Conservative treatments for tennis elbow: do subgroups of patients respond differently?

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Title Conservative treatments for tennis elbow: do subgroups of patients respond differently?
Author Bisset, Leanne Margaret; Smidt, N.; Windt, D. A. van der; Bouter, L. M.; Jull, G.; Brooks, P.; Vicenzino, B.
Journal Name Rheumatology
Editor R A Watts
Year Published 2007
Place of publication United Kingdom
Publisher Oxford University Press
Abstract Objective: To determine if subgroups of patients with tennis elbow respond differently to treatment. Methods: This study used individual patient data (N=383) from two randomised controlled trials that investigated a wait and see policy, corticosteroid injections and physiotherapy. Common outcome measures were: pain severity, global improvement, severity assessed by a blinded assessor, elbow disability, and pain free grip strength. Subgroup analyses for previous history of elbow pain, baseline pain severity, duration of the current episode and employment status were performed at six and 52 weeks. Results: Patients' age, previous elbow symptoms and baseline pain severity were similar between trials, but other characteristics differed between trial populations. Based on individual patient data from both trials, we found that corticosteroid injections were statistically and clinically superior at six weeks, but significantly worse at 52 weeks compared to both wait and see and physiotherapy. Subgroup effects were scarce and small. Patients with higher baseline pain score showed less benefit on pain outcomes between physiotherapy and a wait and see policy at six weeks. It also appeared that non-manual workers who had an injection were the only work subgroup to demonstrate similar differential effects between injections and a wait and see policy on global improvement at 52 weeks. Conclusions: The treatment outcomes were largely similar between trials and not different between most subgroups studied. In tennis elbow, it would appear that patient characteristics play only a small role in predicting treatment outcomes, which supports the generalisability of individual trial results.
Peer Reviewed Yes
Published Yes
Publisher URI http://rheumatology.oxfordjournals.org/
Alternative URI http://dx.doi.org/10.1093/rheumatology/kem192
Copyright Statement Copyright 2007 authors. This is an open access paper. http://creativecommons.org/licenses/by/3.0/ license that permits unrestricted use, provided that the paper is properly attributed.
Volume 46
Issue Number 10
Page from 1601
Page to 1605
ISSN 1462-0324
Date Accessioned 2007-06-27
Date Available 2009-05-27T08:41:51Z
Language en_AU
Research Centre Griffith Health Institute; Centre for Musculoskeletal Research
Faculty Griffith Health Faculty
Subject PRE2009-Therapies and Therapeutic Technology
URI http://hdl.handle.net/10072/17779
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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