative care utilizing ART and rehabilitation. J Can Chiropr Assoc 2006;50:182-9.
  • 7. Aaron SE, Delgado-Diaz DC, Kostek MC. Continuous Ultrasound Decreases Pain Perception and Increases Pain Threshold in Damaged Skeletal Muscle. Clin J Sport Med 2017;27:271-7.
  • 8. Tikiz C, Duruöz T, Ünlü Z, Cerrahoglu L, Yalcinsoy E. Comparison of the efficacy of low-level laser therapy and pulsed ultrasound treatment in carpal tunnel syndrome: A placebo-controlled study. Turk J Phys Med Rehab 2013,59:201-8.
  • 9. Sarı H. Hareket sistemi hastalıklarında fiziksel tıp yöntemleri. In: Karamehmetoğlu ŞS, editör. Derin ısıtıcılar. İstanbul: Nobel Tıp Kitabevleri; 2002. s. 51-60.
  • 10. Wilder RP, Jenkins J, Seto C. Treatment techniques and special equipment. In: Braddom RL, editor. Physical medicine & rehabilitation. 3th ed. Philadelphia: Saunders Elsevier Inc; 2007. p. 413-36.
  • 11. Yazmalar L, Sarıyıldız MA, Batmaz İ, Alpaycı M, Burkan YK, Özkan Y, et al. Efficiency of therapeutic ultrasound on pain, disability, anxiety, depression, sleep and quality of life in patients with subacromial impingement syndrome: A randomized controlled study. J Back Musculoskelet Rehabil 2016;29:801-7.
  • 12. Sánchez AG, Andrade EL, Marsal JV, Tauste LA, Mingot CG, Monge JL, et al. A study to evaluate the effect of ultrasound treatment on nodules in multiple sclerosis patients. Int J Neurosci 2017;127:404-11.
  • 13. Tan JC, editor. Practical manual of physical medicine and rehabilitation. 2nd ed. Philadelphia: Mosby; 2006.
  • 14. Akin C, Oken O, Koseoglu BF. Short-term effectiveness of ultrasound treatment in patients with lateral epicondylitis: randomized, single-blind, placebo-controlled, prospective study. Turk J Rheumatol 2010;25:50-5.
  • 15. D'Vaz AP, Ostor AJ, Speed CA, Jenner JR, Bradley M, Prevost AT, et al. Pulsed low-intensity ultrasound therapy for chronic lateral epicondylitis: a randomized controlled trial. Rheumatology (Oxford) 2006;45:566-70.
  • 16. Haker E, Lundeberg T. Pulsed ultrasound treatment in lateral epicondylalgia. Scand J Rehabil Med 1991;23:115- 8.
  • 17. Lundeberg T, Abrahamsson P, Haker E. A comparative study of continuous ultrasound, placebo ultrasound and rest in epicondylalgia. Scand J Rehabil Med 1988;20:99-101.
  • 18. Oken O, Kahraman Y, Ayhan F, Canpolat S, Yorgancioglu ZR, Oken OF. The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial. J Hand Ther 2008;21:63-7.
  • 19. Rosenberg N, Soudry M, Stahl S. Comparison of two methods for the evaluation of treatment in medial epicondylitis: pain estimation vs grip strength measurements. Arch Orthop Trauma Surg 2004;124:363-5.
  • 20. Svernlöv B, Adolfsson L. Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Scand J Med Sci Sports 2001;11:328-34.
  • 21. Wuori JL, Overend TJ, Kramer JF, MacDermid J. Strength and pain measures associated with lateral epicondylitis bracing. Arch Phys Med Rehabil 1998;79:832-7.
  • 22. Duruöz MT, Poiraudeau S, Fermanian J, Menkes CJ, Amor B, Dougados M, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol 1996;23:1167-72.
  • 23. 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.
  • 24. 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.
  • 25. Struijs PA, Spruyt M, Assendelft WJ, van Dijk CN. The predictive value of diagnostic sonography for the effectiveness of conservative treatment of tennis elbow. AJR Am J Roentgenol 2005;185:1113-8.
  • 26. Murtezani A, Ibraimi Z, Vllasolli TO, Sllamniku S, Krasniqi S, Vokrri L. Exercise and Therapeutic Ultrasound Compared with Corticosteroid Injection for Chronic Lateral Epicondylitis: A Randomized Controlled Trial. Ortop Traumatol Rehabil 2015;17:351-7.
  • 27. Binder A, Hodge G, Greenwood AM, Hazleman BL, Page Thomas DP. Is therapeutic ultrasound effective in treating soft tissue lesions? Br Med J (Clin Res Ed) 1985;290:512-4.
  • 28. Kachanathu SJ, Vellapallil DMSNS. Pulsed versus continuous ultrasound therapy: as a management of lateral epicondylitis. IJMHS 2013;3:242-5.
