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The effects of counterforce brace on pain in subjects with lateral elbow tendinopathy: A systematic review and meta-analysis of randomized controlled trials

Posted on 2020-07-09 - 12:08
Background:

Lateral elbow tendinopathy, also known as “tennis elbow” or “lateral epicondylitis,” is a common disease leading to pain in the lateral side of the elbow and disability during hand gripping. A counterforce brace is one of the most conventional treatments. However, its effects on outcomes remain inconclusive.

Objectives:

To investigate the effects of counterforce braces on pain in subjects with lateral elbow tendinopathy. Grip strength was reviewed as a secondary outcome.

Study design:

Systematic review and meta-analysis of randomized controlled trials.

Methods:

PubMed, Embase, Scopus, Web of Science, CENTRAL, PEDro, ProQuest, RECAL, and RehabData were searched from January 1, 1995, through June 15, 2019.

Results:

Seventeen studies were included with a total of 1145 participants. A small improvement in pain over the short term (standardized mean difference −0.02; 95% confidence interval: −0.85 to 0.80) and a moderate-to-large improvement in pain in subjects 45 years or younger (standardized mean difference −0.86; 95% confidence interval: −2.45 to 0.72) in favor of the brace versus physiotherapy interventions were found. In contrast, over the long-term physiotherapy interventions (standardized mean difference 1.17; 95% confidence interval: −0.00 to 2.34), wrist splint (standardized mean difference 0.35; 95% confidence interval: −0.07 to 0.76), and laser therapy (standardized mean difference 0.58; 95% confidence interval: −0.44 to 1.59) had better effects on pain improvement versus the brace.

Conclusion:

The results indicated that physiotherapy interventions compared to counterforce braces have better effects, especially over the long-term. However, counterforce braces may have better effects on pain in younger people (<45 years old) over the short term (<6 weeks).

Clinical relevance

The results suggest that counterforce bracing is a reasonable strategy to alleviate pain over the short term. However, the subgroup analysis suggests that factors such as age may have a role in their effectiveness.

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Prosthetics and Orthotics International

AUTHORS (8)

Saeed Shahabi
Kamran Bagheri Lankarani
Seyed Taghi Heydari
Maryam Jalali
Sulmaz Ghahramani
Mojtaba Kamyab
Reza Tabrizi
Mostafa Hosseinabadi
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