5% and 15% Dextrose Prolotherapy Efficacy in Lateral Epicondylitis

Study Overview
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Brief Summary
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In the treatment of lateral epicondylitis, 5% dextrose prolotherapy is aimed to be more reliable than 15% prolotherapy in terms of side effects and to show that it is similar in terms of efficacy in treatment.

Detailed Description
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For this prospective randomized controlled study, volunteer patients who met the inclusion criteria and applied to the Health Sciences University, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Physical Medicine and Rehabilitation Outpatient Clinic will be included in the study. Participants who volunteered for the study will be divided into study groups and control groups by stratified randomization. A total of 26 volunteers will be recruited. A solution to be used for prolotherapy is containing 30% dextrose, 2% lidocaine, and physiological saline. In the beginning, all patients were asked about gender, age, body mass index, education level, occupation, duration of complaint, dominant side and affected extremity, previous treatments, and when the last treatment was applied. Patients in the study group will receive a total of 3 sessions of prolotherapy solution containing 5% dextrose at the beginning(0.) 3rd week and 6th week. Prolotherapy was planned with the multiplanar injection technique (peppering technique) after palpating the most sensitive point on the lateral epicondyle and entering the lateral epicondyle from here and ensuring bone contact. Patients in the control group will receive a total of 3 sessions of prolotherapy solution containing 15% dextrose, initially (0.) Week 3 and Week 6. The injection will be made with the same method as the study group. Measurements; will be evaluated at baseline (week 0), immediately after treatment at Week 3, Week 6, and Week 12. Patients; In the evaluation of the visual analog scale (VAS), quick Disabilities of the Arm, Shoulder and Hand (QDASH), Grip strength, hand dynamometer measurements, and adverse events during the study period will be noted.

Official Title
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Demonstration and Comparison of 5% Dextrose Prolotherapy and 15% Dextrose Prolotherapy Efficacy in Lateral Epicondylitis

Conditions
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Lateral Epicondylitis

Intervention / Treatment
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* Other: %5 dextrose prolotherapy
* Other: %15 dextrose prolotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pain score ≥3 according to VAS for more than 3 months in the lateral elbow joint tenderness on palpation over the lateral epicondyle Positiveness in at least two of the tests specific to lateral epicondylitis(LE) (Mills test, resistant middle finger extension and cozen test), > 20 years old , < 60 years old Exclusion Criteria: Patients who received physical therapy modalities and/or steroid injections in the last 3 months, Having a history of malignancy, Pregnant cases, Those who have bone and joint diseases in the neck, shoulder and elbow, Patients with infection in the treatment area, Patients with arrhythmia or pacemaker in the heart, Patients receiving coagulation disorder or anticoagulant therapy, Those with local dermatological problems, Patients with a history of surgery in the elbow joint, Having a tendon tear Presence of nerve involvement Lack of cooperation and refusal to participate in the study due to cognitive dysfunction

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 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: %5 dextrose prolotherapy<br>A total of 3 sessions of prolotherapy solution containing 5% dextrose will be applied at the beginning, 3rd week, and the 6th week. | Other: %5 dextrose prolotherapy<br>* Patients in the study group will receive a total of 3 sessions of prolotherapy solution containing 5% dextrose at the beginning(0.) 3rd week and 6th week. Prolotherapy was planned with the multiplanar injection technique (peppering technique) after palpating the most sensitive point on the lateral epicondyle and entering the lateral epicondyle from here and ensuring bone contact.<br>|
| Active Comparator: %15 dextrose prolotherapy<br>A total of 3 sessions of prolotherapy solution containing 15% dextrose will be applied at the beginning, 3rd week, and the 6th week. | Other: %15 dextrose prolotherapy<br>* Patients in the study group will receive a total of 3 sessions of prolotherapy solution containing 15% dextrose at the beginning(0.) 3rd week and 6th week. Prolotherapy was planned with the multiplanar injection technique (peppering technique) after palpating the most sensitive point on the lateral epicondyle and entering the lateral epicondyle from here and ensuring bone contact.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The upper extremity disability level | The upper extremity disability level will be evaluated by using the Quick Disabilities of Arm, Shoulder and Hand (QDASH) scale. The maximum score is 100 points. A higher score indicates a worse disability level. | Change from baseline upper extremity disability level at 3, 6, and 12 weeks | 
| Pain intensity | Pain intensity will be evaluated by using a visual analog scale (VAS). The maximum score is 10 points. A higher score indicates a worse pain level. | Change from baseline pain intensity at 3, 6, and 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hand grip strength | The standard evaluation tool (a hand dynamometer) will used for measuring grip and squeeze strength minimum value 0 and there is not maximum value, bigger values mean better outcome | Change from baseline hand grip strength at 3, 6, and 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lateral epicondylitis, dextrose prolotherapy, pain, injection