Evidence map›Paper›PMID 31679521›Full record

Trial reportBMC musculoskeletal disorders2019

Prolotherapy injections and physiotherapy used singly and in combination for lateral epicondylalgia: a single-blinded randomised clinical trial.

Michael Yelland, David Rabago, Michael Ryan, Shu-Kay Ng, Dinusha Vithanachchi, Nagarajan Manickaraj, Leanne Bisset

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05238090 (Efficacy of a Whole Upper Limb Stretching Protocol for Lateral Epicondylitis), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05238090 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Efficacy of a Whole Upper Limb Stretching Protocol for Lateral Epicondylitis

TypeinterventionalSponsorUniversity of CadizRan2022 to 2023Enrolled40ConditionsEpicondylitis, Lateral, Elbow Tendinopathy, Epicondylitis of the Elbow, EpicondylitisArmsPassive and active analytical stretching exercises, Static stretching of the extensor carpi radialis brevis and eccentric strengthening of the wrist extensor musculature
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Review
  6. Tendon injections - upper extremity.Skeletal radiology · 2023
    Review
  7. Article
  8. Article
  9. Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 3 countries.

Michael YellandMenzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, 4222, Australia.
David RabagoSchool of Medicine and Public Health, University of Wisconsin, Madison, USA.
Michael RyanSchool of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Shu-Kay NgMenzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, 4222, Australia.
Dinusha VithanachchiSchool of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Nagarajan ManickarajSchool of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia.
Leanne BissetSchool of Allied Health Sciences, Griffith University, Gold Coast, Queensland, Australia. l.bisset@griffith.edu.au.ORCID http://orcid.org/0000-0001-8807-7093
Griffith University · AUUniversity of Wisconsin–Madison · US

Funding

Australasian Faculty of Musculoskeletal Medicine Grant nilAustralian Association of Musculoskeletal Medicine Grant nilGriffith Health Institute, Griffith University nilHackett-Hemwall Foundation nil
6 · The paper itself

Abstract

backgroundLateral epicondylalgia (tennis elbow) is a common, debilitating and often treatment-resistant condition. Two treatments thought to address the pathology of lateral epicondylalgia are hypertonic glucose plus lignocaine injections (prolotherapy) and a physiotherapist guided manual therapy/exercise program (physiotherapy). This trial aimed to compare the short- and long-term clinical effectiveness, cost effectiveness, and safety of prolotherapy used singly and in combination with physiotherapy.

methodsUsing a single-blinded randomised clinical trial design, 120 participants with lateral epicondylalgia of at least 6 weeks' duration were randomly assigned to prolotherapy (4 sessions, monthly intervals), physiotherapy (weekly for 4 sessions) or combined (prolotherapy+physiotherapy). The Patient-Rated Tennis Elbow Evaluation (PRTEE) and participant global impression of change scores were assessed by blinded evaluators at baseline, 6, 12, 26 and 52 weeks. Success rate was defined as the percentage of participants indicating elbow condition was either 'much improved' or 'completely recovered.' Analysis was by intention-to-treat.

resultsEighty-eight percent completed the 12-month assessment. At 52 weeks, there were substantial, significant improvements compared with baseline status for all outcomes and groups, but no significant differences between groups. The physiotherapy group exhibited greater reductions in PRTEE at 12 weeks than the prolotherapy group (p = 0.014).

conclusionThere were no significant differences amongst the Physiotherapy, Prolotherapy and Combined groups in PRTEE and global impression of change measures over the course of the 12-month trial.

trial registrationACTRN12612000993897 .

Indexed as

AdultAnesthetics, LocalCombined Modality TherapyExercise TherapyFemaleFollow-Up StudiesGlucoseHumansLidocaineMaleMiddle AgedProlotherapyProspective StudiesSingle-Blind MethodTennis ElbowTreatment OutcomeAnesthetics, LocalGlucoseLidocaineElbowInjectionLateral epicondylalgiaPhysiotherapyProlotherapyTendinopathyTennis elbow

Identifiers

PMID31679521
PMCPMC6825722
OpenAlexW2988120660

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.