Elbow injuries.

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Abstract

[Indexed for MEDLINE] 5. Clin Rehabil. 2024 Aug;38(8):1063-1079. doi: 10.1177/02692155241249968. Epub 2024 Apr 26. 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. Dunning J(1)(2)(3), Mourad F(4)(5), Bliton P(2)(6), Charlebois C(2), Gorby P(2)(7), Zacharko N(8), Layson B(9), Maselli F(10), Young I(11), Fernández-de-Las-Peñas C(1)(12). Author information: (1)Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain. (2)American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL, USA. (3)Montgomery Osteopractic Physical Therapy & Acupuncture, Montgomery, AL, USA. (4)Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg. (5)Luxembourg Health & Sport Sciences Research Institute, Differdange, Luxembourg. (6)William Middleton VA Hospital, Madison, WI, USA. (7)Gorby Osteopractic Physiotherapy, Colorado Springs, CO, USA. (8)Osteopractic Physical Therapy of the Carolinas, Fort Mill, SC, USA. (9)Advocate Physical Therapy, Helena, MT, USA. (10)Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy. (11)Tybee Wellness & Osteopractic, Tybee Island, GA, USA. (12)Cátedra de Clínica, Investigación y Docencia en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. OBJECTIVE: 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. DESIGN: Randomized, single-blinded, multicenter, parallel-group trial. SETTING: Thirteen outpatient physical therapy clinics in nine different US states. PARTICIPANTS: One hundred and forty-three participants (n = 143) with lateral elbow tendinopathy were randomized. INTERVENTION: Cervical spine manipulation, extremity manipulation, and percutaneous tendon electrical dry needling plus multimodal physical therapy (n = 73) or multimodal physical therapy (n = 70) alone. MAIN MEASURES: 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. RESULTS: 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