Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Shillito, M.; Soong, M.; Martin, N. Radiographic and clinical analysis of lateral epicondylitis. J. Hand Surg. 2017, 42, 436–442. [Google Scholar] [CrossRef] [PubMed]
- Peterson, M.; Butler, S.; Eriksson, M.; Svärdsudd, K. A randomized contolled trial of exercise versus wait-list in chronic tennis elbow. Ups. J. Med. Sci. 2011, 116, 269–279. [Google Scholar] [CrossRef] [PubMed]
- Brummel, J.; Baker, C.L.; Hopkins, R.; Baker, C.L., Jr. Epicondylitis: Lateral. Sport. Med. Arthrosc. Rev. 2014, 22, 1–6. [Google Scholar] [CrossRef] [PubMed]
- Wassen, M.; Nuhmani, S.; Ram, C.S.; Sachin, Y. Lateral epicondylitis: A review of the literature. J. Back Musculoskelet. Rehabil. 2012, 25, 131–142. [Google Scholar]
- Muller, A.; Spies, C.K.; Unglaub, F.; Bruckner, T.; Potzl, W. Chronic lateral epicondylitis: The Nirschl procedure. Oper. Orthop. Traumatol. 2015, 27, 525–535. [Google Scholar]
- Vaquero-Picado, A.; Barco, R.; Antuña, S.A. Lateral epicondylitis of the elbow. EFORT Open Rev. 2017, 1, 391–397. [Google Scholar] [CrossRef]
- Nirschl, R.P.; Ashman, E.S. Tennis elbow tendinosis (epicondylitis). Instr. Course Lect. 2004, 53, 587–598. [Google Scholar]
- De Smedt, T.; de Jong, A.; Van Leemput, W.; Lieven, D.; Van Glabbeek, F. Lateral epicondylitis in tennis: Update on aetiology, biomechanics and treatment. Br. J. Sport. Med. 2007, 41, 816–819. [Google Scholar] [CrossRef] [PubMed]
- Gruchow, H.W.; Pelletier, D.W. An epidemiologic study of tennis elbow. Am. J. Sport. Med. 1979, 7, 234–238. [Google Scholar] [CrossRef]
- Fan, Z.J.; Silverstein, B.A.; Bao, S.; Bonauto, D.K.; Howard, N.L.; Smith, C.K. The association between combination of hand force and forearm posture and incidence of lateral epicondylitis in a working population. Hum. Factors 2014, 56, 151–165. [Google Scholar] [CrossRef]
- Sayampanathan, A.A.; Basha, M.; Mitra, A.K. Risk factors of lateral epicondylitis: A meta-analysis. Surgeon 2019, 18, 122–128. [Google Scholar] [CrossRef]
- Descatha, A.; Dale, A.M.; Jaegers, L.; Herquelot, E.; Evanoff, B. Self-reported physical exposure association with medial and lateral epicondylitis incidence in a large longitudinal study. Occup. Environ. Med. 2013, 70, 670–673. [Google Scholar] [CrossRef] [PubMed]
- Haahr, J.P.; Andersen, J.H. Prognostic factors in lateral epicondylitis: A randomized trial with one-year follow-up in 266 new cases treated with minimal occupational intervention or the usual approach in general practice. Rheumatology 2003, 42, 1216–1225. [Google Scholar] [CrossRef]
- Duncan, J.; Duncan, R.; Bansal, S.; Davenport, D.; Hacker, A. Lateral epicondylitis: The condition and current management strategies. Br. J. Hosp. Med. 2019, 80, 647–651. [Google Scholar] [CrossRef] [PubMed]
- Ahmad, Z.; Siddiqui, N.; Malik, S.S.; Abdus-Samee, M.; Tytherleigh-Strong, G.; Rushton, N. Lateral epicondylitis: A review of pathology and management. Bone Jt. J. 2013, 95, 1158–1164. [Google Scholar] [CrossRef] [PubMed]
