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Published byGordon Ferguson Modified over 5 years ago
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The Research Question Lateral epicondylosis (tennis elbow) is common, debilitating and often refractory to routine care. Prolotherapy, an injection-based “regenerative” therapy, and guided physical therapy (PT) are safe, evidence-based modalities, but have not been compared. Study question: Among adults with tennis elbow, what is the effect of prolotherapy, PT and the two combined on disease- specific quality of life as assessed by a validated questionnaire?
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Research Design and Method
Design: 12 month randomized controlled trial (N=120). Participants: Adults with chronic tennis elbow. Intervention: Participants were allocated to: 4 monthly sessions of prolotherapy with hypertonic dextrose, OR… 4 weekly sessions of PT, OR… Prolotherapy and PT combined. Assessment: Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire. The outcomes assessor was blinded to group.
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What the Research Found
120 participants Adherence to treatment and 12-month questionnaire adherence were high: 93% and 88% respectively. All groups reported PRTEE score improvements of approximately 28 points on this 100-point scale. Meets clinical importance standard. There was not a difference between groups at 12 months; combined care did not improve outcomes. Participants in all groups were satisfied. There were no adverse events.
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What this means for Clinical Practice
Prolotherapy, PT and combined therapy resulted in safe, significant, substantial and sustained improvement of PRTEE- based elbow pain and function by 52 weeks. Clinicians can feel comfortable recommending prolotherapy and supervised PT to patients who are refractory to other non- surgical care. Combination therapy did not add improvement to either therapy alone.
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