Article

OBJECTIVE: To analyse treatment effects of eccentric vs. concentric graded
exercise in chronic tennis elbow. DESIGN: Randomized controlled trial. SETTING:
Primary care in Uppsala County, Sweden. SUBJECTS: A total of 120 subjects with
tennis elbow lasting more than three months were recruited from primary care and
by advertisement. INTERVENTION: Eccentric (n = 60) or concentric exercise (n =
60), by lowering or lifting a weight, at home daily, for three months with
gradually increasing load. MAIN MEASURES: Pain during muscle contraction and
muscle elongation, as well as strength, was assessed at baseline and after one,
two, three, six, and 12 months. Function and quality of life was assessed at
baseline and after three, six and 12 months. RESULTS: The eccentric exercise
group had faster regression of pain, with an average of 10% higher responder rate
at all levels of pain reduction, both during muscle contraction and elongation,
(p < 0.0001 and p = 0.006, respectively). Significant differences were found in
Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI)
0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the
eccentric vs. the concentric group and a number-needed-to-treat of 10. The
eccentric group also had a greater increase of muscle strength than the
concentric (p < 0.02). The differences persisted throughout the follow-up period.
There were no significant differences between the groups regarding function or
quality of life measures. CONCLUSION: Eccentric graded exercise reduced pain and
increased muscle strength in chronic tennis elbow more effectively than
concentric graded exercise.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS