- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07495254
Effectiveness of Combined Super Inductive System (SIS) Therapy With Therapeutic Exercise and Health Education in Lateral Elbow Tendinopathy (SIS)
Effectiveness of Combined Super Inductive System (SIS) Therapy With Therapeutic Physical Therapy Exercise and Health Education in Lateral Elbow Tendinopathy
Background Lateral epicondylalgia is the most common cause of lateral elbow pain and affects approximately 1% to 3% of the population. It reduces strength, functionality, and quality of life, leading to limitations in work and daily activities and representing a relevant public health concern.
Current scientific evidence suggests conservative physical therapy as the first-line treatment; however, heterogeneity exists among approaches, and clinical guidelines remain unclear. Rest and pharmacological treatment may provide short-term relief but do not resolve the underlying condition and may lead to recurrences.
Therapeutic exercise has been shown to improve pain, strength, and function and is recommended as a first-line conservative intervention due to its favorable cost-benefit ratio. Thermotherapy and electrotherapy may also reduce pain and improve function compared with placebo.
This study aims to evaluate the efficacy of the Super Inductive System (SIS) combined with a conventional physical therapy program.
Hypothesis SIS therapy, combined with an upper extremity therapeutic exercise program and health education, will reduce pain, improve mobility and limb function, increase grip strength, facilitate return to activities of daily living (ADLs), and enhance perceived quality of life in individuals with lateral elbow tendinopathy.
Objective To assess the effectiveness of SIS combined with therapeutic exercise and health education in adults aged 18 years and older with lateral elbow tendinopathy, compared with the application of SIS at a non therapeutic dose combined with conventional therapeutic exercise and health education.
Methodology A prospective, experimental, randomized clinical trial will be conducted using a triple blind design (principal investigator, assessor, and participant). The study will include an intervention group (IG) (SIS at a therapeutic dose plus therapeutic exercise and health education) and a control group (CG) (SIS at a non therapeutic dose plus therapeutic exercise and health education).
This multicenter study will take place at three Rehabilitation and Physical Therapy Services (Mataró, Sant Andreu-Barcelona, and Drassanes-Barcelona), all part of the Primary Care network of the Catalan Health Institute (ICS).
Data collection will occur at baseline, post treatment, and at 3 and 6 month follow ups.
Outcome measures will assess pain using the Visual Analog Scale (VAS) and algometry, mobility through goniometric evaluation, upper limb function using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), grip strength with dynamometry, health related quality of life with the EQ 5D 5L, and elbow specific pain and functional status using the Patient-Rated Tennis Elbow Evaluation (PRTEE).
Inferential analyses will be performed for within group and between group comparisons. Data will be processed in accordance with current legislation.
Data management will be performed using REDCap (Research Electronic Data Capture).
Expected Outcomes A statistically significant improvement is expected in the intervention group compared with the control group. The use of SIS may contribute to reduced recovery time, fewer and shorter temporary work disabilities, and lower pharmaceutical costs among individuals with lateral epicondylalgia.
Applicability and Relevance SIS is an innovative non invasive therapeutic technology that reduces acute and chronic pain, improves joint mobility, and promotes muscle strengthening in tendinopathies. Demonstrating its effectiveness and cost efficiency may support its incorporation into routine clinical practice, potentially reducing treatment duration, recovery time, and reliance on pharmacological therapy.
This study will provide evidence to inform the implementation of SIS as an additional therapeutic tool in primary care physical therapy and rehabilitation settings.
Study Overview
Status
Detailed Description
Background Lateral elbow tendinopathy, commonly referred to as lateral epicondylalgia or "tennis elbow," is the most frequent cause of lateral elbow pain in adults and represents a major musculoskeletal complaint in Primary Care. It is estimated to affect 1-3% of the population annually, with a peak incidence between 40 and 59 years. This condition is characterized by degenerative changes of the extensor carpi radialis brevis and, less frequently, the common extensor tendon. Clinically, individuals typically present with lateral epicondylar pain, decreased grip strength, functional impairment, and reduced quality of life, often affecting work performance and daily activities.
Diagnosis is mainly clinical, based on pain reproduction during resisted wrist extension or gripping tasks, and through positive provocative maneuvers such as Cozen's and Mill's tests. Additional assessments include pain intensity scales (VAS, NRS), pressure pain threshold via algometry, and grip strength using a JAMAR dynamometer. Ultrasound imaging may supplement clinical evaluation in selected cases.
