Comparison of PELOID Therapy and Kinesio Tape Effectiveness in Patients With Lateral Epicondylitis
Condition: Lateral Epicondylitis; Patient Engagement
MeSH terms: Tennis Elbow
Study type: Observational [Patient Registry]

Summary: 
      In this study, the difference in effectiveness between PELOID therapy and kinesio tape in the
      treatment of lateral epicondylitis; It was planned to evaluate the effects of these
      treatments on pain, functionality, activities of daily living and quality of life.
    

Detailed description: 
      This study was conducted between November 2017 and January 2021 with 126 patients who applied
      to Konya Training and Research Hospital Physical Therapy and Rehabilitation outpatient clinic
      with complaints of elbow pain and were diagnosed with lateral epicondylitis, who met the
      inclusion criteria and did not meet the inclusion criteria.

      Lateral epicondylitis diagnosis will be made according to clinical criteria. For the clinical
      diagnosis of Lateral epicondylitis, if there is resistant wrist extension and pain by
      pressing the lateral epicondyle of the humerus, Lateral epicondylitis will be diagnosed.
      Other pathologies that may present with elbow pain will be ruled out. Detailed stories of all
      participants will be taken and detailed physical examinations will be made. Sociodemographic
      and clinical characteristics of the participants will be determined by questions such as age,
      gender, height, weight, educational status, employment status and income level.

      126 patients diagnosed with Lateral epicondylitis will be divided into 3 groups. Totally 15
      sessions of peloid therapy for 42 patients in 1 group for 3 weeks, 5 days a week, 2 sessions
      of muscle and fascia correction techniques for 3 weeks in the second group, and 3 sets per
      day for 42 patients in the third group for 3 weeks. You will be given a home exercise program
      with 10 repetitions.

      In addition, the home exercise program will be shown to both groups. Cold application: At the
      beginning of each treatment, gel ice packs are wrapped with a moist towel and placed around
      the elbow joint for 15 minutes. will be applied.

      PELOID therapy; PELOIDs are naturally and indigenous to the hot springs; They are used in
      clinics or packaged at home.In the local peloid application, as the effects of heat; increase
      in blood flow, decrease in peripheral vein tone, increase in heart rate and heart rate,
      slight increase in systolic blood pressure, decrease in diastolic pressure, increase in cell
      division, decrease in viscosity in skin fluids, warm analgesia, increased elasticity in
      tendons, ligaments and fascia, general sedation, hormonal stimulation (stress hormones,
      pituitary adrenal cortex and medulla), adaptive effect, elongation of collagen tissue.
      Vasodilation occurs in the deep parts of the body with the stimulation formed in the parts of
      the body that come into contact with the peloid, and vasodilation occurs in the deep parts of
      the body. In addition, hot applications have an anti-inflammatory effect in chronic
      inflammation. As a result of the studies done, with PELOID therapy; it has positive effects
      on the symptoms and functional capacity of osteoarthritis; It has significant positive
      effects on parameters such as the number of painful and swollen joints, morning stiffness,
      and subjective pain in inflammatory rheumatic diseases; It has been observed that combined
      therapies are more successful than single treatments, and with the repetition of the
      treatments, adaptation to work increases, workday loss and treatment costs decrease. Hot
      peloid is applied to the area as a 1.5-2 cm thick layer. The surface of the application area
      is covered with a material that provides transparent impermeability, the temperature of the
      mixture is maintained and it is covered with a towel.

      PELOID therapy was applied to our patients at a temperature of 45 degrees for 20 minutes on
      the elbow. At the end of the application (20 minutes later), the peloid layer is removed and
      discarded again not to be used. The treatment area is cleaned with soft cloths soaked in hot
      water. The patient is 10-15 minutes. the session is completed by resting.

