Title |
Percutaneous tendon dry needling and thrust manipulation as an adjunct to multimodal physical therapy in patients with lateral elbow tendinopathy: A multicenter randomized clinical trial.
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Published in |
Clinical Rehabilitation, April 2024
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DOI | 10.1177/02692155241249968 |
Pubmed ID | |
Authors |
James Dunning, Firas Mourad, Paul Bliton, Casey Charlebois, Patrick Gorby, Noah Zacharko, Brus Layson, Filippo Maselli, Ian Young, César Fernández-de-Las-Peñas |
Abstract |
The purpose of this study was to assess the effects of adding electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization, and ultrasound in patients with lateral elbow tendinopathy. Randomized, single-blinded, multicenter, parallel-group trial. Thirteen outpatient physical therapy clinics in nine different US states. One hundred and forty-three participants (n = 143) with lateral elbow tendinopathy were randomized. Cervical spine manipulation, extremity manipulation, and percutaneous tendon electrical dry needling plus multimodal physical therapy (n = 73) or multimodal physical therapy (n = 70) alone. The primary outcome was elbow pain intensity and disability as measured by the Patient-Rated Tennis Elbow Evaluation at baseline, 1 week, 4 weeks, and 3 months. Secondary outcomes included the Numeric Pain Rating Scale, Tennis Elbow Functional Scale, Global Rating of Change, and medication intake. The 2 × 4 analysis of covariance demonstrated that individuals with lateral elbow tendinopathy receiving electrical dry needling and thrust manipulation plus multimodal physical therapy experienced significantly greater improvements in disability (Patient-Rated Tennis Elbow Evaluation: F = 19.675; P < 0.001), elbow pain intensity (Numeric Pain Rating Scale: F = 22.769; P < 0.001), and function (Tennis Elbow Function Scale: F = 13.269; P < 0.001) than those receiving multimodal physical therapy alone at 3 months. The between-group effect size was large for pain and disability (Patient-Rated Tennis Elbow Evaluation: standardized mean difference = 1.13; 95% confidence interval: 0.78, 1.48) in favor of the electrical dry needling and thrust manipulation group. The inclusion of percutaneous tendon electrical dry needling and thrust manipulation into a multimodal program of exercise, mobilization and ultrasound was more effective than multimodal physical therapy alone in individuals with lateral elbow tendinopathy.Trial Registration: www.clinicaltrials.gov NCT03167710 May 30, 2017. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 8 | 24% |
India | 2 | 6% |
United Kingdom | 2 | 6% |
Kenya | 2 | 6% |
Brazil | 1 | 3% |
Mexico | 1 | 3% |
Spain | 1 | 3% |
Paraguay | 1 | 3% |
Germany | 1 | 3% |
Other | 1 | 3% |
Unknown | 13 | 39% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 27 | 82% |
Practitioners (doctors, other healthcare professionals) | 4 | 12% |
Science communicators (journalists, bloggers, editors) | 1 | 3% |
Scientists | 1 | 3% |