Comparison Between Steroid and 2 Different Sites of Botulinum Toxin Injection in the Treatment of Lateral Epicondylalgia: A Randomized, Double-Blind, Active Drug-Controlled Pilot Study

Guo, Yao-Hong; Kuan, Ta Shen; Chen, Kuan‐Lin; Lien, Wei‐Chih; Hsieh, Pei-Chun; Hsieh, I-Chieh; Chiu, S. E.; Lin, Yu‐Ching

doi:10.1016/j.apmr.2016.08.475

Cited by 22 publications

(23 citation statements)

References 32 publications

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“…For analyzing the feasibility, the percentages of recruitment, retention, and occurrence of adverse events were compared between the groups. Effect sizes (ES) were calculated by using GPower V.3.1.7 (University of Kiel, Kiel, Germany) as previously described by Guo et al 17 Betweengroup ES used only exercises group as control. The ESs were generally defined as small (r ¼ 0.1), median (r ¼ 0.3), and large (r ¼ 0.5).…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

et al. 2020

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Introduction Pectus carinatum (PC) is a congenital chest wall deformity which is characterized by the protrusion of the sternum and costal cartilages. Although orthotic and exercise therapies are commonly offered by physicians for PC treatment, there is a lack of evidence on the benefits of exercises and how long the orthosis should be worn. The aim of this study is to investigate the effects and feasibility of custom-made compression orthosis and exercises in the treatment of PC. Materials and Methods Patients with PC aged 7 to 17 years old were randomized into three groups: compression orthosis 23 hours, compression orthosis 8 hours, and control group. All groups received exercises for 1 hour a day for 3 weeks. Additionally, compression orthosis 23 hours group wore the orthosis for 23 hours a day, while compression orthosis 8 hours group wore the orthosis for 8 hours a day. PC protrusion, pressure of correction, thorax lateral and anteroposterior parameters, external chest wall measurements, and Nuss Questionnaire were evaluated before and after the treatment. Also, adverse effects, retention, and compliance were assessed. Feasibility was evaluated by calculating the percentages of recruitment, retention, and safety. Results The compression orthosis 23 hours group showed greater improvements than the other groups. After treatment, all groups showed significant changes in protrusion, pressure of correction, and external chest wall measurements. Adverse events occurred with similar frequency across groups. Retention percentages did not differ among groups. Conclusion Compression orthosis use for 23 hours can be recommended rather than its use for 8 hours because 23 hours of orthosis use has better correction and similar adverse effects.

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Section: Discussionmentioning

confidence: 99%

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

et al. 2020

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“…The Mann‐Whitney U test was used to analyze differences between groups. Effect sizes were also calculated for the between‐group comparisons by using GPower V.3.1.7 (University of Kiel, Kiel, Germany) as previously described by Guo et al; 95% CI was also calculated for the effect sizes via an Excel spreadsheet . The effect sizes were generally defined as small (d = 0.2), medium (d = 0.5), and large (d = 0.8) .…”

Section: Methodsmentioning

confidence: 99%

“…1,3,6,7 For those patients who do not respond to noninvasive treatment modalities, more invasive therapies such as injections of steroid, prolotherapy, platelet-rich plasma, and botulinum toxin A have been used prior to surgical treatment. [8][9][10] Numerous terms including tennis elbow, lateral epicondylalgia, tendonitis, tendinosis, and tendinopathy have been used to describe this condition. Lateral elbow tendinopathy (LET) seems to be the most appropriate term because histopathological studies showed that degenerative changes rather than inflammation play a role in pathophysiology.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Kinesiotaping, Sham Taping or Exercises Only in Lateral Epicondylitis Treatment: A Randomized Controlled Study