Conservative management is considered the first-line approach for lateral elbow tendinopathy. Structured therapeutic exercise, including eccentric, isometric, and progressive strengthening programs, has demonstrated consistent benefits in reducing pain and improving function, with a favorable cost-benefit ratio. Manual therapy techniques used in combination with exercise may enhance outcomes. Electrotherapy modalities such as Transcutaneous Electrical Nerve Stimulation (TENS), laser therapy, iontophoresis, shortwave diathermy, and pulsed electromagnetic fields (PEMF) have shown varying degrees of effectiveness; however, heterogeneity in treatment protocols and evidence quality limits generalizability. Adjunctive treatments, such as orthoses, kinesiotape, and cryotherapy, may provide temporary symptom relief. More invasive options, such as corticosteroid injections, platelet-rich plasma, or surgery, are typically reserved for refractory cases and may be associated with adverse effects or limited long-term benefit.
The Super Inductive System (SIS) is a high-intensity pulsed electromagnetic fields (PEMF) technology capable of generating electromagnetic fields of up to approximately 2.5 Tesla. The device induces deep neuromuscular stimulation, producing muscle contractions and neuromodulatory effects that may reduce pain, improve joint mobility, and promote strengthening. Preliminary evidence, primarily from small-sample pilot studies and case series, suggests that SIS may generate immediate and short-term pain reduction and possibly contribute to tendon microstructural recovery. Despite promising findings, robust clinical trials evaluating SIS in lateral elbow tendinopathy are scarce, highlighting the need for higher-quality evidence.
Rationale Given the prevalence, functional impact, and healthcare burden associated with lateral elbow tendinopathy, it is essential to evaluate interventions capable of improving patient outcomes and reducing clinical, occupational, and pharmacological costs. In Primary Care settings, where most cases are managed, optimized conservative approaches are particularly relevant. While therapeutic exercise and education remain the cornerstone of treatment, incorporating SIS may provide additional benefits, including enhanced pain reduction, improved muscle activation, and accelerated functional recovery.
There is an important evidence gap regarding the integration of SIS into multimodal rehabilitation programs for lateral elbow tendinopathy. Current literature is limited by small sample sizes, methodological variability, and short follow-up durations. This trial addresses a relevant clinical question: whether adding SIS at a therapeutic dose to a standardized exercise and education protocol provides superior outcomes compared with an active placebo SIS dose combined with the same conservative care.
Hypothesis The study hypothesizes that the application of therapeutic dose Super Inductive System (SIS) therapy, when combined with an upper extremity therapeutic exercise program and health education, will result in greater clinical improvement than a non therapeutic SIS dose combined with the same exercise and education protocol. Specifically, it is expected that participants receiving therapeutic dose SIS will exhibit a more pronounced reduction in pain intensity, greater improvements in elbow mobility and upper limb function, increased grip strength, enhanced performance of daily activities, and better health related quality of life throughout the intervention and follow up periods.
Objectives
Primary Objective:
To evaluate the effectiveness of therapeutic-dose SIS combined with therapeutic exercise and health education in adults aged 18 years or older with lateral elbow tendinopathy, compared with a non-therapeutic SIS dose plus exercise and education.
Secondary Objectives:
- Quantify changes in pain using VAS and algometry.
- Assess changes in active elbow mobility using a goniometer.
- Evaluate functional improvement using the QuickDASH.
- Determine changes in grip strength measured with a JAMAR dynamometer.
- Analyze health-related quality of life using the EQ 5D 5L.
- Evaluate elbow-specific pain and disability using the PRTEE.
- Document adherence to exercise and treatment attendance.
- Register adverse events associated with the interventions.
- Compare medication use before and after treatment.
- Assess temporary work disability (frequency and duration).
- Compare baseline clinical and sociodemographic characteristics between groups.
Study Design This study is a multicenter, randomized, prospective, experimental clinical trial with a triple-blind structure. Participants, the principal investigator, and the outcome assessors will remain blinded to group allocation. Due to the nature of the intervention, physical therapists administering SIS cannot be blinded, but they will not participate in outcome assessment or data analysis.
Randomization will be simple, using a computer-generated numerical sequence, with allocation concealed through opaque envelopes handled by administrative staff. The evaluator responsible for baseline and follow-up assessments will have no access to the allocation sequence. Participants will be informed that two active modalities of SIS are compared but will not be informed which dosing protocol they receive.
The trial will be conducted in three Primary Care Rehabilitation and Physical Therapy Services: Mataró (Barcelona), Sant Andreu (Barcelona), and Drassanes (Barcelona), all part of the Catalan Health Institute. Recruitment, intervention, and follow-up assessments will occur between 2026 and 2027, with final data analysis and dissemination extended through 2028. The sample size has been calculated based on detecting a ≥20% difference in primary outcomes with α = 0.05, statistical power >0.80, and accounting for 20% attrition, resulting in a target enrollment of 224 participants (112 per group).
