Bilateral Cervical Dysfunction in Patients With Unilateral Lateral Epicondylalgia Without Concomitant Cervical or Upper Limb Symptoms: A Cross-Sectional Case-Control Study

Coombes, Brooke K., Bisset, Leanne and Vicenzino, Bill (2013) Bilateral Cervical Dysfunction in Patients With Unilateral Lateral Epicondylalgia Without Concomitant Cervical or Upper Limb Symptoms: A Cross-Sectional Case-Control Study. Journal of Manipulative and Physiological Therapeutics, 37 2: 79-86. doi:10.1016/j.jmpt.2013.12.005

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Author Coombes, Brooke K.
Bisset, Leanne
Vicenzino, Bill
Title Bilateral Cervical Dysfunction in Patients With Unilateral Lateral Epicondylalgia Without Concomitant Cervical or Upper Limb Symptoms: A Cross-Sectional Case-Control Study
Journal name Journal of Manipulative and Physiological Therapeutics   Check publisher's open access policy
ISSN 0161-4754
1532-6586
Publication date 2013
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.jmpt.2013.12.005
Open Access Status Other
Volume 37
Issue 2
Start page 79
End page 86
Total pages 8
Place of publication Philadelphia, PA United States
Publisher Mosby
Collection year 2014
Language eng
Subject 3602 Chiropractics
Abstract Objective: The purposes of this study were to examine the prevalence and distribution of spinal and neurodynamic dysfunction in a population with unilateral lateral epicondylalgia (LE) without concomitant cervical or upper limb symptoms, compare with cervical examination in a healthy control population, and investigate potential associations with clinical and demographic factors. Methods: This cross-sectional study included 165 patients with LE along with 62 healthy controls. Manual examination (C4-T2) was performed by an unblinded examiner with dysfunction defined as pain of 3 or higher on a numerical rating scale in the presence of a severe or moderate hypomobility or hypermobility. Neurodynamic testing (radial nerve) was classified positive if LE symptoms were reproduced and altered by sensitization maneuver. Repeated-measures analysis of variance was used to compare sides, segmental levels, and groups. Regression analysis was used to determine associations between variables. Results: Thirty-six percent of patients had dysfunction of at least 1 spinal palpation site, and 41% had a positive neurodynamic test. Significant group-by-level (P = .02) and group-by-side (P = .04) interactions were found for spinal examination, with greater dysfunction bilaterally at C4-7 (P < .01) in LE compared with control arms. The number of positive palpation sites was associated with injury duration (P = .03), whereas neurodynamic response was associated with severity of resting pain (P = .04). Conclusions: Cervical dysfunction is evident in individuals with LE without obvious neck pain and may reflect central sensitization mechanisms. Further study of the nature of the relationship between cervical dysfunction and LE is required.
Keyword Musculoskeletal Manipulations
Neck Pain
Radial Nerve
Tennis Elbow
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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