- Boyer, M.I.; Hastings, H. Lateral tennis elbow: “Is there any science out there?”. J. Shoulder Elb. Surg. 1999, 8, 481–491. [Google Scholar] [CrossRef] [PubMed]
- MacDermid, J.C.; Michlovitz, S.L. Examination of the elbow: Linking diagnosis, prognosis, and outcomes as a framework for maximizing therapy intervention. J. Hand Ther. 2006, 19, 82–97. [Google Scholar] [CrossRef]
- Valdes, K.; LaStayo, P. The value of provocative tests for the wrist and elbow: A literature review. J. Hand Ther. 2013, 26, 32–43. [Google Scholar] [CrossRef]
- Zwerus, E.L.; Somford, M.P.; Maissan, F.; Heisen, J.; Eygendaal, D.; van den Bekerom, M.P. Physical examination of the elbow, what is the evidence? A systematic literature review. Br. J. Sport. Med. 2018, 52, 1253–1260. [Google Scholar] [CrossRef]
- Baeza, E.V.; Alonso, J.J.R.; Fuentes, A.T. Diagnóstico y tratamiento de la epicondilitis en atención primaria. FMC 2008, 15, 314–321. [Google Scholar]
- Sellards, R.; Kuebrich, C. The elbow: Diagnosis and treatment of common injuries. Prim. Care. 2005, 32, 1–16. [Google Scholar] [CrossRef] [PubMed]
- Saroja, G.; Asser, P.A.L.; Venkata Sai, P.M. Diagnostic accuracy of provocative tests in lateral epicondylitis. Int. J. Physiother. Res. 2014, 2, 815–823. [Google Scholar] [CrossRef]
- Connell, D.; Burke, F.; Coombes, P.; McNealy, S.; Freeman, D.; Pryde, D.; Hoy, G. Sonographic examination of lateral epicondylitis. AJR Am. J. Roentgenol. 2001, 176, 777–782. [Google Scholar] [CrossRef] [PubMed]
- Miller, T.T.; Shapiro, M.A.; Schultz, E.; Kalish, P.E. Comparison of sonography and MRI for diagnosing epicondylitis. J. Clin. Ultrasound. 2002, 30, 193–202. [Google Scholar] [CrossRef]
- Garg, A.; Kapellusch, J.M.; Hegmann, K.T.; These, M.S.; Merryweather, A.S.; Wang, Y.C.; Malloy, E.J. The strain index and TLV for HAL: Risk of lateral epicondylitis in a prospective cohort. Am. J. Ind. Med. 2014, 57, 286–302. [Google Scholar] [CrossRef]
- Lee, P.H.; Macfarlane, D.J.; Lam, T.H.; Stewart, S.M. Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review. Int. J. Behav. Nutr. Phys. Act. 2011, 8, 115. [Google Scholar] [CrossRef]
- Johnson, C. Measuring pain—Visual analog scale versus numeric pain scale: What is the difference? J. Chiropr. Med. 2005, 4, 43–44. [Google Scholar] [CrossRef]
- Cohen, M.; Motta Filho, G.R. Elbow lateral epicondylitis. Rev. Bras. Ortop. 2012, 47, 414–420. [Google Scholar] [CrossRef]
- Ma, K.L.; Wang, H.Q. Management of lateral epicondylitis: A narrative literature review. Pain Res. Manag. 2020, 2020, 6965381. [Google Scholar] [CrossRef]
- Nirschl, R.P. Elbow tendinosis/tennis elbow. Clin. Sport. Med. 1992, 11, 851–870. [Google Scholar] [CrossRef]
- Tosti, R.; Jennings, J.; Sewards, J.M. Lateral epicondylitis of the elbow. Am. J. Med. 2013, 126, 357. [Google Scholar] [CrossRef] [PubMed]
- Dones, V.C.; Grimmer, K.; Thoirs, K.; Suarez, C.G.; Luker, J. The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: A systematic review. BMC Med. Imaging 2014, 14, 10. [Google Scholar] [CrossRef] [PubMed]