      Kinesio Taping Application: In addition to classical physiotherapy, kinesio taping was
      applied to the second group; Lateral epicondylitis taping, consisting of muscle technique and
      fascia correction techniques, will be performed.Theoretically, it is thought to increase the
      space between the skin and muscles by raising the skin, relieving this pressure on neural and
      sensory receptors formed in the tissue due to any reason and supporting the increase of blood
      and lymph circulation. This effect seen in the circulatory system reduces edema and
      inflammation and accelerates tissue healing. The reduction in inflammation provides a
      reduction in pain. Activating the gate control mechanism and the pattern inhibitory
      mechanisms through mechanoreceptors are also accepted as other mechanisms of pain reduction.
      When the pain reduction by taping is explained according to the gate control theory; The band
      reduces the inputs transmitted from the nerve fibers to the nociceptors. Convulsions seen on
      the skin after tape application raise the skin and reduce painful stimuli by decreasing the
      pressure on subcutaneous nociceptors. Stretching the skin and applying pressure to the skin
      stimulate the cutaneous mechanoreceptors. Proprioceptive sensation can be increased by the
      ability of these mechanoreceptors to change joint motion information.Belt applications can be
      named as I, Y, X, rake, net or ring depending on their appearance. Type of tape to be
      applied; It varies according to the technique, the stage of the disease, the length of the
      muscle, the application area and the targeted treatment. Since I and Y strips are used to
      reduce pain and edema, they are the most common application methods. Y-strips are also used
      to surround the muscle to facilitate or suppress movement.

      The X-strip method is generally used in cases where the origo and insertion of the muscle
      changes due to movements or when they are stretched to the maximum, the lengths of which vary
      greatly and involve the double joint. The rake shape is used especially for reducing edema
      and for lymph drainage. The web shape created by modifying the rake (fan) shape is used in
      highly mobile joints such as elbow joints. In order to prevent skin discomfort, the beginning
      and end regions of the tape should not be stretched during the applications.

      Kinesiology tape application is applied with different degrees of tension according to the
      treatment purpose. The amount of stretching; Maximum stretching (100%), submaximal stretching
      (75%), moderate stretching (50%), light stretching (25%), very light stretching (10-15%) and
      no stretching. A total of 6 sessions of kinesio taping will be applied 2 sessions per week.
      The tapes will remain on the tissue for 48 hours and patients will be asked to remove the
      tape before coming for treatment.

      Home Exercise Program: Patients will be given a home exercise program consisting of eccentric
      strengthening exercises and stretching exercises, which are planned to increase resistance
      every week. To the patients; for forearm pronation-supination with wrist extensors
      Strengthening exercises will be taught and a home exercise program will be started as 3 sets
      of 10 repetitions per day.

      All groups will be evaluated at the beginning of the treatment, in the 3rd week after the
      treatment and in the 4th week after treatment.

      During the evaluations; Pain intensity and pain localization with 0-10 point Visual Analogue
      Scale (VAS), 0-10 point pain questioning with Visual Analogue Scale (VAS) during one, maximum
      grip, Arm-Shoulder and Hand Distortion Questionnaire (Arm Disabled, Shoulder and Hand) (DASH)
      and function and disability, Patient-Rated Forearm Evaluation Questionnaire (PRFEQ) finds the
      pain and functions of the arm in a 1-week period, and the Short Form-36 (SF-36) will be used
      in life course. . Visual Analogue Scale (VAS) (0-10 cm); Jamar Hand Dynamometer for pain
      intensity and pain localization; Visual Analogue Scale (VAS) (0-10 cm) for maximum hand grip
      strength; Arm-Shoulder and Hand Injury Questionnaire (Arm, Shoulder and Hand Barriers (DASH)
      Questionnaire) to ensure the level of pain during maximum hand grip; Patient-Based Forearm
      Assessment Questionnaire (Patient-Graded Forearm Assessment Questionnaire (PRFEQ)) for
      function and disability; To learn the pain and functions of the arm in a 1-week period, Short
      Form-36 (SF-36); It has been used for life continues.
    

Intervention name(s): PELOID therapy, kinesio tape, exercise
Intervention type(s): Combination Product
Intervention description(s): 126 patients diagnosed with lateral epicondylitis will be divided into 3 groups. Totally 15 sessions of peloid therapy for 42 patients in 1 group for 3 weeks, 5 days a week, 2 sessions of muscle and fascia correction techniques for 3 weeks in the second group for 3 weeks, and 3 sets per day for 42 patients in the third group for 3 weeks. You will be given 10 repetitive home workouts.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        126 patients between the ages of 18-65 were included in the study according to the
        inclusion and exclusion criteria.