Giray

Karali-Bingul

Akyüz

2019

PM&R

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Background Lateral epicondylitis is a common musculoskeletal condition presenting with pain and tenderness over the lateral epicondyle and dorsal forearm, pain and weakness in gripping and limitations in daily activities. It is proposed that kinesiotaping, a new application of adhesive taping, reduces pain and improves muscle function. Objective To compare efficacy of kinesiotaping, sham taping, or exercises only in the treatment of lateral epicondylitis. Design Double‐blind, randomized, controlled trial. Setting Tertiary medical center, university hospital. Participants Thirty patients with lateral epicondylitis for less than 12 weeks. Methods or Interventions Patients were randomized into three groups: kinesiotaping plus exercises (n = 10), sham taping plus exercises (n = 10), and control (exercises only) (n = 10) groups. All recipients were provided a home exercise program including strengthening and stretching exercises. In kinesiotaping and sham taping groups, tapings were performed and changed every 3–4 d for 2 weeks. Main Outcome Measure(s) The primary outcome was the patient‐rated tennis elbow evaluation (PRTEE). Pain visual analogue scale (VAS), grip strength, and the disabilities of the arm, shoulder and hand (QuickDASH) scales were secondary outcomes. Evaluations were done at baseline, posttreatment, and at 4 weeks after treatment. The immediate effect was also assessed by VAS and grip strength immediately after real and sham tapings. Results PRTEE total scores at posttreatment and at 4 weeks after treatment were statistically significantly lower in kinesiotaping plus exercises group compared to sham taping plus exercises group and exercises only group. The effects of kinesiotaping were larger than sham taping and only exercises at posttreatment (d = −1.21, d = −1.33) and at 4 weeks after treatment (d = −1.39, d = −1.34). Repeated‐measures anova showed a significant interaction between the time and the groups (F 2950 = 4849; P = .006). Significant between‐group differences were found in QuickDASH score and VAS at rest at 4 weeks after treatment, VAS at daily activity at posttreatment and 4 weeks after treatment when kinesiotaping plus exercises and sham taping plus exercises groups and kinesiotaping plus exercises and exercises only groups were compared. Real taping but not sham taping immediately led to an increase in grip strength, decrease in VAS at rest and VAS at daily activity (P = .0017, P = .041, P = .028; respectively). Conclusions Kinesiotaping in addition to exercises is more effective than sham taping and exercises only in improving pain in daily activities and arm disability due to lateral epicondylitis. Level of Evidence I

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“…Placzek et al [13,18] In der 4. Guo et al [16] In der 7. Studie von Guo et al [16] Anzahl der beschwerdefreien Probanden und die Probanden mit Einschränkung der beruflichen Aktivitäten.…”

Section: In-label-und Off-label-indikationen Dosierungenunclassified

“…Guo et al [16] In der 7. Studie von Guo et al [16] Anzahl der beschwerdefreien Probanden und die Probanden mit Einschränkung der beruflichen Aktivitäten. Keine signifikanten Unterschiede ergaben sich hinsichtlich der maximalen Griffstärke und der Anzahl der Probanden mit Einschränkungen bei sportlichen Aktivitäten und der Anzahl der arbeitsunfähigen Probanden (Zeitverlauf und Gruppenvergleich), ferner auch bei der Anzahl der Probanden mit Einschränkungen der Aktivitäten des täglichen Lebens (Gruppenvergleich, Abnahme in beiden Gruppen zu beiden Kontrollzeitpunkten).…”

Section: In-label-und Off-label-indikationen Dosierungenunclassified

Botulinum Toxin for Chronic Lateral Epicondylitis (LE)

Grüner¹,

Schulz²,

Schlüter-Brust

et al. 2020

Z Orthop Unfall

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Lateral epicondylitis is a common disease in orthopaedic practice. Although the majority of cases do not become chronic, patients who do not respond to the initial treatment may suffer from pain in the long term and effective treatment is challenging. The off-label use of botulinum toxin is one of the common potential indications for the substance in orthopaedics and traumatology. In a literature review of 2000 – 2019, eight EBM ≥ level 3 studies evaluating the use of botulinum toxin in lateral epicondylitis were found. Five of these studies evaluated botulinum toxin versus placebo in chronic cases; two other studies compared botulinum toxin with corticosteroids in acute cases and classic Hohmann surgery in chronic cases; the eighth study compared botulinum toxin in two different injection sites and corticosteroids by classic injection. Our findings suggest that the use of this substance may be a treatment option in refractory chronic cases before surgery is indicated. The working group on botulinum toxin in O & T of the International Musculoskeletal Pain Society (IMPS/IGOST) introduced an alternative injection schedule, which combines findings from the recent clinical literature with practical experience in order to reduce the risk of side effects while ensuring treatment effectiveness. Using 2 simple tests of function and, if necessary, sonographic verification, 2 separate injection sites in the extensor carpi radialis or the extensor digitorum can be identified by palpation. The tendon level on the lateral epicondyle acts as the third injection site. With optimal use of the ampoule content, the 3 injection sites can be infiltrated individually, depending on the muscle status. On the one hand, this enables treatment to take place after a dual therapy approach and, on the other hand, the risk of overdose in a muscle with subsequent unnecessary muscle weakening can be reduced.

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Comparison Between Steroid and 2 Different Sites of Botulinum Toxin Injection in the Treatment of Lateral Epicondylalgia: A Randomized, Double-Blind, Active Drug-Controlled Pilot Study

Cited by 22 publications

References 32 publications

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

A Comparative Study on Short-Term Effects of Compression Orthosis and Exercises in the Treatment of Pectus Carinatum: A Randomized Controlled Pilot Feasibility Trial

The Effectiveness of Kinesiotaping, Sham Taping or Exercises Only in Lateral Epicondylitis Treatment: A Randomized Controlled Study

Botulinum Toxin for Chronic Lateral Epicondylitis (LE)

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