eS1568 WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642
Special Interest Report Poster Presentation
Number: SI-PO-22-09-Sun
Sunday 3 May 2015 12:15
Exhibit halls 401–403
CLINICAL AND ULTRASONOGRAPHIC
RESULTS OF
PERCUTANEOUS-NEEDLE-ELECTROLYSIS
IN CHRONIC LATERAL EPICONDILITIS
F. Valera-Garrido 1,2,3 ,
F. Minaya-Muñoz 1,2,3 ,
F. Medina-Mirapeix 4
1 MV Clinic, Physical Therapy, Madrid, Spain; 2 San Pablo
CEU University, Physical Therapy, Madrid,
Spain; 3 FREMAP Hospital, Physical Therapy, Madrid,
Spain; 4 University of Murcia, Physical Therapy, Murcia,
Spain
Background: Lateral epicondylitis (LE) is the most com-
mon cause of lateral elbow pain. Ultrasound (US)-guided
percutaneous needle electrolysis (PNE) is a novel minimally
invasive approach which consists in the application of a gal-
vanic current through a puncture needle which produces a
local inflammatory process in the soft tissue and the repara-
tion of the affected tissue.
Purpose: To evaluate the clinical and ultrasonographic
effectiveness of a multimodal program (PNE, eccentric exer-
cise (EccEx) and stretching) in the short term for patients with
chronic lateral epicondylitis (LE), and to determine whether
the clinical outcomes achieved decline over time.
Methods: One-way repeated measures design. 36 patients
in a clinical setting presenting with LE (mean age = 38, mean
time since injury = 12.6 months) received one session of US-
guided PNE per week over 4–6 weeks, associated with a home
program of EccEx and stretching. The main outcome meas-
ures were severity of pain (VAS, digital algometer, Cozen
and Thompson tests), disability (DASH questionnaire), struc-
tural tendon changes (ultrasound), hypervascularity (power
doppler) and patient’s perceptions of overall outcome (4-
point scale). Measurements at 6, 26 and 52 weeks follow-up
included recurrence rates (increase of severity of pain or
disability compared to discharge), the perception of over-
all outcome and success rates. Paired Student t-tests and Chi
squared tests were applied to data.
Results: All outcome measures registered significant
improvements between pre-intervention and discharge. Most
patients (30, i.e. 83.3%) rated overall outcome as ‘success-
ful’ at 6 weeks. The ultrasonographic finding revealed that
the hypoechoic regions and hypervascularity of the exten-
sor carpi radialis brevis change significantly. At 26 and 52
weeks, all participants (32) perceived a ‘successful’ outcome.
Recurrence rates were null after discharge, and at the 6, 26
and 52 week follow-ups.
Conclusion(s): US-guided PNE, associated with EccEx
and stretching for chronic LE produces a reduction of
symptoms and degenerative structural changes, with encour-
agingly low recurrences in the mid to long term.
Implications: The US-guided PNE, associated with
eccentric exercises (EccEx) and stretching is a useful bio-
logical tool for regenerative healing by enhancing the
proliferation and matrix synthesis of tenocytes from tendons
with degenerative structures.
This treatment program provided clinical and ultrasono-
graphic benefits at discharge which did not decline in the
short term.
Keywords: Tennis elbow; Percutaneous needle electroly-
sis; Ultrasonography
Funding acknowledgements: No funding.
Ethics approval: Academic Review Committee of Qual-
ity Management Program at the Faculty of Medicine of
University of Murcia (Murcia, Spain).
http://dx.doi.org/10.1016/j.physio.2015.03.1569
Research Report Platform Presentation
Number: RR-PL-2898
Saturday 2 May 2015 14:07
Rooms 303–304
EFFECTS OF PREOPERATIVE AQUATIC
RESISTANCE TRAINING ON KNEE PAIN,
MOBILITY LIMITATION AND MUSCLE
IMPAIRMENTS IN PEOPLE WITH
LATE-STAGE KNEE OSTEOARTHRITIS
A. Valtonen 1,2 , T. Pöyhönen 2 ,
M. Manninen 3 , A. Heinonen 4 , S. Sipilä 5
1 Helsinki Metropolia University of Applied Sciences,
Department of Human Movement and Functioning,
Helsinki, Finland; 2 Kymenlaakso Central Hospital, Care,
Rehabilitation and Pain Unit, Kotka, Finland; 3 Orton
Hospital, Orthopaedic Department, Helsinki,
Finland; 4 University of Jyväskylä, Department of Health
Sciences, Jyväskylä, Finland; 5 University of Jyväskylä,
Gerontology Research Center, Department of Health
Sciences, Jyväskylä, Finland
Background: Knee joint osteoarthritis (OA) is the most
common joint disease in the world. It causes severe pain,
and further leads to muscle weakness, mobility limitation,
and thus disability. Exercise is an important part of the con-
servative treatment for knee OA. However, it is difficult to
find training methods, which would be effective in increasing
muscle strength, decreasing pain and mobility limitation with
minimal adverse effects. Aquatic training offers several bene-
fits for training for people with painful weight-bearing joints
of the lower limbs. Earlier aquatic training studies without