No abstract available.

Objective

To examine the frequency of use and establish routine clinical practice of patient-reported outcome measures (PROMs), performance-based OMs and clinician-reported OMs in the assessment of a suspected case of lateral elbow tendinopathy (LET).

Methods

Physiotherapists from eight countries completed an anonymous online survey, rating their frequency of use (never, rarely, sometimes, often and always) for unidimensional PROMs, multidimensional PROMs, performance-based OMs and clinician-reported OMs. To establish clinical practices, responses were dichotomised into routine (≥70% often/always) and not-routine (≥70% sometimes/rarely/never); items below both thresholds were classified as neither.

Results

Two hundred ninety-nine respondents completed the survey. No outcome measure met the criteria for routine practice. Eight of 17 multidimensional PROMs, and six of eight clinician-reported OMs met the criteria for not-routine practice. All unidimensional PROMs and performance-based OMs, and a select number of multidimensional PROMs and clinician-reported OMs did not meet the threshold for routine or not-routine practice.

Conclusions

Our results suggest no single outcome measure is routinely used by physiotherapists assessing a suspected case of LET. It is plausible that physiotherapists select OMs based on patient presentation, rather than the clinical diagnosis, or that outcome measures are perhaps seen more as a research tool than common place in clinical practice.

To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy.

Randomised crossover trial.

Biomechanics laboratory.

27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration.

Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions.

Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions.

There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F

= 0.02,

= 0.98; extended position: F

= 2.26,

= 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F

= 0.94,

= 0.34; extended position: F

= 0.79,

= 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F

= 0.54,

= 0.54) or across timepoints (affected lateral epicondyle: F

= 0.94,

= 0.34).

Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist.

Background

Pain-free grip strength is an important outcome measure in lateral elbow tendinopathy (LET); yet, the reliability and minimum detectable change (MDC) in functional positions are unknown.

Purpose

The purpose of this study is to examine the between- and within-session pain-free grip strength reliability and MDC in LET.

Methods

Twenty-three individuals with LET completed three pain-free grip strength trials with the elbow flexed and extended. The first trial and the mean of three trials were analyzed. Between-session data were collected 2–28 days apart. Within-session data were collected 20–30 min apart.

Results

Between-session intraclass correlation coefficients (ICCs) were good (ICC2,1 = 0.75) for single trials (flexed), excellent (ICC2,1 = 0.89–0.94) for single trials (extended), and excellent for the mean of three trials (both positions). Within-session ICCs were excellent for single (ICC2,1 = 0.89–0.91) and the mean of three trials (ICC2,3 = 0.96–0.98) in both positions. Between-session flexed MDCs were 133 N (single) versus 90 N (mean) and extended MDCs were 118 N (single) versus 92 N (mean). Within-session flexed MDCs were 79 N (single) versus 52 N (mean) and extended MDCs were 125 N (single) versus 46 N (mean).

Conclusions

Using the mean of three trials is recommended, and clinicians can be confident of true change if between-session differences are >92 N and within-session differences are >52 N.

Background

Lateral elbow tendinopathy is associated with changes to forearm muscle activity and wrist posture during gripping. Multidirectional elastic tape is thought to exert a deloading effect on underlying musculotendinous structures, which could potentially alter muscle activity or wrist posture.

Methods

This single-blinded randomised crossover trial compared the immediate effects of tensioned multidirectional elastic tape, untensioned control tape, and no tape, in individuals with lateral elbow tendinopathy. Muscle activity of extensor carpi radialis longus and brevis, extensor carpi ulnaris, and extensor digitorum and wrist extension angle were recorded during a submaximal gripping task. Muscle activity was normalised to the maximum amplitude recorded during maximal grip. Change scores were calculated (post-condition minus baseline). Repeated-measure analyses of variance were used to examine between-condition differences.

Findings

27 participants (16 males, mean age (SD): 48.6 (11.9) years) underwent all conditions. Extensor digitorum muscle activity was reduced during the multidirectional elastic tape, compared to control tape and no tape (MD −5.6% [95%CI: −9.9 to −1.3], MD −5.8% [95%CI: −10.2 to −1.4], respectively). Extensor carpi ulnaris muscle activity was reduced during the multidirectional elastic tape, compared to the control tape (mean difference [MD] −3.2% [95%CI: −5.3 to −1.1]), but increased during the control tape, compared to the no tape (MD 2.9% [95%CI: 0.8 to 5.0]). No differences were observed in extensor carpi radialis brevis or longus muscle activity, or extension wrist angle between conditions.

Interpretation

A decreased in extensor carpi ulnaris and extensor digitorum muscle activity during multidirectional elastic tape may be evidence of a deloading effect during submaximal gripping.