Lateral Epicondyle Tendinopathy Toolkit: Section C - Outcome Measures: Difference between revisions
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== Orthopaedic Tests == | == Orthopaedic Tests == | ||
===== <u>'''Pain-free grip strength (PFGS) | ===== <u>'''Pain-free grip strength (PFGS)'''</u> ===== | ||
Using a hand held dynamometer such as a Jamar, the patient is instructed to squeeze slowly until they begin to feel discomfort. Both the physiotherapist and patient should be unable to read the dial of the dynamometer during testing. The pain free grip strength is measured 3 times, with a 20-second rest interval between each measurement. Record the mean value of 3 efforts. The research for this test was done with the elbow at 0° but could be done with the elbow at 90° if grip is very painful. | Using a hand held dynamometer such as a Jamar, the patient is instructed to squeeze slowly until they begin to feel discomfort. Both the physiotherapist and patient should be unable to read the dial of the dynamometer during testing. The pain free grip strength is measured 3 times, with a 20-second rest interval between each measurement. Record the mean value of 3 efforts. The research for this test was done with the elbow at 0° but could be done with the elbow at 90° if grip is very painful. | ||
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===== <u>'''Thomsen Test | ===== <u>'''Thomsen Test'''</u> ===== | ||
With the shoulder flexed to 60°, the elbow extended, the forearm pronated and the wrist extended about 30°, pressure is applied to the dorsum of the second and third metacarpal bones in the direction of flexion and ulnar deviation to stress the extensor carpi radialis brevis and longus. A positive test is pain elicited in the region of the lateral epicondyle. | With the shoulder flexed to 60°, the elbow extended, the forearm pronated and the wrist extended about 30°, pressure is applied to the dorsum of the second and third metacarpal bones in the direction of flexion and ulnar deviation to stress the extensor carpi radialis brevis and longus. A positive test is pain elicited in the region of the lateral epicondyle. | ||
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===== <u>'''Maudsley Test | ===== <u>'''Maudsley Test'''</u> ===== | ||
Resisted extension of the middle finger with the elbow extended. A positive test causes pain in the region of the lateral epicondyle. | Resisted extension of the middle finger with the elbow extended. A positive test causes pain in the region of the lateral epicondyle. | ||
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== Pain Rating Scales == | == Pain Rating Scales == | ||
===== <u>'''Numeric Pain Rating Scale (NPRS) | ===== <u>'''Numeric Pain Rating Scale (NPRS)'''</u> ===== | ||
The patient is asked to rate their pain on a scale of zero to ten with zero being no pain and ten being the worst pain they can imagine. | The patient is asked to rate their pain on a scale of zero to ten with zero being no pain and ten being the worst pain they can imagine. | ||
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===== <u>'''Visual Analog Scale | ===== <u>'''Visual Analog Scale'''</u> ===== | ||
The scale consists of a line, usually 10 cm long, whose ends are labeled 'no pain' and 'unbearable pain'. The rest of the line is blank. The patient is asked to mark the line at a position that best describes their pain. | The scale consists of a line, usually 10 cm long, whose ends are labeled 'no pain' and 'unbearable pain'. The rest of the line is blank. The patient is asked to mark the line at a position that best describes their pain. | ||
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== Download Lateral Epicondyle Tendinopathy Toolkit: Appendix F - Outcome Measures == | == Download Lateral Epicondyle Tendinopathy Toolkit: Appendix F - Outcome Measures == | ||
http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-F.-Lateral-Epicondyle-Tendinopathy-Outcome-Measures-June-2013.pdf | http://physicaltherapy.med.ubc.ca/files/2013/07/Appendix-F.-Lateral-Epicondyle-Tendinopathy-Outcome-Measures-June-2013.pdf | ||
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== Acknowledgements == | == Acknowledgements == | ||
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*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix A|''Appendix A: Details of the Articles'']] | *''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix A|''Appendix A: Details of the Articles'']] | ||
*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix B|''Appendix B: Manual Therapy'']] | *''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix B|''Appendix B: Manual Therapy'']] | ||
*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix C|''Appendix C: Details of Exercise Prescription'']] | *''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix C|''Appendix C: Details of Exercise Prescription'']] | ||
*''Click to skip to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix D|''Appendix D: LASER Dosage Calculation'']] | *''Click to skip to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix D|''Appendix D: LASER Dosage Calculation'']] | ||
*''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix E|''Appendix E: Braces, Splints, and Taping'']] | *''Click to return to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix E|''Appendix E: Braces, Splints, and Taping'']] | ||
*''Click to continue to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix G|''Appendix G: Medical and Surgical Interventions'']] | *''Click to continue to ''[[Lateral Epicondyle Tendinopathy Toolkit: Appendix G|''Appendix G: Medical and Surgical Interventions'']] | ||
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== References == | == References == | ||
Revision as of 01:43, 14 August 2013
Note: The following outcome measures have been selected as they are commonly reported in the literature, supported by expert clinical opinion and used extensively clinically.
Orthopaedic Tests[edit | edit source]
Pain-free grip strength (PFGS)[edit | edit source]
Using a hand held dynamometer such as a Jamar, the patient is instructed to squeeze slowly until they begin to feel discomfort. Both the physiotherapist and patient should be unable to read the dial of the dynamometer during testing. The pain free grip strength is measured 3 times, with a 20-second rest interval between each measurement. Record the mean value of 3 efforts. The research for this test was done with the elbow at 0° but could be done with the elbow at 90° if grip is very painful.
Thomsen Test[edit | edit source]
With the shoulder flexed to 60°, the elbow extended, the forearm pronated and the wrist extended about 30°, pressure is applied to the dorsum of the second and third metacarpal bones in the direction of flexion and ulnar deviation to stress the extensor carpi radialis brevis and longus. A positive test is pain elicited in the region of the lateral epicondyle.
Maudsley Test[edit | edit source]
Resisted extension of the middle finger with the elbow extended. A positive test causes pain in the region of the lateral epicondyle.
Both the Thomsen and Maudsley tests can be measured using a hand held dynamometer. The score should be the mean of three readings of the amount of pressure needed for the patient to start to feel discomfort.
Pain Rating Scales[edit | edit source]
Numeric Pain Rating Scale (NPRS)[edit | edit source]
The patient is asked to rate their pain on a scale of zero to ten with zero being no pain and ten being the worst pain they can imagine.
The NPRS can be used to rate pain during the Thomsen or Maudsley's tests or while doing a specific activity such as picking up a full cup of coffee or a milk bottle.
Visual Analog Scale[edit | edit source]
The scale consists of a line, usually 10 cm long, whose ends are labeled 'no pain' and 'unbearable pain'. The rest of the line is blank. The patient is asked to mark the line at a position that best describes their pain.
Download Lateral Epicondyle Tendinopathy Toolkit: Appendix F - Outcome Measures[edit | edit source]
Acknowledgements[edit | edit source]
Developed by the BC Physical Therapy Tendinopathy Task Force: Dr. Joseph Anthony, Dr. Angela Fearon, Diana Hughes, Carol Kennedy, Dr. Alex Scott, Michael Yates, & Alison Hoens.
A Physical Therapy Knowledge Broker project supported by: UBC Department of Physical Therapy, Physiotherapy Association of BC, Vancouver Coastal Research Institute and Providence Healthcare Research Institute.
June 2013
[edit | edit source]
- Click to return to the Contents Page
- Click to return to the Summary of the Evidence
- Click to return to the Treatment Algorithm
- Click to return to Appendix A: Details of the Articles
- Click to return to Appendix B: Manual Therapy
- Click to return to Appendix C: Details of Exercise Prescription
- Click to skip to Appendix D: LASER Dosage Calculation
- Click to return to Appendix E: Braces, Splints, and Taping
- Click to continue to Appendix G: Medical and Surgical Interventions
References[edit | edit source]
Orthopaedic Tests
- Stratford P, Levy D. Assessing valid change over time in patients with lateral epicondylitis at the elbow. Clinical Journal of Sport Medicine. 1994;4:88-91.
Pain Rating Scales
- Downie W, Leatham P, Rhind V, Wright V, Branco J, Anderson J . Studies with pain rating scales. Ann Rheum Dis. 1978;37:378-381.
