Assessment of functional recovery in tennis elbow

Alizadehkhaiyat, Omid; Fisher, Anthony C.; Kemp, Graham J.; Vishwanathan, Karthik; Frostick, Simon P.

doi:10.1016/j.jelekin.2008.01.008

Cited by 45 publications

(45 citation statements)

References 33 publications

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“…Our findings partially contradicted those of Alizadehkhaiyat et al (2007Alizadehkhaiyat et al ( , 2009. These authors noted an overall weakness of wrist flexion and an increase in ECRB muscle activation in Recovered players.…”

Section: Discussioncontrasting

confidence: 99%

“…In contrast, our results indicated that Recovered players show both higher capacity of wrist flexor muscles and higher wrist capacity ratio thus demonstrating a complete functional recovery and an adaptation of muscle force capacities. A first explanation of these important differences might be that the Recovered players tested in this study had already returned to playing tennis for more than one year, as against 6 months in Alizadehkhaiyat et al (2009). Another explanation is that the measurement approach used by these authors differed substantially from the one used in this study.…”

Section: Discussionmentioning

confidence: 88%

“…Another explanation is that the measurement approach used by these authors differed substantially from the one used in this study. Alizadehkhaiyat et al (2007Alizadehkhaiyat et al ( , 2009) directly estimated muscle force capacities and ratios using the measured net wrist moments. However, as already explained in the introduction, net joint moments are not representative of muscle force capacities since these measurements corresponded to the resultant action of all the muscles involved, including both synergistic and antagonistic actions.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the risk and biomechanical consequences of lateral epicondylalgia by estimating wrist and finger muscle capacities in tennis players

Vigouroux

Monsabert

Hayot

et al. 2016

Sports Biomechanics

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Previous studies suggested that a pronounced weakness of the extensor muscles relative to the flexor muscles could increase the risk of occurrence of lateral epicondylalgia. This study investigates this hypothesis by estimating the ratio of extensor to flexor muscle capacities among healthy non-players (n = 10), healthy tennis players (n = 20), symptomatic players (n = 6), and players who have recovered from lateral epicondylalgia (n = 6). Maximum net joint moments in flexion or extension were measured during seven tasks involving the voluntary contraction of wrist and fingers. Using these data, the muscle capacities of the main muscle groups of the hand (wrist flexors, wrist extensors, finger flexors, finger extensors, and intrinsic muscles) were estimated using a musculoskeletal model. These capacities were then used to compute the extensor/flexor capacity ratios about the wrist and the finger joints. Compared to healthy nonplayers, healthy players presented higher extensor muscle capacities and greater capacity ratios showing that playing tennis generates specific adaptations of muscle capacities. Interestingly, symptomatic players, similar to those of non-players, showed more imbalanced ratios than healthy players. These results confirm that the ratio of extensor/flexor muscle capacities seems to be associated with lateral epicondylalgia and can be further used to understand its incidence and consequences.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Assessment of the risk and biomechanical consequences of lateral epicondylalgia by estimating wrist and finger muscle capacities in tennis players

Vigouroux

Monsabert

Hayot

et al. 2016

Sports Biomechanics

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“…As well as finger flexors, forceful grip activates finger extensors to stabilise the wrist [Alizadehkhaiyat et al, 2008;Hagg et al, 1997]. The kinetic chain principle that activation of proximal muscle groups ensures stability within distal segments is particularly pertinent to the GHJ, where muscular activity plays a key role in maintaining joint stability [Hawkes et al].…”

Section: Discussionmentioning

confidence: 99%

Electromyographic assessment of muscle fatigue in massive rotator cuff tear

Hawkes

Alizadehkhaiyat

Kemp

et al. 2015

Journal of Electromyography and Kinesiology

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Shoulder muscle fatigue has not been assessed in massive rotator cuff tear (MRCT). This study used EMG to measure fatigability of 13 shoulder muscles in 14 healthy controls and 11 patients with MRCT. A hand grip protocol was applied to minimise artifacts due to pain experience during measurement. The fatigue index (median frequency slope) was significantly non-zero (negative) for anterior, middle, and posterior parts of deltoid, supraspinatus and subscapularis muscles in the controls, and for anterior, middle, and posterior parts of deltoid, and pectoralis major in patients (p ≤ 0.001). Fatigue was significantly greater in patients compared to the controls for anterior and middle parts of deltoid and pectoralis major (p ≤ 0.001). A submaximal grip task provided a feasible way to assess shoulder muscle fatigue in MRCT patients, however with some limitations. The results suggest increased activation of deltoid is required to compensate for lost supraspinatus abduction torque. Increased pectoralis major fatigue in patients (adduction torque) likely reflected strategy to stabilise the humeral head against superior subluxing force of the deltoid. Considering physiotherapy as a primary or adjunct intervention for the management of MRCT, the findings of this study generate a base for future clinical studies aiming at the development of evidence-based protocol

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“…While a large number of forearm EMG studies have been published on non-tennis populations, this review was able to identify only 13 tennis-related studies of which only two (Bauer and Murray, 1999;Kelley et al, 1994) involved tennis players with a history of LE. While studying tennis players with LE injury may 370 potentially explore only post-injury muscle activation patterns rather than causative factors, it has strong implications for the development of effective rehabilitation interventions and assessment of functional recovery (Alizadehkhaiyat et al, 2009;Gibson, 2012;Regan, 2009). …”

Section: Muscle Activitymentioning

confidence: 99%

Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

Alizadehkhaiyat

Frostick

2015

Journal of Electromyography and Kinesiology

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There is no consensus about the main aetiology of Lateral Epicondylitis (LE) or Tennis Elbow. While electromyographic assessment of alterations in neuromuscular control and activation patterns of forearm muscles has received increasing interest as potential intrinsic factors in non-tennis players, there has been insufficient attention in tennis players. The purpose of present review was to search the 5 literature for the electromyographic studies of forearm muscles in tennis players in order to 1) identify related implications for LE, 2) highlight key technical and methodological shortcomings, and 3) suggest potential pathways for future research.An electronic search of PubMed, Scopus, Web of Science, and Google Scholars (1980 to October 2014) was conducted. Titles, abstracts, and full-text articles were screened to identify "peer-reviewed" 10 studies specifically looking into "electromyographic assessment of forearm muscles" in "tennis players". After screening 104 articles, 13 original articles were considered in the main review involving a total of 216 participants (78% male, 22% female). There were indications of increased extensor activity in all tennis strokes and less experiences single-handed players, however with insufficient evidence to support their relationship with the development of LE. Studies varied widely 15 in study population, sample size, gender, level of tennis skills, electrode type, forearm muscles studied, EMG recording protocol, EMG normalisation, and reported parameters. As a result, it was not possible to present combined results of existing studies and draw concrete conclusions in terms of clinical implications of findings. There is a need for establishment of specific guidelines and recommendations for EMG assessment of forearm musculature in terms of electrode and muscle 20 selection. Further studies of both healthy controls and tennis players suffering from TE with adequate sample sizes and well-defined demographics are warranted.3

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Assessment of functional recovery in tennis elbow

Cited by 45 publications

References 33 publications

Assessment of the risk and biomechanical consequences of lateral epicondylalgia by estimating wrist and finger muscle capacities in tennis players

Assessment of the risk and biomechanical consequences of lateral epicondylalgia by estimating wrist and finger muscle capacities in tennis players

Electromyographic assessment of muscle fatigue in massive rotator cuff tear

Electromyographic assessment of forearm muscle function in tennis players with and without Lateral Epicondylitis

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