Article

OBJECTIVE: To compare the effects of 2 different injection sites of low doses of
botulinum toxin type A with steroid in treating lateral epicondylalgia. DESIGN:
Double-blind, randomized, active drug-controlled trial.
SETTING: Tertiary medical
center. PARTICIPANTS: Patients with lateral epicondylalgia for >6 months were
recruited from a hospital-based outpatient population (N=26).
A total of 66
patients were approached, and 40 were excluded. No participant withdrew because
of adverse effects. INTERVENTIONS: Patients were randomly assigned into 3 groups:
(1) botulinum toxin epic group (n=8), who received 20U of botulinum toxin
injection into the lateral epicondyle; (2) botulinum toxin tend group (n=7), who
received 20U of botulinum toxin injected into tender points of muscles; and (3)
steroid group (n=11), who received 40mg of triamcinolone acetonide injected into
the lateral epicondyle. MAIN OUTCOME MEASURES:
A visual analog scale, a
dynamometer, and the Patient-Rated Tennis Elbow Evaluation were used to evaluate
the perception of pain, maximal grip strength, and functional status,
respectively. Outcome measures were assessed before intervention and at 4, 8, 12,
and 16 weeks after treatment. The primary outcome measure was a visual analog
scale. RESULTS: At 4 weeks after injection, the steroid group was superior to the
botulinum toxin tend group in improvement on the visual analog scale (P=.006),
grip strength (P=.03), and Patient-Rated Tennis Elbow Evaluation (P=.02).
However, these differences were not observed at the 8-, 12-, and 16-week
follow-up assessments. There was no significant difference between the steroid
and botulinum toxin epic groups. CONCLUSIONS: Injections with botulinum toxin and
steroid effectively reduced pain and improved upper limb function in patients
with lateral epicondylalgia for at least 16 weeks. The onset of effect was
earlier in the steroid and botulinum toxin epic groups than in the botulinum
toxin tend group.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS