Comparison of eccentric and combined isotonic exercises combined with extracorporeal shock wave therapy in the treatment of lateral epicondylitis

Aim: It was planned to investigate the effectiveness of combined isotonic exercise technique applied with Extracorporeal shock wave in the treatment of lateral epicondylitis. Material and Method: Individuals between the ages of 39-65 diagnosed with lateral epicondylitis were randomized to one of the Extracorporeal shock wave group, eccentric exercise and Extracorporeal shock wave group, or combined isotonic and Extracorporeal shock wave groups using the closed envelope method. Patients in the combined isotonic exercise and eccentric exercise group were included in the rehabilitation program under the supervision of a physiotherapist 3 days a week for 5 weeks. Extracorporeal shock wave was also applied once a week for 5 weeks for all three groups. Pain intensity was assessed using the Visual Analog Scale, pressure pain threshold algometer, muscle strength using a hand-held dynamometer, grip strength using a digital hand dynamometer, and functionality using the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH). Results: In all treatment groups, significant differences were found in all parameters in intragroup comparisons (p<0.05). There was a significant difference between the groups in terms of pain intensity during activity and pressure pain threshold measurements in favor of the combined isotonic exercise group (p<0.05). No significant difference was found between the groups in terms of pain intensity and muscle strength measurements during rest (p>0.05). DASH scores showed a significant difference between the groups with a greater effect in the combined isotonic exercise group (p=0.046). Conclusion: Combined isotonic exercise with ESWT was shown to cause significant improvements in pain, pressure pain threshold,, and functionality. Keywords: Pain, Exercise, Treatment, Extracorporeal shock wave therapy, Rehabilitation