The sensitivity of the provocation tests in replicating pain on the lateral elbow area of participants with lateral epicondylalgia
Date
2014
Authors
Dones, V.C.
Grimmer, K.A.
Milanese, S.
Kumar, S.
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Journal article
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Journal of case reports and clinical research studies, 2014; 1(1):1-15
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Abstract
To determine the sensitivity of Cozen, Mill, Maudsley and static maximum handgrip tests (SMHGT) in replicating lateral elbow pain in patients with Lateral Epicondylalgia (LE). To determine the relationship of the SMHGT between the symptomatic and asymptomatic elbows. Design: a cohort study in which consecutive patients whose pain in the lateral elbow area was replicated using Cozen, Mill, Maudsley and SMHGT to confirm presence of Lateral Epicondylalgia (LE). Setting: General community in Metro Manila, Philippines Participants: Fifty-four participants with pain in the lateral elbow area were prospectively recruited in the study. Main Outcome Measures: Cozen, Mill, Maudsley and SMHGT. Pain in the lateral elbow area was used as the criterion standard. Results: The most sensitive provocation test in reproducing LE was Cozen (91%) followed by Mill (76%), SMHGT (70%) and Maudsley (66%). Compared to those participants who were positive in only one of three provocation tests, a weaker (although not-statistically significant) SMHGT was recorded for participants who were positive to 2-3 of the tests. There was no significant difference in the SMHGT between the symptomatic and asymptomatic upper limbs of participants with LE. Conclusion: Cozen’s test has the highest diagnostic value. Whilst the sensitivity of Mill, SMHGT and Maudsley’s tests are less than Cozen’s, they may have value if specific anatomical structures are suspected of involvement in LE. Replicating pain on the lateral elbow area using any of the provocation tests was associated with decreased SMHGT strength.
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Copyright 2014 The Authors. This work is licensed under a Creative Commons Attribution 3.0 License http://creativecommons.org/licenses/by/3.0/ (https://web.archive.org/web/20150922170047/http://creativecommons.org/licenses/by/3.0/)