Short and Long-term Effects of Mobilization with Movement and Eccentric Overload to Hand Pain and Function in the Treatment of Lateral Epicondylitis

Abstract

Aim. To determine and compare short and long-term effects of mobilization with movement and eccentric overload to hand pain and function in the treatment of lateral epicondylitis.
 Problem of research & hypothesis. The eccentric overload exercises are one of the best methods in tendinopathy treatment. Mobilization with movement is largely used as an effective treatment method for lateral epicondylitis. Only the short-term effects of these methods in lateral epicondylitis are often evaluated, but no studies were found to use these methods in combination and to evaluate their long-term effects.
 Methods. The study included individuals (n=30) aged 30–54 years who had been diagnosed with lateral epicondylitis. Subjects were tested by assessing their perceived pain using the visual analogue scale (VAS); handgrip strength was assessed by a dynamometer. The QuickDASH questionnaire was used to assess hand function and perceived disability.
 Subjects were randomly divided into three groups: mobilization with movement group (n=10), eccentric overload group (n=10), and combined group (combined mobilization with movement and eccentric overload exercises) (n=10). All subjects got 10 physiotherapy procedures, short-term effect evaluated after 10 procedures of physiotherapy, long-term effect evaluated after 2, 6 and 12 weeks post treatment course.
 Results. Study results revealed that all treatment methods had a significant (p<0.05) effect on pain reduction, increase in handgrip strength as well as improvement in hand function and disability.
 In follow-up assessments at 2, 6 and 12 weeks after the treatment, the most altered indicators of pain intensity, pain-free handgrip strength and hand function were seen in the mobilization with movement group.
 Conclusions. An application of mobilization with movement in the treatment of lateral epicondylitis had the greatest positive effect on pain intensity, maximum handgrip strength and hand function and disability compared to mobilization with movement combined with eccentric overload and eccentric overload exercises alone.
 Keywords: lateral epicondylitis, mobilization with movement, eccentric overload, pain intensity, hand pain-free grip strength.