Objective: To evaluate a new multidisciplinary structured home training programme for patients with lateral epicondylitis compared to conventional attendance.Design: This study utilized a prospective non-randomized design to compare the effect of a home exercise programme against a pragmatic approach to managing patients with lateral epicondylitis in a primary care setting in Sweden.Subjects: A total of 78 patients, presenting to their general practitioner with lateral epicondylitis were recruited from two separate geographical areas. The patients were divided into two group, 51 entered the intervention group and 27 entered the control group.Methods: The intervention group was treated with a specific home training programme, ergonomic advice and when necessary wrist and/or night bandages. The control group was treated with conventional treatment, e.g. corticosteroid injections, stretching or no intervention. Pain and function were evaluated by the PRFEQ. An electronic hand-power gauge measured strength and stamina. Sick-leave absence was collected via the regional Social Insurance Office.Results: After four weeks the intervention group experienced less sick-leave, less pain, better function and returned to work earlier than the control group. After 16 weeks the intervention group still had significantly better function than the control group and were taking less sick-leave. Pain decreased more in the intervention group but this was not significant. There was no difference in grip strength between the two groups.Conclusion: A structured home training programme can improve function and reduce sick leave in patients with lateral epicondylitis. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Musculoskeletal Care)

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(Source: Physiotherapy Theory and Practice)

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(Source: Physiotherapy Theory and Practice)

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(Source: Physiotherapy Theory and Practice)

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(Source: Physiotherapy Theory and Practice)

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(Source: Physiotherapy Theory and Practice)

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(Source: Physiotherapy Theory and Practice)

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Patients with joint hypermobility, perhaps the mildest of the various inherited abnormalities of connective tissue, may present to a rheumatologist or general practitioner although a large proportion are recognized by health professionals, particularly physiotherapists. Hypermobility may be generalized or extreme at a small number of joints. Sometimes it is associated with involvement of other organs because of abnormal inherited collagen structure elsewhere. A small proportion of patients will have one of the more serious conditions such as Ehlers-Danlos syndrome, Marfan’s syndrome or osteogenesis imperfecta. Management is multidisciplinary requiring a team including physicians, physiotherapists, occupational therapists and podiatrists, among others. Patients often wait a long time before receiving their definitive diagnosis and are sometimes dismissed as malingerers. Patients often have a lot of queries about their condition unrelated to their joints. Among these are whether there will be problems in pregnancy, whether the condition will be passed on to their children, whether symptoms arising from organs other than the joints are related and whether they might have been incorrectly accused of battering their children. Copyright © 2006 John Wiley & Sons, Ltd. (Source: Musculoskeletal Care)

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