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. 2001 Nov;51(472):924–929.

Orthotic devices for tennis elbow: a systematic review.

P A Struijs 1, N Smidt 1, H Arola 1, C N van Dijk 1, R Buchbinder 1, W J Assendelft 1
PMCID: PMC1314152  PMID: 11761209

Abstract

Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatment strategies has been described. Asy et, no optimal strategy has been identified. The aim of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow. An electronic database search was conducted using MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trial Register Current Contents, and reference listsf rom all retrieved articles. Experts on the subjects were approachedfor additional trials. All randomised controlled trials (RCTs) descrbiing individuals with diagnosed lateral epicondylitis and assessing the use of an orthotic device as a treatment strategy were evaluatedfor inclusion. Two reviewers independently assessed the validity of the included trials and extracted data on relevant outcome measures. Dichotomous outcomes were expressed as relative risks and continuous outcomes as standardised mean differences, both with corresponding 95% confidence intervals. Statistical pooling and subgroup analyses were intended. Five small-size RCTs (n = 7-49 per group) were included the validity score ranged from three to nine positive items out of 11. Subgroup analyses were not performed owing to the small number of trials. The limited number of included trials present few outcome measures and limited long-term results. Pooling was not possible owing to the high level of heterogeneity of the trials. No definitive conclusions can be drawn concerning effectiveness of orthotic devices for lateral epicondylitis. More well-designed and well-conducted RCTs of sufficient power are warranted.

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Selected References

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  1. Allander E. Prevalence, incidence, and remission rates of some common rheumatic diseases or syndromes. Scand J Rheumatol. 1974;3(3):145–153. doi: 10.3109/03009747409097141. [DOI] [PubMed] [Google Scholar]
  2. Assendelft W. J., Hay E. M., Adshead R., Bouter L. M. Corticosteroid injections for lateral epicondylitis: a systematic overview. Br J Gen Pract. 1996 Apr;46(405):209–216. [PMC free article] [PubMed] [Google Scholar]
  3. BAILY R. A., BROCK B. H. Hydrocortisone in tennis elbow; a controlled series. Proc R Soc Med. 1957 Jun;50(6):389–390. [PMC free article] [PubMed] [Google Scholar]
  4. Binder A., Hodge G., Greenwood A. M., Hazleman B. L., Page Thomas D. P. Is therapeutic ultrasound effective in treating soft tissue lesions? Br Med J (Clin Res Ed) 1985 Feb 16;290(6467):512–514. doi: 10.1136/bmj.290.6467.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chard M. D., Hazleman B. L. Tennis elbow--a reappraisal. Br J Rheumatol. 1989 Jun;28(3):186–190. doi: 10.1093/rheumatology/28.3.186. [DOI] [PubMed] [Google Scholar]
  6. Ernst E. Conservative therapy for tennis elbow. Br J Clin Pract. 1992 Spring;46(1):55–57. [PubMed] [Google Scholar]
  7. Hamilton P. G. The prevalence of humeral epicondylitis: a survey in general practice. J R Coll Gen Pract. 1986 Oct;36(291):464–465. [PMC free article] [PubMed] [Google Scholar]
  8. Hudak P. L., Cole D. C., Haines A. T. Understanding prognosis to improve rehabilitation: the example of lateral elbow pain. Arch Phys Med Rehabil. 1996 Jun;77(6):586–593. doi: 10.1016/s0003-9993(96)90300-7. [DOI] [PubMed] [Google Scholar]
  9. Kivi P. The etiology and conservative treatment of humeral epicondylitis. Scand J Rehabil Med. 1983;15(1):37–41. [PubMed] [Google Scholar]
  10. Labelle H., Guibert R. Efficacy of diclofenac in lateral epicondylitis of the elbow also treated with immobilization. The University of Montreal Orthopaedic Research Group. Arch Fam Med. 1997 May-Jun;6(3):257–262. doi: 10.1001/archfami.6.3.257. [DOI] [PubMed] [Google Scholar]
  11. Lau J., Ioannidis J. P., Schmid C. H. Quantitative synthesis in systematic reviews. Ann Intern Med. 1997 Nov 1;127(9):820–826. doi: 10.7326/0003-4819-127-9-199711010-00008. [DOI] [PubMed] [Google Scholar]
  12. Moher D., Cook D. J., Eastwood S., Olkin I., Rennie D., Stroup D. F. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of Reporting of Meta-analyses. Lancet. 1999 Nov 27;354(9193):1896–1900. doi: 10.1016/s0140-6736(99)04149-5. [DOI] [PubMed] [Google Scholar]
  13. Valle-Jones J. C., Hopkin-Richards H. Controlled trial of an elbow support ('Epitrain') in patients with acute painful conditions of the elbow: a pilot study. Curr Med Res Opin. 1990;12(4):224–233. doi: 10.1185/03007999009111651. [DOI] [PubMed] [Google Scholar]
  14. Verhaar J. A. Tennis elbow. Anatomical, epidemiological and therapeutic aspects. Int Orthop. 1994 Oct;18(5):263–267. doi: 10.1007/BF00180221. [DOI] [PubMed] [Google Scholar]
  15. van Tulder M. W., Assendelft W. J., Koes B. W., Bouter L. M. Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine (Phila Pa 1976) 1997 Oct 15;22(20):2323–2330. doi: 10.1097/00007632-199710150-00001. [DOI] [PubMed] [Google Scholar]

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