  • 29. Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc 1998;30:1349-55.
  • 30. Rutjes AW, Nüesch E, Sterchi R, Jüni P. Therapeutic ultrasound for osteoarthritis of the knee or hip. Cochrane Database Syst Rev 2010;(1):CD003132.
  • 31. Fu SC, Shum WT, Hung LK, Wong MW, Qin L, Chan KM. Low-intensity pulsed ultrasound on tendon healing: a study of the effect of treatment duration and treatment initiation. Am J Sports Med 2008;36:1742-9.
  • 32. Korstjens CM, van der Rijt RH, Albers GH, Semeins CM, Klein-Nulend J. Low-intensity pulsed ultrasound affects human articular chondrocytes in vitro. Med Biol Eng Comput 2008;46:1263-70.
  • 33. Baker KG, Robertson VJ, Duck FA. A review of therapeutic ultrasound: biophysical effects. Phys Ther 2001;81:1351-8
  • 34. Norris C, editor. Sports injuries diagnosis and management. 3rd ed. Oxford: Butterworth Heinemann Elsevier Limited; 2004.
  • 35. Nimgade A, Sullivan M, Goldman R. Physiotherapy, steroid injections, or rest for lateral epicondylosis? What the evidence suggests. Pain Pract 2005;5:203-15.
  • 36. Gündüz R, Malas FÜ, Borman P, Kocaoğlu S, Özçakar L. Physicaltherapy,corticosteroidinjection,andextracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison. Clin Rheumatol 2012;31:807-12.
  • 37. Aktaş S. Baskı yaraları tedavisinde terapötik ultrasonun etkileri. Atatürk Üniversitesi Tıp Bülteni 1990;22:503-8.
  • 38. Turner JA, Deyo RA, Loeser JD, Von Korff M, Fordyce WE. The importance of placebo effects in pain treatment and research. JAMA 1994;271:1609-14.
  • 39. Zubieta JK, Stohler CS. Neurobiological mechanisms of placebo responses. Ann N Y Acad Sci 2009;1156:198-210.
APA Unver H, Bakılan F, BERKAN F, ARMAGAN O, özgen m (2021). Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. , 99 - 106. 10.5606/tftrd.2021.4789
Chicago Unver Hasan Huseyin,Bakılan Fulya,BERKAN FUNDA,ARMAGAN ONUR,özgen merih Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. (2021): 99 - 106. 10.5606/tftrd.2021.4789
MLA Unver Hasan Huseyin,Bakılan Fulya,BERKAN FUNDA,ARMAGAN ONUR,özgen merih Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. , 2021, ss.99 - 106. 10.5606/tftrd.2021.4789
AMA Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. . 2021; 99 - 106. 10.5606/tftrd.2021.4789
Vancouver Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. . 2021; 99 - 106. 10.5606/tftrd.2021.4789
IEEE Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m "Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study." , ss.99 - 106, 2021. 10.5606/tftrd.2021.4789
ISNAD Unver, Hasan Huseyin vd. "Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study". (2021), 99-106. https://doi.org/10.5606/tftrd.2021.4789
APA Unver H, Bakılan F, BERKAN F, ARMAGAN O, özgen m (2021). Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. Turkish Journal of Physical Medicine and Rehabilitation, 67(1), 99 - 106. 10.5606/tftrd.2021.4789
Chicago Unver Hasan Huseyin,Bakılan Fulya,BERKAN FUNDA,ARMAGAN ONUR,özgen merih Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. Turkish Journal of Physical Medicine and Rehabilitation 67, no.1 (2021): 99 - 106. 10.5606/tftrd.2021.4789
MLA Unver Hasan Huseyin,Bakılan Fulya,BERKAN FUNDA,ARMAGAN ONUR,özgen merih Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. Turkish Journal of Physical Medicine and Rehabilitation, vol.67, no.1, 2021, ss.99 - 106. 10.5606/tftrd.2021.4789
AMA Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. Turkish Journal of Physical Medicine and Rehabilitation. 2021; 67(1): 99 - 106. 10.5606/tftrd.2021.4789
Vancouver Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study. Turkish Journal of Physical Medicine and Rehabilitation. 2021; 67(1): 99 - 106. 10.5606/tftrd.2021.4789
IEEE Unver H,Bakılan F,BERKAN F,ARMAGAN O,özgen m "Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study." Turkish Journal of Physical Medicine and Rehabilitation, 67, ss.99 - 106, 2021. 10.5606/tftrd.2021.4789
ISNAD Unver, Hasan Huseyin vd. "Comparing the efficacy of continuous and pulsed ultrasound therapies in patients with lateral epicondylitis: A double-blind, randomized, placebo-controlled study". Turkish Journal of Physical Medicine and Rehabilitation 67/1 (2021), 99-106. https://doi.org/10.5606/tftrd.2021.4789