Lateral Epicondyle Tendinopathy Toolkit: Section D - Summary of the Evidence: Difference between revisions
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*''Click to continue to: ''[[Achilles Tendinopathy Toolkit: Appendix D|''Appendix D: Medical and Surgical Interventions'']] | *''Click to continue to: ''[[Achilles Tendinopathy Toolkit: Appendix D|''Appendix D: Medical and Surgical Interventions'']] | ||
=== Manual Therapy === | === Manual Therapy === | ||
{| width="800" border=" | {| width="800" border="1" cellpadding="1" cellspacing="1" | ||
|- | |- | ||
! colspan="3" scope="row" | | ! colspan="3" scope="row" | | ||
'''Joint | '''Elbow Joint Mobilizations'''''<br>'' | ||
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! colspan="3" scope="row" | | ! colspan="3" scope="row" | | ||
''' | '''Spinal Mobilization Techniques''' | ||
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| <u>May consider</u> using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | | <u>May consider</u> using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | ||
| <u>May consider</u> a trial of soft tissue techniques, such as<br>frictions, in the chronic stage. | | <u>May consider</u> a trial of soft tissue techniques, such as<br>frictions, in the chronic stage. | ||
'''Elbow Joint Mobilizations'''''<br>'' | |||
|- | |||
! scope="row" | '''Stage of pathology''' | |||
| '''Acute''' | |||
| '''Chronic''' | |||
|- | |||
! scope="row" | '''Clinical research evidence''' | |||
| No | |||
| | |||
Yes | |||
1CS<ref name="Voorn 1998">Voorn, R. Case report: can sacroiliac joint dysfunction cause chronic Achilles tendonitis? JOSPT. 1998;27(6);436‐443.</ref> | |||
|- | |||
! scope="row" | '''Published expert opinion''' | |||
| Yes<ref name="Carcia 2010">Carcia CR, Martin RL, Houck J, Wukich DK. Achilles pain, stiffness, and muscle power deficits: achilles tendinitis. J Orthop Sports Phys Therapy. 2010;40(9)A1‐A26.</ref> | |||
| Yes<ref name="Carcia 2010" /> | |||
|- | |||
! scope="row" | '''Take home message''' | |||
| There is no clinical evidence but there is expert level consensus to <u>support</u> the use of joint mobilizations in the acute stage if assessment reveals joint restriction. | |||
| There is a small amount of clinical evidence and more substantial expert level consensus to <u>support </u>the use of joint mobilizations in the chronic stage if assessment reveals joint restriction. | |||
|- | |||
! scope="row" | '''[[Achilles Tendinopathy Toolkit: Summary of Interventions#Explanation_of_clinical_implications|Clinical implication]]''' | |||
| <u>May consider</u> using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | |||
| <u>May consider</u> using manual therapy in the chronic stage<br>after undertaking a comprehensive biomechanical<br>evaluation of the hip, knee, foot and ankle. | |||
|} | |} | ||
Revision as of 00:42, 26 July 2013
PURPOSE, SCOPE & DISCLAIMER: The purpose of this document is to provide physical therapists with a summary of the evidence for interventions commonly used to manage tendinopathy of the lateral epicondyle. This decision-making tool is evidence-informed and where there is insufficient evidence, expert-informed. It is not intended to replace the clinician’s clinical reasoning skills and inter-professional collaboration. ‘Acute’ refers primarily to symptoms of less than 3 months duration and ‘chronic’ to greater than 3 months. For studies which (1) included participants with symptoms that encompassed both acute and chronic stages or (2) did not clarify the duration of symptoms, the results have been reported within the ‘chronic’ stage.
Lateral Epicondyle Tendinopathy:
Summary of the Evidence for Physical Therapy Interventions
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- Click to go back to the contents page
- Click to continue to Treatment Algorithm
- Click to continue to Appendix A: Exercise Programs
- Click to continue to Appendix B: Low Level Laser Therapy Dosage Calculation
- Click to continue to: Appendix C: Details of Articles on Interventions
- Click to continue to: Appendix D: Medical and Surgical Interventions
Manual Therapy[edit | edit source]
|
Elbow Joint Mobilizations | ||
|---|---|---|
| Stage of pathology | Acute | Chronic |
| Clinical research evidence | No |
Yes 1CS[1] |
| Published expert opinion | Yes[2] | Yes[2] |
| Take home message | There is no clinical evidence but there is expert level consensus to support the use of joint mobilizations in the acute stage if assessment reveals joint restriction. | There is a small amount of clinical evidence and more substantial expert level consensus to support the use of joint mobilizations in the chronic stage if assessment reveals joint restriction. |
| Clinical implication | May consider using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | May consider using manual therapy in the chronic stage after undertaking a comprehensive biomechanical evaluation of the hip, knee, foot and ankle. |
|
Spinal Mobilization Techniques | ||
| Stage of pathology | Acute | Chronic |
| Clinical research evidence | No | Yes 1 SR[3] 2 CS[4][5] |
| Published expert opinion | No | Yes[2] |
| Take home message | The clinical evidence neither supports nor refutes the use of frictions in the acute stage. | There is a small amount of clinical evidence to support the use of soft tissue techniques, such as frictions, in the chronic stage. |
| May consider using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | May consider a trial of soft tissue techniques, such as frictions, in the chronic stage. Elbow Joint Mobilizations | |
| Stage of pathology | Acute | Chronic |
| Clinical research evidence | No |
Yes 1CS[1] |
| Published expert opinion | Yes[2] | Yes[2] |
| Take home message | There is no clinical evidence but there is expert level consensus to support the use of joint mobilizations in the acute stage if assessment reveals joint restriction. | There is a small amount of clinical evidence and more substantial expert level consensus to support the use of joint mobilizations in the chronic stage if assessment reveals joint restriction. |
| Clinical implication | May consider using manual therapy in the acute stage after undertaking a comprehensive biomechanical evaluation of the ‐ Joint mobs hip, knee, foot and ankle. | May consider using manual therapy in the chronic stage after undertaking a comprehensive biomechanical evaluation of the hip, knee, foot and ankle. |
CS ‐ Case studies; SR ‐ Systematic reviews.
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Background
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Objectives
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if appropriate
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References[edit | edit source]
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- ↑ 1.0 1.1 Voorn, R. Case report: can sacroiliac joint dysfunction cause chronic Achilles tendonitis? JOSPT. 1998;27(6);436‐443.
- ↑ 2.0 2.1 2.2 2.3 2.4 Carcia CR, Martin RL, Houck J, Wukich DK. Achilles pain, stiffness, and muscle power deficits: achilles tendinitis. J Orthop Sports Phys Therapy. 2010;40(9)A1‐A26.
- ↑ Brosseau L, Casimiro L, Milne S. et al. Deep transverse friction massage for treating tendinitis. 2002. Cochrane Database Systematic Reviews. 4.
- ↑ Woodman RM, Pare L. Evaluation and treatment of soft tissue lesions of the ankle and forefoot using a Cyriax approach. Physical Therapy. 1982;62(8);1144‐47.
- ↑ Christenson RE. Effectiveness of specific soft tissue mobilizations for the management of Achilles tendinosis: Single case study‐ Experimental design. Manual Therap. 2007;12;63‐71.
