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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.

BMJ open
December 20, 2024
Håkon Sveinall et al. (6 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

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

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
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
Abstract

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.

Medical Subject Headings (MeSH)
HumansTennis ElbowMaleFemaleNorwayFeasibility StudiesResistance TrainingMiddle AgedAdultExtracorporeal Shockwave TherapyPatient ComplianceTreatment OutcomePatient Education as Topic
Study Links
Quality Scores
Safety30
Efficacy40/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score2.34
Normalized Score0.43
Related Supplements
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