The Beneficial Effects of Eccentric Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and Meta-Analysis

Seo Yeon Yoon, Yong Wook Kim, In Soo Shin, Seok Kang, Hyun Im Moon, Sang Chul Lee, Seo Yeon Yoon, Yong Wook Kim, In Soo Shin, Seok Kang, Hyun Im Moon, Sang Chul Lee

Abstract

As a first-line treatment for lateral elbow tendinopathy (LET), eccentric exercise has been suggested as a conservative treatment method. This study aimed to investigate the impact of eccentric exercise on LET with regard to pain reduction, and strength and functional improvement. The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched, and studies up to May 2021 were included if (1) randomization was used for patient allocation, (2) the study comprised patients with LET, (3) the intervention was eccentric exercise, and (4) the primary outcomes included improvement in pain intensity, muscle strength, or function. The meta-analysis comprised of six studies, totaling 429 participants. Additional eccentric exercise with underlying adjuvant therapy significantly improved the visual analog scale (VAS) scores (standardized mean difference [SMD], -0.63; 95% confidence interval [CI], -0.90--0.36) and muscle strength (SMD, 1.05; 95% CI, 0.78-1.33) compared with adjuvant therapy alone. Compared with the concentric or isotonic exercise group, the eccentric exercise group showed significantly improved VAS scores (SMD, -0.30; 95% CI, -0.58--0.02). However, no differences in muscle strength and function were observed between the two groups. Eccentric exercise can improve pain and muscle strength in patients with LET. The limited number of included studies and heterogeneous exercise parameters are important when interpreting these findings.

Keywords: eccentric exercise; function; lateral elbow tendinopathy; pain; tennis elbow.

Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of study search and selection methods.
Figure 2
Figure 2
Risk of bias summary.
Figure 3
Figure 3
Add-on effects of eccentric exercise with adjuvant therapy on (a) pain intensity and (b) muscles strength in lateral elbow tendinopathy.
Figure 3
Figure 3
Add-on effects of eccentric exercise with adjuvant therapy on (a) pain intensity and (b) muscles strength in lateral elbow tendinopathy.
Figure 4
Figure 4
Effects of eccentric exercise compared with those of other exercise (concentric or isotonic) on (a) pain intensity, (b) muscles strength, and (c) function in lateral elbow tendinopathy.

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