The Effect of Motor Learning Exercises on Lateral Epicondylitis

The aim of this study was to determine the effect of motor learning training in addition to a 6-week conventional physiotherapy program on motor imagery, function pain and grip strength in individuals with chronic lateral epicondylitis. At the end of the study, it is aimed to develop a system for motor learning training in individuals with chronic lateral epicondylitis and to create a new exercise protocol.

The study will include 46 volunteers aged 18-65 years. Participants will be randomly assigned to the Motor learning (n=23) and control (n=23) groups according to an internet-based randomization program.

The system to be used in the first phase of the study will be developed. The system will consist of a glove with a pressure sensor on the inner surface and an M-IMU sensor on the outer surface, a computer and a monitor. The pressure sensor on the inner surface will collect instantaneous data on grip force and the M-IMU sensor on the outer surface will collect instantaneous data on wrist movement. The software to be developed will process the instantaneous information from the sensors and reflect it to the monitor.

In the second phase of the study, the effectiveness of the motor learning exercise protocol to be applied with the developed system will be evaluated.

The motor learning group will receive 3 sessions of motor learning exercise per week for 6 weeks, 5 days a week, in addition to the conventional physiotherapy program.

The control group will receive eccentric training for the extensor carpi radialis brevis (ECRB) muscle and static stretching exercises for the ECRB muscle in addition to the conventional physiotherapy program 5 days a week for 6 weeks.

All evaluations of the participants will be performed blindly by an independent investigator before and at the end of the study.

Participants' motor imagery will be assessed through a left/right judgment task in which they must recognize whether hand images correspond to their left or right side using the Recognise™ application (Neuro Orthopaedic Institute, Adelaide, Australia).

Participants' function will be assessed using the Patient Rated Tennis Elbow Evaluation (PRTEE), pain will be assessed using a visual analog scale, and grip strength will be assessed using a hydraulic hand dynamometer.

Activities of Daily Living The DASH questionnaire is a questionnaire that asks about physical activities and symptoms of disease. It helps to assess problematic arm, shoulder and hand activities. It is a 30-item questionnaire that assesses the patient's ability to perform certain upper limb activities. These activities include activities performed at home, whether there are complaints such as pain, weakness, tingling in the hand, arm or shoulder, sports activities, etc. The DASH is a self-report questionnaire in which patients can rate difficulties and interventions in their daily lives on a 5-point Likert scale. The lower the calculated DASH score, the better the patient's functionality.

Satisfaction Participants' satisfaction will be assessed through a satisfaction survey on technological rehabilitation practices.

Eligibility Criteria:
Inclusion Criteria:

* a diagnosis of chronic LET by a physician and
* a pain score \> 3 on the visual analog scale (VAS)

Exclusion Criteria:

* concomitant disorders of the wrist and forearm, such as elbow fracture or dislocation, and
* treatment with corticosteroid injections within the previous 6 months