Participating Centers
- Rehabilitation and Physical Therapy Service, Mataró-Barcelona
- Rehabilitation and Physical Therapy Service, Sant Andreu-Barcelona
- Rehabilitation and Physical Therapy Service, Drassanes-Barcelona These centers share comparable resources, equipment, and clinical pathways, ensuring protocol standardization and facilitating generalizability across Primary Care settings.
Scope and Study Period The intervention phase of the study is planned to begin in 2026, with participant recruitment, treatment delivery, and follow up assessments extending through the end of 2027. Final data verification, analysis, manuscript preparation, and dissemination activities are expected to continue into 2028. This timeline ensures adequate follow up for medium term outcomes and sufficient power to detect clinically meaningful changes.
Population, Eligibility, and Sampling Strategy The reference population comprises adults aged 18 years and older presenting with acute or chronic lateral elbow tendinopathy. Eligible individuals will be those referred to the participating rehabilitation services from Family Medicine, Rehabilitation, Orthopedics, or Rheumatology. The sampling strategy involves consecutive recruitment of all eligible and consenting individuals until the required sample size is achieved.
Sample size calculations were based on detecting a minimum clinically important difference of at least 20% in the primary outcome variables, using a two sided significance level of 0.05 and statistical power above 0.80. The resulting target sample size is 186 participants (93 per group), increased to 224 participants in total to account for an estimated 20% loss to follow up.
Recruitment and Randomization Procedures Recruitment will be performed through structured referral pathways within the Primary Care network. After a screening review by the service lead, eligible individuals will be contacted by administrative staff to schedule an initial evaluation with a dedicated assessor. During this visit, baseline data will be collected, inclusion/exclusion criteria will be verified, and informed consent (including optional image use) will be obtained.
Allocation will follow a simple randomization process using a numeric sequence generated electronically. Concealment will be ensured using opaque, sealed envelopes. After baseline assessment, the evaluator assigns the envelope to administrative staff, who then schedule participants and communicate the allocation only to the physical therapists responsible for treatment delivery. Throughout the study, blinding will be maintained for participants, the principal investigator, and all assessors involved in data collection.
Interventions Treatment Components Shared by Both Groups
Both the intervention and control groups will receive:
- a standardized therapeutic exercise program, with weekly progression based on pain, mobility, and strength findings, performed four days per week, consisting of 2 sets of 10 repetitions per exercise, supplemented with self massage of the affected musculature;
- a health education component including information on the pathology, ergonomics, preventive guidelines, and recommendations for daily activities.
Participants will receive written materials, visual illustrations, and QR codes linking to exercise videos to support adherence at home.
Intervention Group (IG): Therapeutic Dose SIS Participants in the IG will receive therapeutic dose SIS using the BTL 6000 Super Inductive System Elite, applying a predefined 10 minute protocol for elbow tendinopathies. The intensity will be adjusted according to participant tolerance to achieve motor level stimulation and neuromodulatory effects. SIS will be applied after exercise and education to capitalize on its expected analgesic and muscle activation effects.
Control Group (CG): Active Placebo SIS Participants in the CG will receive a non therapeutic SIS protocol (active placebo), using low intensity parameters (1 Hz, 59 second pause, 1% intensity) for 10 minutes, providing an experience that mimics treatment without delivering clinically meaningful stimulation.
Both groups will attend 2 sessions per week for a total of 8 sessions. Attendance and reasons for non attendance will be systematically documented to quantify adherence and absenteeism.
Outcome Measures and Assessment Tools All outcome measures were selected based on their clinical relevance, validity, and reliability in lateral elbow tendinopathy.
Primary Outcome:
• Pain intensity measured using the Visual Analog Scale (VAS) and pressure pain threshold assessed via algometry.
Secondary Outcomes:
- Elbow range of motion measured using a manual goniometer (flexion, extension, pronation, supination).
- Grip strength measured with a JAMAR hydraulic dynamometer (three maximal trials with standardized positioning).
- Upper limb function assessed using the QuickDASH.
- Health related quality of life measured via the EQ 5D 5L.
- Elbow specific pain and disability measured using the PRTEE.
- Exercise adherence recorded through participant logs.
- Adverse events monitored using a standardized questionnaire.
- Medication consumption related to pain management (pre/post comparison).
- Temporary work disability, including number and duration of episodes.
- Session attendance and percentage of absenteeism.
Measurement Schedule
All participants will undergo assessments at four timepoints:
- Baseline (pre intervention)
- End of treatment (after 8 sessions)
- Three month follow up
- Six month follow up This schedule enables evaluation of both immediate therapeutic effects and medium term outcomes related to functional recovery and symptom recurrence.
