Short-Term Effectiveness of Ultrasound Treatment in Patients with Lateral Epicondylitis: Randomized, Single-Blind, Placebo-Controlled, Prospective Study

Lateral Epikondilitli Hastalarda Ultrason Tedavisinin Kısa Dönem Etkinliÿi: Randomize, Tek Kör Plasebo Kontrollü, Prospektif Çalışma

Özet

Amaç: Lateral epikondilit tanısı almış hastalarda ultrason tedavisinin etkinliğini araştırmak ve plasebo ultrason tedavisi ile karşılaştırmaktı.Yöntem ve Gereçler: Çalışmaya, lateral epikondilit tanısı konan 25-62 yaş (ort. yaş 46.7±8.1) arasında 60 hasta (40 kadın ve 20 erkek) dahil edildi. Hastalar randomize olarak 2 gruba ayrıldı: ultrason (US) grubu ve plasebo grubu. Ultrason grubundaki hastalara (n=30) sürekli ultrason; plasebo grubuna (n=30) ise çalışmayan başlığın kullanıldığı ultrason 5 dakika süreyle 3 hafta boyunca toplam 15 seans uygulandı. Tüm hastalara tedavi süresince (3 hafta) gece splinti verildi. Hastalar tedavi başlangıcı, sonu (3. hafta) ve 15 gün sonra (5. hafta ) değerlendirildi. İstirahat ve hareket ağrısı vizüel ağrı skalası (VAS) ile, el sıkma gücü el dinamometresi ile, günlük yaşam aktivite değerlendirmesi Disabilities of the Arm, Shoulder, and Hand (DASH-T) anketi Türkçe versiyonu ile, yaşam kalitesi Short-Form (SF)-36 ölçeği ile değerlendirildi Ayrıca hasta memnuniyeti de sorgulandı. Bulgular: İstirahat ağrısı (VAS); US grubunda hem tedavi sonunda (3. hafta) hem de 15 gün sonraki takipte (5. hafta) tedavi öncesine göre anlamlı düzelmişti, ancak plasebo grubundaki düzelme sadece 3. haftada gözlendi (p 0.05). DASH-T skorları açısından iki grup arasında tedavi sonunda ve 15 gün sonraki takipte fark yoktu. Tedavi öncesine göre 3. ve 5. haftalardaki DASH-T'taki değişim, US grubunda plasebo grubuna kıyasla anlamlı yüksekti (p<0.017). Hasta memnuniyeti her iki grupta da tedavi ile artmıştı, ancak US grubunda plasebo grubuna göre anlamlı oranda daha yüksekti (p<0.001). Sonuç: Bu çalışmada, ultrason tedavisinin, lateral epikondilitli hastalarda ağrı, günlük yaşam aktiviteleri ve hasta memnuniyetinde anlamlı düzelme sağladığı gösterilmiştir.

Abstract

Objective: We aimed to assess the effectiveness of ultrasound treatment in patients with lateral epicondylitis and to compare with placebo ultrasound treatment. Materials and Methods: Sixty patients with lateral epicondylitis were included. All of the patients were randomized to two groups as: ultrasound (US) group (n=30) and placebo US group (n=30). Continuous US was applied to the patients in the US group whereas placebo US was applied to those in the placebo group for 5 minutes over three weeks (totally 15 sessions). All patients used a static splint at night for the three weeks. Patients were assessed before the treatment (baseline), at the end of the treatment (3rd week) and after 15 days follow-up (5th week). The following parameters were evaluated: pain with the visual analog scale (VAS), hand grip strength using a hand dynamometer, activities of daily living using the Turkish version of Disabilities of the Arm, Shoulder and Hand (DASH-T) questionnaire, and quality of life using the Short-Form (SF)-36 questionnaires. In addition, patient satisfaction was examined. Results: VAS at rest and during motion had significantly improved in both groups at the end of treatment (3rd week) and in the follow-up (5th week), while improvement in the VAS was observed only in the 3rd week in placebo group (p<0.01). Pain with motion was significantly decreased in the 3rd and 5th weeks in the US group while it was increased in the 5th week in the placebo group (p<0.01). Hand grip strength were improved in the 3rd and 5th weeks in both groups (p<0.008). There was no significant difference between the two groups (p>0.05). No difference between the two groups was found in terms of general DASH-T scores at the end of the treatment and follow-up. However, improvement in DASH scores in the US group at the 3rd and 5th weeks was significantly higher than in the placebo group (p<0.017). Patient satisfaction scores increased in both groups, but satisfaction of patients in the US group was significantly higher than of those in the placebo group (p<0.001). Conclusion: In this study, it was found that US treatment for lateral epicondylitis improved pain and activities of daily living and resulted in high patient satisfaction