To evaluate the usefulness of the protocol by comparing treatment outcomes before and after its implementation, based on one year of treatment data for lateral epicondylitis of the humerus.To evaluate the usefulness of the protocol by comparing treatment outcomes before and after its implementation, based on one year of treatment data for lateral epicondylitis of the humerus.
The subjects were 25 patients (7 men, 18 women, average age 50.5 years) diagnosed with lateral epicondylitis of the humerus and prescribed rehabilitation at our clinic from April 2021 to March 2022. From April to September 2021, conventional physical therapy without a protocol was performed, and from October 2021 to March 2022, physical therapy was performed according to the protocol created at our clinic. A retrospective chart review was conducted, targeting patients who had been followed for more than three months. Cases where activities of daily living (ADL) were no longer impaired within three months were classified as the improvement group, and cases that continued for more than three months were classified as the poor response group. The protocol included ultrasound to the ECRB and EDC tendon transition area, LIPUS to the ECRB and EDC origin area, transverse massage, and finally low-frequency therapy. Patients were instructed on stretching and advised to perform it at work or home. Before the protocol, there were individual differences in the content of stretching instructions, so the protocol standardized the instruction content.
There were 12 patients (3 men, 9 women, average age 49.8 years) in the pre-protocol group and 13 patients (4 men, 9 women, average age 51.2 years) in the post-protocol group. The overall average number of visits was 14.4, with 16.1 visits in the pre-protocol group and 12.8 visits in the post-protocol group. In the pre-protocol group, 4 patients (33%) were in the improvement group, and 8 patients (67%) were in the poor response group. In the post-protocol group, 11 patients (85%) were in the improvement group, and 2 patients (15%) were in the poor response group. The proportion of the improvement group significantly increased before and after the protocol creation (Chi-square test P = 0.015).
By creating the protocol, it became possible to accurately treat lateral epicondylitis of the humerus regardless of years of experience, and the proportion of the improvement group significantly increased after the protocol creation. Therefore, it was considered that standardizing treatment through protocol creation was useful. Future challenges include improving treatment techniques and ensuring patients thoroughly perform stretching to further improve treatment effects.
This survey revealed that standardizing treatment through protocol creation was useful.This survey revealed that standardizing treatment through protocol creation was useful.
Protocol
Stretch
