Factors associated with prognosis of lateral epicondylitis after 8 weeks of physical therapy.

OBJECTIVE: To identify key factors associated with outcomes of patients who underwent 8 weeks of physical therapy (PT) for lateral epicondylitis.

DESIGN: Multicenter prospective design with inception cohort of lateral epicondylitis patients commencing PT. Baseline clinical examinations were conducted by 1 physical therapist; self-report outcome measures were completed at baseline and 8 weeks later.

SETTING: Nine private sports medicine clinics and 2 hospital outpatient departments in Ontario, Canada.

PARTICIPANTS: Eighty-three patients with unilateral lateral epicondylitis identified by the treating physical therapists.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: The final scores of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and a vertical pain visual analog scale (VAS) were used as the dependent variables.

RESULTS: The final prognostic model for the 8-week DASH scores included the baseline score (95% confidence interval [CI], 0.34-0.66), sex (female) (95% CI, 3.3-14.5), and self-reported nerve symptoms (95% CI, 0.8-13.8). The model for the 8-week VAS scores included the baseline score (95% CI, 0.01-0.37), sex (female) (95% CI, 0.4-18.2), and self-reported nerve symptoms (95% CI, 4.7-25.5). A subanalysis indicated that women were more likely than men to have work-related onsets, repetitive keyboarding jobs, and cervical joint signs. Among women, these factors were associated with higher final DASH and VAS scores.

CONCLUSIONS: Women and patients who report nerve symptoms are more likely to experience a poorer short-term outcome after PT management of lateral epicondylitis. Work-related onsets, repetitive keyboarding jobs, and cervical joint signs have a prognostic influence on women.