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The American Journal of Sports Medicine 32:462-469 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Conservative Treatment of Lateral Epicondylitis

Brace Versus Physical Therapy or a Combination of Both—A Randomized Clinical Trial

P. A. A. Struijs, PhD*,{dagger}, G. M. M. J. Kerkhoffs, MD{dagger}, W. J. J. Assendelft, MD, PhD{ddagger} and C. N. van Dijk, MD, PhD{dagger}

From the {dagger} Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands, and the {ddagger} Division of Public Health, Department of General Practice, Academic Medical Center, Amsterdam, the Netherlands

* Address correspondence to P. A. A. Struijs, PhD, Academic Medical Center, Department of Orthopaedic Surgery, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, the Netherlands (e-mail: paastruijs{at}hotmail.com).

Background: The authors evaluated the effectiveness of brace-only treatment, physical therapy, and the combination of these for patients with tennis elbow.

Methods: Patients were randomized over 3 groups: brace-only treatment, physical therapy, and the combination of these. Main outcome measures were success rate, severity of complaints, pain, disability, and satisfaction. Data were analyzed using both intention-to-treat and per-protocol analyses. Follow-up was 1 year.

Results: A total of 180 patients were randomized. Physical therapy was superior to brace only at 6 weeks for pain, disability, and satisfaction. Contrarily, brace-only treatment was superior on ability of daily activities. Combination treatment was superior to brace on severity of complaints, disability, and satisfaction. At 26 weeks and 52 weeks, no significant differences were identified.

Conclusion: Conflicting results were found. Brace treatment might be useful as initial therapy. Combination therapy has no additional advantage compared to physical therapy but is superior to brace only for the short term.

Key Words: tennis elbow • randomized controlled trial • treatment • brace • physical therapy • conservative




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