Normalized forces and active range of motion in unilateral radial epicondylalgia (tennis elbow)

Study Design: Single group pretest-posttest. Background: There is a lack of consensus concerning the preferred assessmen t and treatment for radial epicondylalgia. Objectives: Determine whether deficiencies in muscle force, joint range of motion, or painful force threshold are detected when measurements from the involved upper extremity are normalized to values from the uninvolved extre mity. Methods and Measures: Ten patients (70% men) 42 +/- 7 years in age with uni lateral radial epicondylalgia participated. The visual analog pain scale an d 6 measurements involving either muscle force, joint range of motion, or p ainful force threshold were examined. Results: When comparing the initial assessments to final assessments, a sig nificant improvement was found for the visual analog pain scale (5 +/- 3 vs 1 +/- 3) and for the following normalized scores: grip (78 +/- 26% vs 101 +/- 20%) and isometric wrist extension forces (68 +/- 24% vs 95 +/- 35%), p ainful force threshold over the lateral epicondyle (49 +/- 22% vs 94 +/- 14 %), and active wrist extension range of motion (83 +/- 13% vs 96 +/- 10%). Conclusions: Normalized force and range of motion measurements following tr eatment for unilateral radial epicondylalgia are sensitive assessments of p atient progress. In comparison with measurements of force and range of moti on that are not adjusted to a baseline score, normalized measurements detec t changes in patient responses when baseline scores vary.