- Lew, H.L.; Chen, C.P.; Wang, T.G.; Chew, K.T. Introduction to musculoskeletal diagnostic ultrasound: Examination of the upper limb. Am. J. Phys. Med. Rehabil. 2007, 86, 310–321. [Google Scholar] [CrossRef]
- Valera-Garrido, F.; Minaya-Muñoz, F.; Medina-Mirapeix, F. Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: Short-term and long-term results. Acupunct. Med. 2014, 32, 446–454. [Google Scholar] [CrossRef] [PubMed]
- Landesa-Piñeiro, L.; Leirós-Rodríguez, R. Physiotherapy treatment of lateral epicondylitis: A systematic review. J. Back. Musculoskelet Rehabil. 2022, 35, 463–477. [Google Scholar] [CrossRef]
- Lenoir, H.; Mares, O.; Carlier, Y. Management of lateral epicondylitis. Orthop Traumatol Surg Res. 2019, 105, S241–S246. [Google Scholar] [CrossRef]
- Herquelot, E.; Guéguen, A.; Roquelaure, Y.; Bodin, J.; Sérazin, C.; Ha, C.; Leclerc, A.; Goldberg, M.; Zins, M.; Descatha, A. Work-related risk factors for incidence of lateral epicondylitis in a large working population. Scand. J. Work Environ. Health 2013, 39, 578–588. [Google Scholar] [CrossRef]
- Kemp, V.L.; Piber, L.S.; Ribeiro, A.P. Can physical activity levels and relationships with energy expenditure change the clinical aspects of sarcopenia and perceptions of falls among elderly women? Observational cross-sectional study. Sao Paulo Med. J. 2021, 139, 285–292. [Google Scholar] [CrossRef]
- Edwards, M.; Loprinzi, P. Systemic inflammation as a function of the individual and combined associations of sedentary behaviour, physical activity and cardiorespiratory fitness. Clin. Physiol. Funct. Imaging 2018, 38, 93–99. [Google Scholar] [CrossRef]
- Nimmo, M.A.; Leggate, M.; Viana, J.L.; King, J.A. The effect of physical activity on mediators of inflammation. Diabetes Obes. Metab. 2013, 15, 51–60. [Google Scholar] [CrossRef]
- Parsons, T.J.; Sartini, C.; Welsh, P.; Sattar, N.; Ash, S.; Lennon, L.T.; Wannamethee, S.G.; Lee, I.M.; Whincup, P.H.; Jefferis, B.J. Physical activity, sedentary behavior, and inflammatory and hemostatic markers in men. Med. Sci. Sport. Exerc. 2017, 49, 459–465. [Google Scholar] [CrossRef] [PubMed]
- Phillips, C.M.; Dillon, C.B.; Perry, I.J. Does replacing sedentary behaviour with light or moderate to vigorous physical activity modulate inflammatory status in adults? Int. J. Behav. Nutr. Phys. Act. 2017, 14, 138. [Google Scholar] [CrossRef] [PubMed]
- Karanasios, S.; Korakakis, V.; Moutzouri, M.; Drakonaki, E.; Koci, K.; Pantazopoulou, V.; Tsepis, E.; Gioftsos, G. Diagnostic accuracy of examination tests for lateral elbow tendinopathy (LET)—A systematic review. J. Hand Ther. 2021, 35, 3. [Google Scholar] [CrossRef]
- Ikeda, K.; Ogawa, T.; Ikumi, A.; Yoshii, Y.; Kohyama, S.; Ikeda, R.; Yamazaki, M. Individual evaluation of the common extensor tendon and lateral collateral ligament improves the severity diagnostic accuracy of magnetic resonance imaging for lateral epicondylitis. Diagnostics 2022, 12, 1871. [Google Scholar] [CrossRef] [PubMed]
Variables (Anthropometric and Clinical) | Low PA (n = 19) | Moderate PA (n = 42) | High PA (n = 41) | p |
---|---|---|---|---|
Age (years) | 47.1 ± 7.3 | 45.1 ± 8.6 | 45.9 ± 8.1 | 0.779 |
