This study aimed to investigate the effect of unsupervised isometric exercise
compared with a wait-and-see approach on pain
, disability, global improvement, and pain
-free grip strength in individuals with lateral elbow tendinopathy.
Forty participants with unilateral lateral elbow tendinopathy of at least 6 wk duration were randomized to either wait-and-see (n
= 19) or a single supervised instruction session by a physiotherapist, followed by an 8-wk unsupervised daily program of progressive isometric exercise
= 21). Primary outcomes were Patient-Rated Tennis Elbow
Evaluation, global rating of change on a six-point scale (dichotomized to success and no success) and pain
-free grip strength at 8 wk. Secondary outcomes were resting and worst pain
on an 11-point numerical rating scale, and thermal and pressure pain
thresholds as a measure of pain
Thirty-nine (98%) participants completed 8-wk measurements. The exercise
group had lower Patient-Rated Tennis Elbow
Evaluation scores compared with wait-and-see at 8 wk (standardized mean difference [SMD], −0.92; 95% confidence interval [CI], −1.58 to −0.26). No group differences were found for success on global rating of change (29% exercise
vs 26% wait-and-see (risk difference, 2.3%; 95% CI, −24.5 to 29.1)), or pain
-free grip strength (SMD, −0.33; 95% CI, −0.97 to 0.30). No differences were observed for all secondary outcomes except for worst pain
, which was moderately lower in the exercise
group (SMD, −0.80; 95% CI, −1.45 to −0.14).
Unsupervised isometric exercise
was effective in improving pain
and disability, but not perceived rating of change and pain
-free grip strength when compared with wait-and-see at 8 wk. With only one of the three primary outcomes being significantly different after isometric
exercises, it is doubtful if this form of exercise
is efficacious as a sole treatment.