Bilateral Sensorimotor Abnormalities in Unilateral Lateral Epicondylalgia

Abstract

Objective: To evaluate impairments in motor function of the upper limb in unilateral lateral epicondylalgia. Design: Assessor-blinded, case-controlled study. Setting: University laboratory. Participants: Forty participants with lateral epicondylalgia and 40 age- and sex-matched controls were recruited from the general community. Interventions: Not applicable. Main Outcome Measures: Wrist posture adopted during a grip test, grip strength force, as well as upper-limb reaction times and speed of movement. Results: Participants with unilateral lateral epicondylalgia adopted wrist postures that were on average 11° less extended, bilaterally, than controls (P<.000). This was paralleled by increased upper-limb reaction times and reduced speed of movement (mean differences, 2%−15%) in both affected and unaffected limbs. Pain-free grip strength was reduced on the involved side (mean difference, 170N; 95% confidence interval, 144−195N). Conclusions: Motor deficits may be modifiable through exercise and postural retraining. Although further work is required to evaluate the clinical efficacy of such an approach, health care practitioners have an emerging evidence base on which to base their management of lateral epicondylalgia.

Key Words: Hand; Rehabilitation; Tennis elbow; Wrist