Upper Extremity-based Exercises and Elbow-focused Exercises in LET

Study Overview
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Brief Summary
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The aim of the study is to investigate the effects of rotator cuff and scapular muscle strengthening exercises applied in addition to the 8-week elbow focused rehabilitation program in lateral elbow tendinopathy, by comparing it with the elbow focused rehabilitation program.

Official Title
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Comparison of the Effectiveness of Upper Extremity-based Exercises and Elbow-focused Exercises in Lateral Elbow tendiNopathy

Conditions
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Lateral Epicondylitis, Elbow Tendinopathy

Intervention / Treatment
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* Behavioral: Elbow focused rehabilitation
* Behavioral: Scapular and rotator cuff muscles strengthening


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Cases are between the ages of 18-65 Getting a diagnosis of unilateral lateral elbow tendinopathy At least two positive Thomsen, Maudsley's Mill's and Cozen tests on clinical examination Continuing symptoms for at least 3 months The absence of any chronic disease that would prevent participation in the treatment program Exclusion Criteria: History of trauma or surgery in the involved elbow joint Having orthopedic problems in the cervical spine, shoulder joint or wrist To have participated in the rehabilitation program in the last 3 months Corticosteroid injection application in the last 3 months Systemic arthritis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Shoulder and scapular strengthening group<br> | Behavioral: Scapular and rotator cuff muscles strengthening<br>* Patient education Activity modification 2 days/week, 8 weeks in total Exercises for the wrist extensor tendon, especially the extensor carpi radialis brevis (EKRB) (stretching + strengthening) Scapular stabilizer muscle + rotator cuff (RM) strengthening<br>|
| Active Comparator: Control group<br> | Behavioral: Elbow focused rehabilitation<br>* Patient education Activity modification 2 days/week, 8 weeks in total Exercises for the wrist extensor tendon, especially the extensor carpi radialis brevis (EKRB) (stretching + strengthening)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient-Rated Tennis Elbow Evaluation (PRTEE) | The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. | Baseline | 
| Patient-Rated Tennis Elbow Evaluation (PRTEE) | The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. | 8th week | 
| Patient-Rated Tennis Elbow Evaluation (PRTEE) | The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. | 16th week | 
| Patient-Rated Tennis Elbow Evaluation (PRTEE) | The Patient-Rated Tennis Elbow Evaluation questionnaire (PRTEE) is a specific questionnaire available for assessing the health status of patients with lateral epicondylitis. | 6th month | 
| Numeric Pain Rating Scale (NPRS) | The Numerical Rating Scale (NPRS-11) is an 11-point scale for self-report of pain. It is the most commonly used unidimensional pain scale. The respondent selects a whole number (integers 0-10) that best reflects the intensity (or other quality if requested of his/her pain. | Baseline | 
| Numeric Pain Rating Scale (NPRS) | The Numerical Rating Scale (NPRS-11) is an 11-point scale for self-report of pain. It is the most commonly used unidimensional pain scale. The respondent selects a whole number (integers 0-10) that best reflects the intensity (or other quality if requested of his/her pain. | 8th week | 
| Numeric Pain Rating Scale (NPRS) | The Numerical Rating Scale (NPRS-11) is an 11-point scale for self-report of pain. It is the most commonly used unidimensional pain scale. The respondent selects a whole number (integers 0-10) that best reflects the intensity (or other quality if requested of his/her pain. | 16th week | 
| Numeric Pain Rating Scale (NPRS) | The Numerical Rating Scale (NPRS-11) is an 11-point scale for self-report of pain. It is the most commonly used unidimensional pain scale. The respondent selects a whole number (integers 0-10) that best reflects the intensity (or other quality if requested of his/her pain. | 6th month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Pressure Threshold (PPT) | PPT measurement will be made using an algometer. It will be evaluated with an digital algometer over the lateral epicondyle in both upper extremities. | Baseline | 
| Pain Pressure Threshold (PPT) | PPT measurement will be made using an algometer. It will be evaluated with an digital algometer over the lateral epicondyle in both upper extremities. | 8th week | 
| Pain Pressure Threshold (PPT) | PPT measurement will be made using an algometer. It will be evaluated with an digital algometer over the lateral epicondyle in both upper extremities. | 16th week | 
| Pain Pressure Threshold (PPT) | PPT measurement will be made using an algometer. It will be evaluated with an digital algometer over the lateral epicondyle in both upper extremities. | 6th month | 
| Hand Grip Strength | Handgrip strength (HGS) is a simple and reliable measurement of maximum voluntary muscle strength. It is an important tool for diagnosing sarcopenia and is widely used as a single indicator to represent overall muscle strength. To assess grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | Baseline | 
| Hand Grip Strength | Handgrip strength (HGS) is a simple and reliable measurement of maximum voluntary muscle strength. It is an important tool for diagnosing sarcopenia and is widely used as a single indicator to represent overall muscle strength. To assess grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 8th week | 
| Hand Grip Strength | Handgrip strength (HGS) is a simple and reliable measurement of maximum voluntary muscle strength. It is an important tool for diagnosing sarcopenia and is widely used as a single indicator to represent overall muscle strength. To assess grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 16th week | 
| Hand Grip Strength | Handgrip strength (HGS) is a simple and reliable measurement of maximum voluntary muscle strength. It is an important tool for diagnosing sarcopenia and is widely used as a single indicator to represent overall muscle strength. To assess grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 6th month | 
| Pain-free Hand Grip Strength | Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET). To assess pain-free grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | Baseline | 
| Pain-free Hand Grip Strength | Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET). To assess pain-free grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 8th week | 
| Pain-free Hand Grip Strength | Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET). To assess pain-free grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 16th week | 
| Pain-free Hand Grip Strength | Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET). To assess pain-free grip strength, the Jamar dynamometer will be used which is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. | 6th month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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tendinopathy, elbow