Heavy slow resistance training, radial extracorporeal shock wave therapy or advice for patients with tennis elbow in the Norwegian secondary care: a randomised controlled feasibility trial.
Study Goal
The researchers aimed to evaluate the feasibility of recruitment, adherence, and compliance with heavy slow resistance training in patients with lateral epicondylalgia, as well as describe within-group changes in secondary outcomes.
Results Summary
Only 32% of participants complied with heavy slow resistance training, mainly due to pain aggravation. Patient-reported and performance-based outcomes improved in all groups, but compliance issues suggest resistance training may not be suitable for tennis elbow patients.
Population
Patients with lateral epicondylalgia (tennis elbow) recruited from an outpatient clinic.
Effective Dosage
Not specified
Duration
Follow-up at 3 and 6 months (intervention duration not explicitly stated)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
heavy slow resistance training | decrease | compliance | patients with lateral epicondylalgia (tennis elbow) | 32% | low compliance | #1 |
heavy slow resistance training | decrease | suitability | patients with tennis elbow | - | not suitable | #2 |
heavy slow resistance training | increase | pain | patients with tennis elbow | - | pain aggravation | #3 |
heavy slow resistance training | increase | patient-reported and performance-based outcomes | patients with lateral epicondylalgia (tennis elbow) | - | improved | #4 |
radial extracorporeal shock wave therapy | increase | patient-reported and performance-based outcomes | patients with lateral epicondylalgia (tennis elbow) | - | improved | #5 |
information and advice | increase | patient-reported and performance-based outcomes | patients with lateral epicondylalgia (tennis elbow) | - | improved | #6 |
OBJECTIVES: To evaluate the feasibility of recruitment, appointment adherence, intervention compliance, acceptance and comprehensibility, in addition to retention rate and data completeness. An ancillary aim was to describe within-group changes in the secondary outcome measures (patient-reported and performance-based). DESIGN: A single-centre, three-armed, randomised controlled feasibility trial with a parallel design, with follow-up after 3 and 6 months. SETTING: Participants were recruited from the outpatient clinic at Oslo University Hospital. PARTICIPANTS: Patients with lateral epicondylalgia, commonly known as tennis elbow. INTERVENTIONS: Participants were randomised in a 1:1:1 ratio to heavy slow resistance training, radial extracorporeal shock wave therapy or information and advice. MAIN OUTCOME MEASURES: Feasibility was assessed according to a priori criteria for success. RESULTS: In total, 89 patients were screened for eligibility, and 69 (78%) patients were eligible for randomisation. 60 (92%) participants were randomised which gave a recruitment rate of 3.4 per month (against an a priori success cut-off of 3.75). The participants rated all the interventions as acceptable and comprehensive. Only 6 of 19 (32%) did comply with heavy slow resistance training. Retention rate and completeness of data were successful at 3 months. At 6 months, the retention rate was below the criteria for success. Patient-reported and performance-based outcomes improved in all groups. CONCLUSION: The current study shows that the process of recruitment and the retention rate at follow-up can be feasible with minor amendments. Participants had low compliance with heavy slow resistance training mainly due to pain aggravation, which suggests that this intervention was not suitable for patients with tennis elbow. Shock wave therapy and information and advice should be investigated further in a full-scale randomised controlled trial including sham shock wave therapy. TRIAL REGISTRATION NUMBER: NCT04803825.