Examining the effectiveness of percussion therapy at different intensities in the treatment of lateral epicondylitis: A randomized comparative study

The aim of this study is to investigate the effectiveness of percussion application at different frequencies on pain, range of motion, muscle strength, agility and functionality in patients with lateral epicondylitis. Fifty patients who were diagnosed with unilateral lateral epicondylitis for the first time, aged between 18-65, were not professional athletes and had no orthopedic, neurological or metabolic disorders. Forty four of these patients completed the treatment and evaluation process. The patients were randomly divided into four groups with the stratified randomization method. TENS, ultrasound and an exercise program were applied to all patients in the groups included in the treatment. Excluding Group 1, patients in the other three groups were applied percussion with a Hypervolt® hand-held percussion device at 30 Hz/ 40 Hz/ 53 Hz frequencies for 5 minutes each session. All patients received 15 sessions of treatment and were evaluated before, after, 3 weeks and 9 weeks after the end of treatment. Demographic information, 1-maximum repetition strength, grip strength, goniometric measurement of range of motion, visual analog scale, Nelson hand reaction test, patient-based tennis elbow assessment, arm, shoulder and hand disability quick questionnaire were used in the evaluation. In the statistical analysis of the cases between the groups, a significant difference was found in the percussion applied groups in terms of visual analog scale, 1-maximum repetition, and patient-based tennis elbow assessments (p<0.05). Significant differences were found in the within-group assessments in the percussion applied groups when compared to the pre-treatment scores. As a result, percussion applications provided significant changes in the pain, strength and functionality scores of the cases compared to the group not applied percussion. Among the groups to which different frequencies were applied, significant results were found in favor of the group to which 53 Hz was applied (p<0.05). It has been determined that percussion application in lateral epicondylitis cases reduces pain, increases 1-RM strentgh and improves functional status at different frequency types. However, we believe that experimental and clinical studies are needed to determine the effects of the application at different frequency types, applicators, application duration, pressure level and appropriate number of sessions.