Procedures, Operational Flow, and Organization
The study will follow a coordinated workflow involving clinical, administrative, and research personnel to ensure fidelity to the protocol and standardization across the three centers. Key organizational elements include:
- Internal team training involving the principal investigator, evaluators, and physical therapists to ensure understanding of study procedures, documentation, and treatment protocols.
- Baseline assessment visits lasting approximately 45 minutes, where evaluators conduct clinical examination, administer instruments, and manage informed consent.
- Secure management of randomization envelopes and coordination between evaluators, administrative staff, and physical therapists to maintain blinding.
- Systematic recording of follow up assessments and adherence using REDCap and the ICS clinical information system (eCAP).
- Regular monitoring of sessions, dropouts, and adverse effects by the research team.
Sociodemographic and Clinical Variables In addition to the primary and secondary outcomes, the study will collect relevant sociodemographic and clinical variables, including age, sex, educational level, marital status, living situation, employment status, dominant hand, affected limb, medical history, duration of symptoms, referring clinician, diagnostic tests performed, use of orthoses, sports participation, temporary disability status and dates, and pre and post treatment pharmacological management.
Data Management and Storage Study data will be collected and managed using REDCap, with secure access, audit trails, and version control. Data will also be stored on institutionally approved encrypted servers (Office 365 ICS cloud), with strictly controlled access limited to investigators. Each participant will be assigned a randomly generated study code with no direct link to identifiable clinical information in the main dataset. The key linking these codes to personal identifiers will be stored separately in an encrypted and password protected file accessible only to the principal investigators.
Data retention will comply with institutional and legal requirements, with all study data preserved for five years following project completion. No international data transfers are planned, and no data will be shared with third parties unless legally required or authorized by participants.
Ethical Considerations The study adheres to the ethical guidelines established by the Declaration of Helsinki (Fortaleza amendment), Good Clinical Practice standards, the European Union General Data Protection Regulation (GDPR), and Spanish data protection regulations (LOPDGDD). Ethical approval will be sought from the IDIAP Jordi Gol Ethics Committee before initiating recruitment.
Participants will be informed of the study objectives, potential benefits and risks, confidentiality safeguards, data protection measures, and their right to withdraw at any time without prejudice. Consent procedures include optional authorization for image use where applicable.
Safety and Adverse Events Monitoring All adverse events potentially related to SIS or the therapeutic exercise program will be systematically recorded using a standardized form. In cases of intense or persistent discomfort, treatment may be paused or modified as clinically appropriate. Adverse events will be compared between the intervention and control groups using descriptive statistics.
Statistical Analysis Plan
The statistical analysis will include:
- Descriptive statistics (means, SD, medians, IQR, frequencies, percentages).
- Tests of normality (Shapiro-Wilk or Kolmogorov-Smirnov depending on sample size).
- Baseline group comparisons using Student's t test or Mann-Whitney U test for continuous variables and chi square tests for categorical variables.
- Within group pre post changes assessed via paired t tests or Wilcoxon signed rank tests.
- Analysis of changes across all timepoints (baseline, final, 3 and 6 months) using repeated measures ANOVA or Friedman tests, with Bonferroni adjustments for multiple comparisons.
- Multivariate modeling incorporating variables with p < 0.25 in univariate analyses or those considered clinically relevant, assessing confounding, interactions, and collinearity.
- Statistical significance set at α = 0.05.
Anticipated Challenges and Limitations Potential limitations include loss to follow up due to absenteeism, health changes, or participant motivation. The protocol accounts for this through oversampling and systematic follow up reminders. Variability in adherence to home exercises will be mitigated through clear written instructions, video resources, and monitoring logs. The study attempts to control for concurrent treatments through careful documentation and consideration during analysis.
Expected Impact, Utility, and Applicability Integrating therapeutic dose SIS into a multimodal rehabilitation program is expected to enhance recovery by reducing pain more effectively, improving mobility and function, strengthening grip, and improving quality of life. Additionally, improvements may translate into reduced medication use, fewer temporary work disability days, and decreased healthcare utilization. Findings will provide robust evidence regarding the safety and effectiveness of SIS in Primary Care and may support its adoption into routine rehabilitation practice.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Anna Escribà Salvans, Degree in Physical Therapy
- Phone Number: +34616384685
- Email: anna.escriba1@uvic.cat
Study Contact Backup
- Name: Maria del Carmen Sánchez Mato
- Phone Number: +34667617354
- Email: mariadelcarmen.sanchez@uvic.cat
Study Locations
-
-
Barcelona
-
Mataró, Barcelona, Spain, 08303
- Anna Escribà Salvans
-
Contact:
- Maria del Carmen Sánchez Mato
- Phone Number: +34667617354
- Email: mariadelcarmen.sanchez@uvic.cat
-
Contact:
- Anna Escribà Salvans
- Phone Number: +34616384685
- Email: annaescriba1@uvic.cat
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults aged 18 years or older.
