Tennis Elbow Trial (Epi-X)

Uppsala University

Status: Completed

Conditions: Lateral Epicondylitis

Treatments: Procedure: Concentric exercise; Procedure: Eccentric exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT00888225

VR K2005

Details and patient eligibility

About

Epi-X is a multicentered randomized controlled clinical trial of chronic lateral epicondylitis with parallel group design and two phases. In the first phase physical exercise treatment is given in the intervention group and expectance in the reference group. In phase 2 eccentric exercise versus concentric is tested.

Full description

Chronic lateral epicondylitis is defined as the presence of a "tennis elbow" for more than 3 months. It is a common condition in the general population and often results in long-term sick-leave. The etiology is unknown. A large number of treatments have been tried but none is generally accepted. However, in Achilles tendinitis a new treatment has been shown effective. It consists of eccentric exercise, i.e. work during stretching rather than shortening of the muscle (concentric exercise). The latter is currently the most common treatment method.

This project is a randomised controlled clinical trial of eccentric versus concentric exercise in 205 patients with chronic lateral epicondylitis. Pain and muscle strength were recorded at start of treatment and after 1,2,3,6 and 12 months. Activities of daily life (ADL) and well-being were recorded at start of treatment and after 3, 6 and 12 months. In addition, blood specimens for a number of neural peptides have been sampled. Moreover, the involvement of the peripheral nervous system in the elbow area has been examined in a subsample of patients. A biopsy from 20 patients per treatment group and from 20 healthy subjects, and a positron emission tomography (PET) scan of 23 patients were performed to allow qualitative and quantitative examination of neural fibres, peptides and receptors. The health economy of the two treatments will be investigated using data from this project and from available registers.

Enrollment: 205 patients

Sex: All

Ages: 20 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Verified tennis elbow for more than three months
• Age 20-75 years
• Informed consent

Exclusion criteria

• Inability to understand or follow instructions
• Inability to read or fill in questionnaires
• Inability to participate at measurement sessions
• Supinator syndrome
• Compartment syndrome of anconeus muscle
• Rhizopathy of arm
• Inflammatory joint or soft tissue disease including fibromyalgia
• Previous surgery because of tennis elbow

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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205 participants in 2 patient groups

Eccentric exercise

Experimental group

Description:

Group exposed to eccentric exercise treatment

Treatment:

Procedure: Eccentric exercise

Concentric exercise

Active Comparator group

Description:

Group exposed to concentric exercise treatment

Treatment:

Procedure: Concentric exercise