Strengthening of Rotator Cuff and Scapular Muscles in Patients With Lateral Elbow Tendinopathy: A Randomized Controlled Study
Archives of Physical Medicine and Rehabilitation, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.apmr.2026.05.006
- Dergi Adı: Archives of Physical Medicine and Rehabilitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, MLA - Modern Language Association Database, SportDiscus, MLA International Bibliography
- Anahtar Kelimeler: Exercise, Function, Lateral elbow tendinopathy, Pain, Randomized controlled trial, Rehabilitation, Upper extremity
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır
Özet
Objective: To assess the impact of scapular and rotator cuff muscle strengthening exercises in addition to an elbow-focused rehabilitation program for patients with lateral elbow tendinopathy (LET). Design: Prospective, parallel group, randomized controlled trial. Setting: Yalova Research and Training Hospital. Participants: Individuals diagnosed with LET, between 18 and 65 years of age, unilateral pain for a minimum of 3 months, and pain in at least 2 of the 4 clinical tests (Cozen's, Maudsley, Mill's maneuver, and Thomsen's tests). Interventions: Participants were randomly assigned to 2 groups. Group 1 (n=29) received rotator cuff and scapular muscle strengthening exercises in addition to wrist extensor exercises, whereas Group 2 (n=29) performed only wrist extensor exercises. Participants in both groups received education on activity modifications. Supervised exercise programs for both groups conducted twice a week for 8 weeks. Main Outcome Measures: The primary outcomes were the Patient-Rated Tennis Elbow Evaluation (PRTEE) and Numerical Pain Rating Scale (NPRS). Secondary outcomes included maximum and pain-free grip strength, pressure pain threshold (PPT), rotator cuff and scapular muscles strength, and Global Rating of Change score. Results: A total of 58 participants (mean age 40.72±8.36y, 63% female, average symptom durations 35.2mo) completed primary and secondary outcomes at each follow-up time point. The mean difference (95% confidence interval) between Group 1 and Group 2 for PRTEE score was −13.06 [−16.73, 9.39] at 1-year follow-up. Group-by-time interaction for repeated measures analysis of covariance was significant for NPRS-activity and NPRS-rest, maximum and pain-free grip strength, PPT, and strength of rotator cuff and scapular muscles (P<.05). Conclusions: This study provides evidence of added benefit for the addition of rotator cuff and scapular muscle strengthening exercises to an elbow-focused rehabilitation program for patients with LET compared with an exercise program that targets the wrist extensors alone.