- Clinical diagnosis of lateral elbow tendinopathy confirmed by a Family Care Physician, Rehabilitation Physiatrist, Orthopedic Surgeon, or Rheumatologist.
- Referral to one of the three participating Rehabilitation and Physical Therapy Services (Mataró, Sant Andreu, or Drassanes).
- Presence of at least one positive provocative test (Cozen's test or Mill's test).
- Ability and willingness to participate in the study after reading the patient information sheet and signing the informed consent, including consent for image use.
Exclusion Criteria:
- Medial elbow tendinopathy.
- Recent traumatic injury to the affected upper limb within the past 6 months.
- Passive elbow joint range of motion limited by more than 20°.
- Injection in the affected elbow within 6 weeks prior to baseline assessment.
- Systemic inflammatory, autoimmune, infectious, or neoplastic disease.
- Pregnancy.
- Metal implants in the affected elbow region.
- Pacemaker or implantable defibrillator.
- Radial tunnel syndrome / Frohse arcade syndrome.
- Coagulation disorders.
- Cognitive or sensory impairment that precludes participation in the study procedures.
- Central sensitization syndromes (e.g., fibromyalgia, chronic fatigue syndrome).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Therapeutic-dose Super Inductive System (SIS) + Therapeutic Exercise + Health Education
Participants in this arm will receive therapeutic-dose Super Inductive System (SIS) treatment using the BTL-6000 Super Inductive System Elite, combined with a standardized therapeutic exercise program and a brief health education component.
Treatment is provided twice per week for a total of eight sessions.
Assessments will be performed at baseline, at the end of treatment, and at 3- and 6-month follow-ups.
|
Therapeutic-dose Super Inductive System (SIS) delivered with the BTL-6000 Super Inductive System Elite for 10 minutes using the protocol for elbow tendinopathy.
Intensity is adjusted to the participant's tolerated motor threshold
Standardized upper-extremity therapeutic exercise program with weekly progression based on mobility, strength, and pain.
Exercises are performed four days per week, two sets of ten repetitions per exercise, and include self-massage of the affected musculature.
Brief education session including information about lateral elbow tendinopathy, ergonomic recommendations, preventive strategies, and guidance for daily activities.
|
|
Active Comparator: Non-therapeutic SIS (Active Placebo) + Therapeutic Exercise + Health Education
Participants in this arm will receive a non-therapeutic SIS protocol (active placebo: 10 minutes at 1 Hz, 59-second pause, 1% intensity) delivered with the BTL-6000 Super Inductive System Elite, together with the same standardized therapeutic exercise program and health education as the intervention arm.
Treatment is provided twice per week for a total of eight sessions.
Assessments will be performed at baseline, at the end of treatment, and at 3- and 6-month follow-ups.
|
Standardized upper-extremity therapeutic exercise program with weekly progression based on mobility, strength, and pain.
Exercises are performed four days per week, two sets of ten repetitions per exercise, and include self-massage of the affected musculature.
Brief education session including information about lateral elbow tendinopathy, ergonomic recommendations, preventive strategies, and guidance for daily activities.
Non-therapeutic SIS protocol delivered for 10 minutes at 1 Hz with a 59-second pause and 1% intensity using the BTL-6000 Super Inductive System Elite.
Used as an active placebo.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in pain intensity measured with the 10-cm Visual Analog Scale (VAS)
Time Frame: Baseline, 4 weeks (end of treatment), 3 months, and 6 months after end of treatment. Unit of Measure: Units on a 10 cm scale.
|
Pain intensity will be assessed using a 10 cm Visual Analog Scale (VAS), where 0 indicates "no pain" and 10 indicates "worst imaginable pain."
Participants mark their perceived pain intensity on the line, and the score is recorded in centimeters.
|
Baseline, 4 weeks (end of treatment), 3 months, and 6 months after end of treatment. Unit of Measure: Units on a 10 cm scale.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pressure Pain Threshold measured by algometry
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: kg/cm²
|
Pressure Pain Threshold (PPT) will be assessed using a handheld algometer.
Progressive pressure is applied perpendicular to the skin over the affected lateral epicondyle until the participant indicates the first sensation of pain.
Three measurements will be taken, and the mean value will be used for analysis.
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Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: kg/cm²
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Elbow range of motion measured with a goniometer
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Degrees (°).
|
Elbow joint mobility will be assessed using a standard universal goniometer, measuring active flexion, extension, pronation, and supination.
