Theses and dissertations (Health Sciences)
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Item The efficacy of dry needling in patients suffering from lateral epicondylitis(2002) Haswell, Garrick David; White, Horace LindsayLateral epicondylitis is a relatively common disorder affecting approximately one third of the nearly thirty-two million tennis players worldwide. It usually presents as a chronic disorder that follows a remitting relapsing course, and as such represents a challenge to manage. At present the scientific literature does not favour any particular treatment modality and as such well designed placebo studies are required to assess the efficacy of the various modalities of treatment, with a long term view of establishing an effective treatment protocol to manage lateral epicondylitis. The purpose of this study was to determine the efficacy of dry needling the posterior distal muscles of the upper extremity as a treatment for lateral epicondylitis. Sixty patients were included in the study. They all under went a case history, physical examination and an elbow regional examination. They were then randomly allocated into the experimental or control groups. The thirty patients in the experimental group received dry needling while the thirty included in the control group received placebo or 'sham' needling. All participants in the study received three treatments over a nine-day period with subjective and objective measurements being taken before the 1st. 2nd, and 3rd treatments, with a 4th being taken after the third treatment. Examination of the statistical data revealed that a significant improvement in the experimental group versus the control group in terms of both subjectiveItem The clinical effectiveness of therapeutic exercises alone and in combination with orthotic bracing in the treatment of lateral epicondylalgia(2012) Flanders, Megan; Korporaal, Charmaine MariaLateral epicondylalgia (L.E) is a common diagnosis in elbow pathology. The aetiology is poorly understood but it is generally accepted to be as a result of repetitive microtrauma, affecting the proximal end of the extensor carpi radialis brevis tendon. Elbow bracing and exercise modification are often utilised by sufferers in order to reduce symptoms. In addition, there have been multiple treatment regimes used in practice to treat L.E, but none has stood out as being more effective than another. Thus, the aim of this study was to investigate the relative clinical effectiveness of therapeutic exercises alone and in combination with orthotic bracing, in terms of subjective and objective clinical findings. Methods This stratified, quantitative, prospective clinical trial consisted of two equal groups (n=15) diagnosed with L.E. Group One consisted of a strengthening and stretching programme alone, and Group Two consisted of a combination of the same programme and an orthotic brace. The participants performed the programme daily at home for six weeks, and the brace was worn throughout the day for six weeks. Each participant was assessed before, during and after the programme, in terms of subjective and objective clinical data which was then statistically analysed using SPSS version 18. Repeated measures ANOVA testing was also used to compare the outcomes between the groups over the time points. Results Both groups showed significant statistical improvement in terms of all the outcome measures. The groups also showed a clinically significant improvement for all the outcome measures except pressure pain threshold where Group Two showed clinically significant improvement over Group One. v Conclusion The results show that there was negligible benefit when combining an orthotic brace with therapeutic exercises as opposed to performing the therapeutic exercises alone.