Skip to main content Skip to main navigation menu Skip to site footer

The Efficacy of Blood Flow Restriction Training for Grip Strength and Disability in Lateral Epicondylitis

  • Gede Parta Kinandana ,
  • Anak Ayu Nyoman Trisna Narta Dewi ,
  • I Made Niko Winaya ,
  • Ni Komang Ayu Juni Antari ,
  • Ari Wibawa ,
  • I Putu Gde Surya Adhitya ,

Abstract

Background: Lateral epicondylitis is a work-related musculoskeletal disorder caused by inflammation of the extensor carpi radialis longus and brevis muscles tendons with symptoms of pain in the lateral side of the elbow and decreased range of motion that causes forearm muscle weakness and disability. This study aimed to compare the effectiveness of blood flow restriction (BFR) training with resistance exercise (RE) in increasing grip strength and forearm disability in lateral epicondylitis patients.

Methods: This study used the randomized controlled trial design that involved 28 subjects who were divided into intervention and control groups. All subjects received the treatment 3 times per week for 4 weeks, including the standard ultrasound therapy and electro-muscular stimulation interventions for 20 mins with additional treatment of the low-load BFR training for the intervention group and the high-intensity RE for the control group. This study measured grip muscle strength using a handgrip dynamometer, and functional ability was measured using a patient-rated tennis elbow evaluation questionnaire (PrTEEQ) before and after the treatment session. The statistical analyses of paired t-tests and independent t-tests were used in this study.

Results: This study found significant differences between pretest and posttest scores in the measurements of forearm muscle strength (change= 20.0~49.0%, p-values <0.001) and PrTEEQ (change= 64.5~70.5%, p-value <0.001) in the intervention and control groups. In addition, the independent t-tests resulted in significant differences in the score changes of forearm muscle strength and PrTEEQ measurement between these groups with p-values <0.001.

Conclusion: This study described that BFR training had better effects on grip strength and functional ability than RE in people with lateral epicondylitis.

References

  1. Vaquero-Picado A, Barco R, Antuña SA. Lateral epicondylitis of the elbow. EFORT open reviews. 2016;1(11):391-7.
  2. Smidt N, Lewis M, Windt DAVD, Hay EM, Bouter LM, Croft P. Lateral epicondylitis in general practice: course and prognostic indicators of outcome. J Rheumatol. 2006;33(10):2053-9.
  3. Ahmad Z, Siddiqui N, Malik S, Abdus-Samee M, Tytherleigh-Strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. The bone & joint journal. 2013;95(9):1158-64.
  4. Lee S, Ko Y, Lee W. Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial. Journal of physical therapy science. 2014;26(7):1037-40.
  5. Weber C, Thai V, Neuheuser K, Groover K, Christ O. Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis. BMC musculoskeletal disorders. 2015;16(1):1-13.
  6. Olaussen M, Holmedal Ø, Mdala I, Brage S, Lindbæk M. Corticosteroid or placebo injection combined with deep transverse friction massage, Mills manipulation, stretching and eccentric exercise for acute lateral epicondylitis: a randomised, controlled trial. BMC músculoskeletal disorders. 2015;16(1):1-13.
  7. Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The beneficial effects of eccentric exercise in the management of lateral elbow tendinopathy: A systematic review and meta-analysis. Journal of clinical medicine. 2021;10(17):3968.
  8. Ma K-L, Wang H-Q. Management of lateral epicondylitis: a narrative literature review. Pain Research and Management. 2020;2020.
  9. Scott BR, Loenneke JP, Slattery KM, Dascombe BJ. Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports medicine. 2015;45(3):313-25.
  10. Wilson JM, Lowery RP, Joy JM, Loenneke JP, Naimo MA. Practical blood flow restriction training increases acute determinants of hypertrophy without increasing indices of muscle damage. The Journal of Strength & Conditioning Research. 2013;27(11):3068-75.
  11. Loenneke JP, Fahs CA, Rossow LM, Sherk VD, Thiebaud RS, Abe T, et al. Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise. European journal of applied physiology. 2012;112(8):2903-12.
  12. Ramji RLS. Non-drug Non-invasive Treatment in the Management of Tennis Elbow: RICE and Guided Rehabilitation: management of Tennis elbow. Jurnal Orthopaedi dan Traumatologi Indonesia. 2021;4(2):32-40.
  13. Cook SB, Murphy BG, Labarbera KE. Neuromuscular function after a bout of low-load blood flow-restricted exercise. Med Sci Sport Exer. 2013;45(1):67-74.
  14. Dorf ER, Chhabra AB, Golish SR, McGinty JL, Pannunzio ME. Effect of elbow position on grip strength in the evaluation of lateral epicondylitis. The Journal of hand surgery. 2007;32(6):882-6.
  15. Rompe JD, Overend TJ, MacDermid JC. Validation of the patient-rated tennis elbow evaluation questionnaire. Journal of Hand Therapy. 2007;20(1):3-11.
  16. Buckner SL, Jessee MB, Dankel SJ, Mattocks KT, Mouser JG, Bell ZW, et al. Acute skeletal muscle responses to very low‐load resistance exercise with and without the application of blood flow restriction in the upper body. Clinical physiology and functional imaging. 2019;39(3):201-8.
  17. Skovlund SV, Aagaard P, Larsen P, Svensson RB, Kjaer M, Magnusson SP, et al. The effect of low‐load resistance training with blood flow restriction on chronic patellar tendinopathy—A case series. Translational Sports Medicine. 2020;3(4):342-52.
  18. Anderson AB, Owens JG, Patterson SD, Dickens JF, LeClere LE. Blood flow restriction therapy: from development to applications. Sports medicine and arthroscopy review. 2019;27(3):119-23.
  19. Fujita S, Abe T, Drummond MJ, Cadenas JG, Dreyer HC, Sato Y, et al. Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. Journal of applied physiology. 2007.
  20. Centner C, Lauber B, Seynnes OR, Jerger S, Sohnius T, Gollhofer A, et al. Low-load blood flow restriction training induces similar morphological and mechanical Achilles tendon adaptations compared with high-load resistance training. Journal of Applied Physiology. 2019;127(6):1660-7.
  21. Jiang D, Jiang Z, Zhang Y, Wang S, Yang S, Xu B, et al. Effect of young extrinsic environment stimulated by hypoxia on the function of aged tendon stem cell. Cell biochemistry and biophysics. 2014;70(2):967-73.
  22. Slysz J, Stultz J, Burr JF. The efficacy of blood flow restricted exercise: A systematic review & meta-analysis. Journal of science and medicine in sport. 2016;19(8):669-75.

How to Cite

Kinandana, G. P., Anak Ayu Nyoman Trisna Narta Dewi, I Made Niko Winaya, Ni Komang Ayu Juni Antari, Ari Wibawa, & I Putu Gde Surya Adhitya. (2023). The Efficacy of Blood Flow Restriction Training for Grip Strength and Disability in Lateral Epicondylitis. Bali Medical Journal, 12(1), 410–415. https://doi.org/10.15562/bmj.v12i1.3973

HTML
25

Total
10

Share

Search Panel

Gede Parta Kinandana
Google Scholar
Pubmed
BMJ Journal


Anak Ayu Nyoman Trisna Narta Dewi
Google Scholar
Pubmed
BMJ Journal


I Made Niko Winaya
Google Scholar
Pubmed
BMJ Journal


Ni Komang Ayu Juni Antari
Google Scholar
Pubmed
BMJ Journal


Ari Wibawa
Google Scholar
Pubmed
BMJ Journal


I Putu Gde Surya Adhitya
Google Scholar
Pubmed
BMJ Journal