Three measurements will be recorded for each movement, and the mean value will be used.
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Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Degrees (°).
|
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Grip strength measured with JAMAR dynamometer
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Kilograms (kg).
|
Grip strength will be measured using a JAMAR hydraulic hand dynamometer.
Participants will perform three maximal voluntary contractions with the affected hand, and the mean force output will be recorded.
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Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Kilograms (kg).
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Upper limb disability measured with the QuickDASH score
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Score (0-100)
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Upper limb function and disability will be evaluated using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire.
Total scores range from 0 (no disability) to 100 (severe disability).
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Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Score (0-100)
|
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Health related quality of life measured with the EQ 5D 5L
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Index score; VAS score (0-100)
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Quality of life will be assessed using the EQ 5D 5L, which measures health status across five dimensions and includes a Visual Analog Scale (0 = worst health, 100 = best health).
Both the index value and the VAS score will be recorded.
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Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Index score; VAS score (0-100)
|
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Elbow specific pain and function measured with the PRTEE
Time Frame: Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Score (0-100).
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The Patient Rated Tennis Elbow Evaluation (PRTEE) will be used to assess pain and functional difficulty related to lateral elbow tendinopathy.
Scores range from 0 (best) to 100 (worst), combining pain and function subscales.
|
Baseline, 4 weeks, 3 months, and 6 months after end of treatment. Unit of Measure: Score (0-100).
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Collaborators and Investigators
Collaborators
Investigators
- Study Director: Anna Escribà Salvans, Universitat de Vic, Universitat Central de Catalunya (UVIC-UCC)
Publications and helpful links
General Publications
- 42. Van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. julio de 2012;15(5):708-15.
- 41. EuroQol Research Foundation. EQ-5D-5L User Guide [Internet]. Euroqool; 2019. Disponible en: www.euroqol.org.
- 40. Zhou T, Guan H, Wang L, Zhang Y, Rui M, Ma A. Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review. Front Public Health. 29 de junio de 2021;9:675523.
- 39. Hernandez G, Garin O, Pardo Y, Vilagut G, Pont À, Suárez M, et al. Validity of the EQ-5D 5L and reference norms for the Spanish population. Qual Life Res. 2018;27(9):2337-48.
- 38. García González GLA, Aguilar Sierra SF, Rodríguez Ricardo RMC. Validación de la versión en español de la escala de función del miembro superior abreviada: Quick Dash. Rev Colomb Ortop Traumatol. 1 de diciembre de 2018;32(4):215-9.
- 37. Mathiowetz V. Comparison of Rolyan and Jamar dynamometers for measuring grip strength. Occup Ther Int. 2002;9(3):201-9.
- 36. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. febrero de 1985;66:69-74.
- 35. Hanks J, Myers B. Validity, Reliability, and Efficiency of a Standard Goniometer, Medical Inclinometer, and Builder's Inclinometer. Int J Sports Phys Ther. 2023 Aug 1;18(4):989-996. doi: 10.26603/001c.83944. PMID: 37547826; PMCID: PMC10399115.
- 34. Chapleau J, Canet F, Petit Y, Laflamme GY, Rouleau DM. Validity of goniometric elbow measurements: comparative study with a radiographic method. Clin Orthop Relat Res. 2011 Nov;469(11):3134-40. doi: 10.1007/s11999-011-1986-8. Epub 2011 Jul 21. PMID: 21779866; PMCID: PMC3183177.
- 33. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res. 2011;63(S11):S240-52.
- 32. Kouloulas EJ. Peripheral application of repetitive pulse magnetic stimulation on joint contracture for mobility restoration: controlled randomized study. Int J Physiother. 2016;3(5):519-524. doi: 10.15621/ijphy/2016/v3i5/117441.
- 31. Zarkovic D, Prouza O. Acute epicondylitis and chronic shoulder pain management with high-intensity electromagnetic stimulation: a case study. J Pain Manag. 2024;15(3):123-130. doi: 10.1234/jpm.2024.56789.
- 30. Kholinne E, Singjie LC, Anastasia M, Liu F, Anestessia IJ, Kwak JM, Jeon IH. Comparison of Clinical Outcomes After Different Surgical Approaches for Lateral Epicondylitis: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2024 May 2;12(5):23259671241230291. doi: 10.1177/23259671241230291. PMID: 38708009; PMCID: PMC11067684.
- 29. Ma X, Qiao Y, Wang J, Xu A, Rong J. Therapeutic Effects of Dry Needling on Lateral Epicondylitis: An Updated Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2024 Mar 13:S0003-9993(24)00823-2. doi: 10.1016/j.apmr.2024.02.713. Epub ahead of print. PMID: 38484834.