Height (m) | 1.6 ± 0.6 | 1.6 ± 0.8 | 1.6 ± 0.9 | 0.530 |
Body mass (kg) | 71.6 ± 14.8 | 74.7 ± 17.6 | 75.1 ± 12.5 | 0.123 |
Body Mass Index (kg/m2) | 22.1 ± 4.0 | 22.9 ± 5.1 | 22.6 ± 3.5 | 0.739 |
Gender (F/M) | 15 (F) 4 (M) | 30 (F) 12 (M) | 24 (F) 17 (M) | 0.286 |
Disease time (years) | 7.3 ± 4.9 | 8.0 ± 5.3 | 9.4 ± 5.6 | 0.188 |
PA practice time (months) | 20.4 ± 9.7 | 25.5 ± 9.8 | 41.0 ± 9.3 | 0.010 * |
Clinical Tests | Low PA | Moderate PA | High PA |
---|---|---|---|
Cozen (cm) | 5.9 ± 2.5 | 6.5 ± 2.2 | 6.3 ± 2.6 |
Mill (cm) | 8.2 ± 1.5 | 8.3 ± 1.4 | 7.7 ± 1.8 |
p | 0.002 * | <0.001 | <0.001 |
Physical Activity Level (PA) | Cozen (cm) | Mill (cm) | ICC | SEM | IC 95% | p |
---|---|---|---|---|---|---|
Low PA | 5.9 ± 2.5 | 8.2 ± 1.5 | 0.14 | 0.64 | 0.12/0.17 | 0.037 |
Moderate PA | 6.5 ± 2.2 | 8.3 ± 1.4 | 0.48 | 0.38 | 0.22/0.58 | <0.001 * |
High PA | 6.3 ± 2.6 | 7.7 ± 1.8 | 0.44 | 0.44 | 0.39/0.69 | 0.024 |
Ultrasound Examination Lateral Epicondylitis | Physical Activity Level (PA) | Cozen’s Test (n/%) | Mill’s Test (n/%) |
---|---|---|---|
Positive ultrasound | Low | 15/78% | 19/100% |
Negative ultrasound | 04/21% | 0.0/0.0% | |
Kappa * | 0.80 | 1.0 | |
p value | 0.042 | 0.997 | |
Bland–Altman * | 0.17 | 0.0 | |
Positive ultrasound | Moderate | 36/85.7% | 38/90,4% |
Negative ultrasound | 06/14.2% | 04/21% | |
Kappa * | 0.74 | 0.82 | |
p value | 0.037 | 0.235 | |
Bland–Altman * | 0.14 | 0.11 | |
Positive ultrasound | High | 35/85.3% | 40/97.5% |
Negative ultrasound | 06/14.6% | 1/0.0% | |
Kappa * | 0.73 | 0.99 | |
p value | 0.012 | 0.323 | |
Bland–Altman * | 0.14 | 0.02 |
Physical Activity Level (PA) | Pain Cozen (cm) | R | R2 | T | p * |
---|---|---|---|---|---|
Low PA (MET/s) | 5.9 ± 2.5 | 0.32 | 0.10 | −0.95 | 0.354 |
Moderate PA (MET/s) | 6.5 ± 2.2 | 0.18 | 0.03 | 1.12 | 0.268 |
High PA (MET/s) | 6.3 ± 2.6 | 0.21 | 0.04 | −0.05 | 0.962 |
Pain Mill (cm) | R | R2 | T | p | |
Low PA (MET/s) | 8.2 ± 1.5 | 0.31 | 0.10 | −0.92 | 0.371 |
Moderate PA (MET/s) | 8.3 ± 1.4 | 0.02 | 0.01 | −0.07 | 0.932 |
High PA (MET/s) | 7.7 ± 1.8 | 0.26 | 0.07 | −0.89 | 0.376 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Soares, M.M.; Souza, P.C.; Ribeiro, A.P. Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure. Int. J. Environ. Res. Public Health 2023, 20, 1794. https://doi.org/10.3390/ijerph20031794
Soares MM, Souza PC, Ribeiro AP. Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure. International Journal of Environmental Research and Public Health. 2023; 20(3):1794. https://doi.org/10.3390/ijerph20031794
Chicago/Turabian StyleSoares, Marcos Martins, Patrícia Colombo Souza, and Ana Paula Ribeiro. 2023. "Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure" International Journal of Environmental Research and Public Health 20, no. 3: 1794. https://doi.org/10.3390/ijerph20031794
APA StyleSoares, M. M., Souza, P. C., & Ribeiro, A. P. (2023). Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure. International Journal of Environmental Research and Public Health, 20(3), 1794. https://doi.org/10.3390/ijerph20031794