Tennis elbow brace and wrist cock-up splint in the management of tennis elbow: a comparative study
Keywords:Tennis elbow, Lateral epicondylitis, Tennis elbow brace, Cock up splint, Brace
Background: The purpose of our study was to compare the efficacy of a wrist splint with a forearm counterforce strap brace in the management of tennis elbow.
Methods: This prospective study was conducted between January and December 2018 comprising of 75 patients suffering from lateral epicondylitis managed conservatively with splints. Patients were randomized into three treatment groups, group 1 received tennis elbow forearm brace, group 2 received wrist extension splint, group 3 received both tennis elbow forearm brace and wrist extension splint. The patient-rated tennis elbow evaluation (PRTEE) score and visual analogue scale (VAS) scores were calculated at 0, 3 and 6 weeks of the treatment.
Results: Mean difference of pre-treatment and post-treatment PRTEE score was significant in all three groups and was maximum for group 3 patients (32.42) followed by group 2 patients (27.04) followed by group 1 patients (20.06). Pre-treatment and post-treatment VAS score difference was maximum for group 3 patients.
Conclusions: Significant symptomatic relief can be achieved in patients with tennis elbow by using either tennis elbow forearm brace or wrist extension splint or both. Provided proper patient selection and compliance, wrist extension splint achieves better symptomatic relief and functional outcome as compared to tennis elbow brace.
Struijs PA, Smidt N, Arola H, Dijk VCN, Buchbinder R, Assendelft WJ. Orthotic devices for tennis elbow: a systematic review. Br J Gen Pract. 2001;51(472):924-9.
Buchanan BK, Varacallo M. Tennis Elbow (Lateral Epicondylitis). In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing; 2019.
Regan W, Wold LE, Coonrad R, Morrey BF. Microscopic histopathology of chronic refractory lateral epicondylitis. American J Sports Med. 1992;20(6):746-9.
Boyer MI. Lateral tennis elbow: Is there any science out there. J Shoulder Elbow Surg. 1999;8(5):481-91.
Rompe JD, Overend TJ, Dermid MJC. Validation of the patient-rated tennis elbow evaluation questionnaire. J Hand Therapy. 2007;20(1):3-11.
Ilfeld FW, Field SM. Treatment of tennis elbow: use of a special brace. JAMA. 1966;195(2):67-70.
Nirschl RP. Tennis elbow. Orthop Clin North Am. 1973;4:747-400.
Mackler SL, Epler M. Effect of standard and air cast tennis elbow bands on integrated electromyography of forearm extensor musculature proximal to the bands. American J Sports Med. 1989;17(2):278-81.
Meyer NJ, Walter F, Haines B, Orton D, Daley RA. Modelled evidence of force reduction at the extensor carpi radialis brevis origin with the forearm support band. J Hand Surg. 2003;28(2):279-87.
Jansen CW, Olson SL, Hasson SM. The effect of use of a wrist orthosis during functional activities on surface electromyography of the wrist extensors in normal subjects. J Hand Ther. 1997;10:243-9.
Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med. 2005;39:411-22.
Struijs PA, Bos KIB, Tulder VMW, Dijk VCN, Bouter LM, Assendelft WJ. Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow. British J Sports Med. 2006;40(7):637-43.
Streek MV, Schans CV, Greef MD, Postema K. The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis. Prosthetics Orthotics Int. 2004;28(2):183-9.