- 28. Navarro-Santana MJ, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, López-de-Uralde-Villanueva I, Fernández-de-Las-Peñas C, Plaza-Manzano G. Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis. Clin Rehabil. 2020 Nov;34(11):1327-1340. doi: 10.1177/0269215520937468. Epub 2020 Jun 23. PMID: 32576044.
- 27. Rosso F, Bonasia DE, Marmotti A, Cottino U, Rossi R. Mechanical Stimulation (Pulsed Electromagnetic Fields "PEMF" and Extracorporeal Shock Wave Therapy "ESWT") and Tendon Regeneration: A Possible Alternative. Front Aging Neurosci. 2015 Nov 9;7:211. doi: 10.3389/fnagi.2015.00211. PMID: 26617513; PMCID: PMC4637423.
- 26. Karanasios S, Tsamasiotis GK, Michopoulos K, Sakellari V, Gioftsos G. Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis. Clin Rehabil. 2021 Oct;35(10):1383-1398. doi: 10.1177/02692155211006860. Epub 2021 Apr 4. PMID: 33813913.
- 25. Yao G, Chen J, Duan Y, Chen X. Efficacy of Extracorporeal Shock Wave Therapy for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Biomed Res Int. 2020 Mar 18;2020:2064781. doi: 10.1155/2020/2064781. PMID: 32309425; PMCID: PMC7106907.
- 24. Heales LJ, McClintock SR, Maynard S, Lems CJ, Rose JA, Hill C, Kean CO, Obst S. Evaluating the immediate effect of forearm and wrist orthoses on pain and function in individuals with lateral elbow tendinopathy: A systematic review. Musculoskelet Sci Pract. 2020 Jun;47:102147. doi: 10.1016/j.msksp.2020.102147. Epub 2020 Mar 5. PMID: 32452393.
- 23. George CE, Heales LJ, Stanton R, Wintour SA, Kean CO. Sticking to the facts: A systematic review of the effects of therapeutic tape in lateral epicondylalgia. Phys Ther Sport. 2019 Nov;40:117-127. doi: 10.1016/j.ptsp.2019.08.011. Epub 2019 Aug 27. PMID: 31518778.
- 22. Landesa-Piñeiro L, Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: A systematic review. J Back Musculoskelet Rehabil. 2022;35(3):463-477. doi: 10.3233/BMR-210053. PMID: 34397403.
- 21. Torretta E, Moriggi M, Capitanio D, Orfei CP, Raffo V, Setti S, Cadossi R, de Girolamo L, Gelfi C. Effects of Pulsed Electromagnetic Field Treatment on Skeletal Muscle Tissue Recovery in a Rat Model of Collagenase-Induced Tendinopathy: Results from a Proteome Analysis. Int J Mol Sci. 2024 Aug 14;25(16):8852. doi: 10.3390/ijms25168852. PMID: 39201538; PMCID: PMC11354614.
- 20. Wilms P, Schröder J, Scheit L, Reer R. Die Wirkung von elektromagnetischen Feldern auf Tendinopathien: Studie zur Effektanalyse einer singulären Anwendung von hochenergetischen gepulsten elektromagnetischen Feldern [The effect of electromagnetic fields on tendinopathies: Study on the effect analysis of a singular application of high-energy pulsed electromagnetic fields]. Orthopadie (Heidelb). 2024 Sep;53(9):668-676. German. doi: 10.1007/s00132-024-04541-3. Epub 2024 Aug 22. PMID: 39172175; PMCID: PMC11384642.
- 19. Kim YJ, Wood SM, Yoon AP, Howard JC, Yang LY, Chung KC. Efficacy of Nonoperative Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2021 Jan 1;147(1):112-125. doi: 10.1097/PRS.0000000000007440. PMID: 33002980.
- 18. Mascaró A, Cos MA, Morral A, Roig A, Purdam C, Cook J. Load management in tendinopathy: clinical progression for achilles and patellar tendinopathy. Original article. Apunts Med Esport. 2018;53 (197): 19-27.
- 17. Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and Meta-Analysis. J Clin Med. 2021 Sep 1;10(17):3968. doi: 10.3390/jcm10173968. PMID: 34501416; PMCID: PMC8432114.
- 16. Mollazehi N, Mohamadi M, Rezaeian S, Razeghi M. How effective is proprioception exercise on pain, grip force, dexterity and proprioception of elbow joint in patients with tennis elbow? A randomized controlled trial. J Bodyw Mov Ther. 2024 Oct;40:1821-1827. doi: 10.1016/j.jbmt.2024.10.035. Epub 2024 Oct 16. PMID: 39593530.
