Scapular PNF Versus Shoulder Strengthening Exercises in Patients With Lateral Epicondylitis.

Scapular Proprioception Neuromuscular Facilitation Versus Shoulder Strengthening Exercises in Patients With Lateral Epicondylitis.

The purpose of this study is to compare between the effect of scapular proprioceptive neuromuscular facilitation versus shoulder and scapular strengthening exercise on pain, functional outcome and grip strength in patients with lateral epicondylitis.

There is no standard treatment for lateral epicondylitis, it is always a combination of physical therapy modalities aimed to reduce pain and increase the ability to return functional activities participation. Accordingly, many researchers have added shoulder strengthening exercise to the rehabilitation plan for treating lateral epicondylitis.

Consequently, development of new concept of scapula motor control exercise using proprioceptive neuromuscular facilitation to add proximal stability to patients with lateral epicondylitis may be beneficial. We believe that this study can serve as a step toward documenting the evidence of scapular proprioceptive neuromuscular facilitation exercise in the treatment of patients with lateral epicondylitis which was not available before.

Patients with lateral epicondylitis will be recruited after approval of ethical committee of the faculty of physical therapy, Cairo University. All participants will sign a written informed consent form. After group assignment, patients' demographics will be collected, and then assessment of pain, function and grip strength will be performed. The same assessment procedure will be conducted by the end of the treatment (by the end of the 12th visit).

The study will be two comparative groups, pre-post experimental design, the subjects will be randomly assigned into one of two groups:

• Group (I) : will receive scapular proprioceptive neuromuscular facilitation exercises.
• Group (II) : will receive shoulder strengthening exercises.

Inclusion Criteria:

• Patients will be included if they have the following criteria:

  • Fifty-two male and female subjects.
  • Patients complaining of chronic lateral epicondylitis (more than three months).
  • Age between 20-50.

Exclusion Criteria:

• Patients will be excluded if they had any of the following conditions:

  • Received physiotherapy in last 3 months.
  • Received corticosteroids injection in lateral epicondyle in last 3 months.
  • Receiving anti-inflammatories medications on regular basis.
  • Had neurologic problems in shoulder, neck and thoracic regions.
  • Had history of rheumatic disease.
  • Had cooperation difficulties due to cognitive disorders. All Patients will be instructed to keep away from activities that aggravate the symptoms such as grasping, lifting, knitting and using a screwdriver during the treatment period.