COUNTERFORCE ORTHOSIS IN THE MANAGEMENT OF LATERAL EPICONDYLITIS
AbstractBackground: Lateral Epicondylitis (LE), is a condition characterized by the pain and tenderness over the lateral epicondyle of the humerus. LE is commonly seen among people who are involved in sports such as tennis and golf. Any activity that repeatedly overstrain the extensor carpi radialis brevis tendon can lead to LE. The management of lateral epicondylitis generally involves the use of counterforce orthosis. The aim of this review is to summarize the evidence regarding the effectiveness of counterforce orthoses on the clinical outcomes of patients with lateral epicondylitis. Methods: The PubMed, Ovid, and ProQuest databases were searched for potential studies which explored the use of counterforce orthosis in the management of lateral epicondylitis Results: To have a better understanding of the effectiveness of various types of orthoses, the review is organized into four sections. The first section explores the use of a single orthotic device, the second section focuses on the combined use of orthotic devices, the third section explore studies that compared the effect of local steroid injection along with orthosis and the last section narrate the studies that compared various types of orthotic devices. The studies support the use of orthotic devices as a treatment modality for lateral epicondylitis. There is rising evidence which supports the use of a comprehensive approach, (by combining routine physiotherapy with orthotic devices) in the management of LE. Conclusion: Orthosis alone or in combination with routine physical therapy can be considered as an evidence-based treatment strategy for patients with lateral epicondylitis. However, on the basis of the literature review conducted, the authors recommend that further high-quality clinical trials regarding the management of lateral epicondylitis are necessary to strengthen the evidence-based physiotherapy practice.Keywords: Lateral Epicondylitis; Tennis Elbow; Counterforce Orthosis; Narrative Review; Literature Review
Faes M, van den Akker B, de Lint JA, Kooloos JG, Hopman MT. Dynamic extensor brace for lateral epicondylitis. Clin Orthop Relat Res 2006;442:149–57.
Najafi M, Arazpour M, Aminian G, Curran S, Madani SP, Hutchins SW. Effect of a new hand-forearm splint on grip strength, pain, and function in patients with tennis elbow. Prosthet Orthot Int 2016;40(3):363–8.
Shamsoddini A, Hollisaz MT, Hafezi R, Amanellahi A. Immediate effects of counterforce forearm brace on grip strength and wrist extension force in patients with lateral epicondylosis. Hong Kong J Occup Ther 2010;20(1):8–12.
Wadsworth CT, Nielsen DH, Burns LT, Krull JD, Thompson CG. Effect of the counterforce armband on wrist extension and grip strength and pain in subjects with tennis elbow. J Orthop Sports Phys Ther 1989;11(5):192–7.
Vicenzino B, Brooksbank J, Minto J, Offord S, Paungmali A. Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. J Orthop Sports Phys Ther 2003;33(7):400–7.
Struijs PA, Kerkhoffs GM, Assendelft WJ, van Dijk CN. Conservative treatment of lateral epicondylitis brace versus physical therapy or a combination of both-a randomized clinical trial. Am J Sports Med 2004;32(2):462–9.
Clements LG, Chow S. Effectiveness of a custom-made below elbow lateral counterforce splint in the treatment of lateral epicondylitis (tennis elbow). Can J Occup Ther 1993;60(3):137–44.
Sölveborn SA. Radial epicondylalgia (‘tennis elbow'): treatment with stretching or forearm band. A prospective study with long‐term follow‐up including range‐of‐motion measurements. Scand J Med Sci Sports 1997;7(4):229–37.
Burton AK. A comparative trial of forearm strap and topical anti-inflammatory as adjuncts to manipulative therapy in tennis elbow. Man Med 1988;3(4):141–3.
Ertuerk H, Celiker R, Sivri A, Cetin A, Cindas A. The efficacy of different treatment regimens that are commonly used in tennis elbow. J Rheumatol Med Rehab 1997;8:298–301.
Haker E, Lundeberg T. Elbow-band, splintage and steroids in lateral epicondylalgia (tennis elbow). Pain Clinic 1993;6(2):103–12.
Jensen B, Bliddal H, Danneskiold-Samsøe B. [Comparison of two different treatments of lateral humeral epicondylitis--" tennis elbow". A randomized controlled trial]. Ugeskr Laeger 2001;163(10):1427–31.
Olaussen M, Holmedal O, Lindbaek M, Brage S, Solvang H. Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: a systematic review. BMJ Open 2013;3(10):e003564.
Sadeghi-Demneh E, Jafarian F. The immediate effects of orthoses on pain in people with lateral epicondylalgia. Pain Res Treat 2013;2013:353597.
Garg R, Adamson GJ, Dawson PA, Shankwiler JA, Pink MM. A prospective randomized study comparing a forearm strap brace versus a wrist splint for the treatment of lateral epicondylitis. J Shoulder Elbow Surg 2010;19(4):508–12.
Thangavelu K, Moorthy AS. Effect of modified elbow brace over custom made elbow binder on pain, hand functions in patients with tennis elbow. Indian J Phys Ther 2015;3(1):60–4.
Goel R, Balthilaya G, Reddy RS. Effect of Kinesio taping versus athletic taping on pain and muscle performance in lateral epicondylalgia. Int J Physiother Res 2015;3(1):839–44.
Bisset LM, Collins NJ, Offord SS. Immediate effects of 2 types of braces on pain and grip strength in people with lateral epicondylalgia: a randomized controlled trial. J Orthop Sports Phys Ther 2014;44(2):120–8.
Wuori JL, Overend TJ, Kramer JF, MacDermid J. Strength and pain measures associated with lateral epicondylitis bracing. Arch Phys Med Rehabil 1998;79(7):832–7.
Anderson MA, Rutt RA. The effects of counterforce bracing on forearm and wrist muscle function. J Orthop Sports Phys Ther 1992;15(2):87–91.
Van De Streek MD, Van Der Schans CP, De Greef MH, Postema K. The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis. Prosthet Orthot Int 2004;28(2):183–9.
Renjith V, George A, D'Souza P. Undertaking Systematic Reviews in Nursing. Int J Nurs Educ 2015;7(4):104–9.
D’Souza P, George A, Norohna JA, Renjith V. Integration of evidence-based practice in nursing education: a novel approach. Manipal J Nurs Health Sci 2015;1(1):51–6.
D’Souza P, George A, Nair SN, Noronha JA, Renjith V, Bhat SK. Resources For Evidence-Based Health Care: Accessibility And Availability. J Educ Pract 2014;5(7):65–72.