- 15. Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil. 2014 Jan;28(1):3-19. doi: 10.1177/0269215513491974. Epub 2013 Jul 23. PMID: 23881334.
- 14. Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and Meta-Analysis. J Clin Med. 2021 Sep 1;10(17):3968. doi: 10.3390/jcm10173968. PMID: 34501416; PMCID: PMC8432114.
- 13. Landesa-Piñeiro L, Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: A systematic review. J Back Musculoskelet Rehabil. 2022;35(3):463-477. doi: 10.3233/BMR-210053. PMID: 34397403.
- 12. Wood SM, Yoon AP, Tseng HJ, Yang LY, Chung KC. Comparative Effectiveness of Physical Therapy and Electrophysiotherapy for the Treatment of Lateral Epicondylitis: A Network Meta-Analysis. Plast Reconstr Surg. 2022 Sep 1;150(3):594e-607e. doi: 10.1097/PRS.0000000000009437. Epub 2022 Jul 1. PMID: 35791264.
- 11. Sipers, W. M. W. H., Verdijk, L. B., Sipers, S. J. E., Schols, J. M. G. A., & van Loon, L. J. C. (2016). The Martin Vigorimeter Represents a Reliable and More Practical Tool Than the Jamar Dynamometer to Assess Handgrip Strength in the Geriatric Patient. Journal of the American Medical Directors Association, 17(5), 466.e1-466.e7. https://doi.org/10.1016/j.jamda.2016.02.026.
- 10. Soares MM, Souza PC, Ribeiro AP. Differences in Clinical Tests for Assessing Lateral Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure. Int J Environ Res Public Health. 2023 Jan 18;20(3):1794. doi: 10.3390/ijerph20031794. PMID: 36767167; PMCID: PMC9914816.
- 9. Chesterton LS, Sim J, Wright CC, Foster NE. Interrater Reliability of Algometry in Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters. Clin J Pain. noviembre de 2007;23(9).
- 8. Navarro-Santana MJ, Sanchez-Infante J, Gómez-Chiguano GF, Cummings M, Fernández-de-Las-Peñas C, Plaza-Manzano G. Effects of manual acupuncture and electroacupuncture for lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis. Acupunct Med. 2021 Oct;39(5):405-422. doi: 10.1177/0964528420967364. Epub 2020 Dec 17. PMID: 33334116.
- 7. Kim YJ, Wood SM, Yoon AP, Howard JC, Yang LY, Chung KC. Efficacy of Nonoperative Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Plast Reconstr Surg. 2021 Jan 1;147(1):112-125. doi: 10.1097/PRS.0000000000007440. PMID: 33002980.
- 6. Bretschneider SF, Los FS, Eygendaal D, Kuijer PPFM, van der Molen HF. Work-relatedness of lateral epicondylitis: Systematic review including meta-analysis and GRADE work-relatedness of lateral epicondylitis. Am J Ind Med. 2022 Jan;65(1):41-50. doi: 10.1002/ajim.23303. Epub 2021 Oct 21. PMID: 34674287; PMCID: PMC9297967.
- 5. Lenoir H, Mares O, Carlier Y. Management of lateral epicondylitis. Orthop Traumatol Surg Res. 2019 Dec;105(8S): S241-S246. doi: 10.1016/j.otsr.2019.09.004. Epub 2019 Sep 19. PMID: 31543413.
- 4. Di Filippo L, Vincenzi S, Pennella D, Maselli F. Treatment, Diagnostic Criteria and Variability of Terminology for Lateral Elbow Pain: Findings from an Overview of Systematic Reviews. Healthcare (Basel). 2022 Jun 14;10(6):1095. doi: 10.3390/healthcare10061095. PMID: 35742152; PMCID: PMC9222841.
- 3. Monge Pelegrín E, Garín Portero N. Abordaje de la epicondilitis. Exploración y tratamiento. RSI. Fisioterapia. 26 septiembre 2021. https://revistasanitariadeinvestigacion.com/category/fisioterapia.
- 2. Uttamchandani SR, Phansopkar P. Conservative Management of Lateral Epicondylalgia: A Review. Cureus. 2024 May 8;16(5): e59875. doi: 10.7759/cureus.59875. PMID: 38854316; PMCID: PMC11157989.
- 1. Vinhas A, Almeida AF, Rodrigues MT, Gomes ME. Prospects of magnetically based approaches addressing inflammation in tendon tissues. Adv Drug Deliv Rev. 2023 May;196:114815. doi: 10.1016/j.addr.2023.114815. Epub 2023 Mar 30. PMID: 37001644.
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- SIS_2025
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- STUDY_PROTOCOL
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