Comparison of efficacy of different physiotherapy methods in patients with lateral epicondylitis

The aim of our study was to investigate the efficacy of different physiotherapy methods in patients with lateral epicondylitis (LE) on pain, grip strength, normal joint motion (NEH), patient satisfaction and functional status, and to determine their superiority over each other. A total of 48 patients, 31 female (64.6%) and 17 male (35.4%) were included in the study. The patients were divided into three groups according to the randomization method. The first group was applied as a home program for a total of 3 weeks, 5 days a week. The first group was given a 3-week home program with 5 days a week of cold application and nerve-gliding exercises. In addition to the home program, the second group received 5 sessions of manual therapy (MT) treatment (deep friction and joint mobilization) for 2 sessions per week. The third group received, in addition to the home program, 2 sessions per week and a total of 5 sessions of extracorporeal shock wave therapy (ESWT) for a total of 3 weeks. Patients' pain was evaluated with Visual Analog Scale (VAS), hand gripping force was evaluated with dynamometer, finger gripping force was evaluated with pinch gauge, normal joint motion (NEH) was evaluated with goniometer, functionality level was evaluated with Shoulder and Hand Problems Questionnaire Turkish version (DASH-T) and patients' satisfaction was evaluated with PSQ-18. The measurements of the participants were done before treatment and after 3 weeks of treatment. When the data is evaluated; no significant difference was found between the groups in terms of maximum grip force in elbow flexion, finger grip force, wrist ulnar and radial deviation angles, DASH-T parameters and technical quality in PSQ-18, interpersonal attitude, communication, financial dimensions, accessibility and convenience (p>0.05). In the manual treatment group, after the treatment compared to the other groups, the VAS values were lower and the mean time score was higher with the health service provider in terms of patient satisfaction parameters. Maximum grip on elbow extension, pain-less grip in elbow extension and pain-less grip forces in elbow flexion, wrist extension and wrist flex increase of ROM, PSQ-18 general satisfaction average score were found higher in MT group than ESWT groupafter the treatment (p<0.05). In our study, it was concluded that the application manual therapy with nerve gliding exercises was more effective in patients with LE. Key Words: Tennis Elbow, home program (cold application and nerve gliding exercise), manual therapy, ESWT