Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study
Abstract Background Lateral epicondylitis is a self-limited disease and refractory condition; thus providing optimal treatment is challenging. This study investigated a method for predicting cases that would not improve sufficiently under a wait-and-see policy using clinical indicators obtained duri...
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BMC
2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08902-7 |
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| author | Kazuhiro Ikeda Akira Ikumi Shinzo Onishi Takeshi Ogawa Sho Kohyama Yuichi Yoshii |
| author_facet | Kazuhiro Ikeda Akira Ikumi Shinzo Onishi Takeshi Ogawa Sho Kohyama Yuichi Yoshii |
| author_sort | Kazuhiro Ikeda |
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| description | Abstract Background Lateral epicondylitis is a self-limited disease and refractory condition; thus providing optimal treatment is challenging. This study investigated a method for predicting cases that would not improve sufficiently under a wait-and-see policy using clinical indicators obtained during the initial consultation. Methods Twenty-two patients with lateral epicondylitis prescribed a resting orthosis and followed up for 6 months were included. Grip strength ratios for affected/unaffected side; quick disabilities of the arm, shoulder, and hand (QuickDASH) scores were measured at 6-week intervals. Receiver operating characteristic curves for predicting refractory cases were created from the initial measurement items to determine the cut-off values and prediction accuracy. Results The 6-month post-treatment QuickDASH scores for the 14 improved patients and 8 refractory patients were 2.3 ± 4.7 and 25.9 ± 15.4, respectively. Grip strength ratios significantly predicted refractoriness risk with a 0.54 cut-off value. The QuickDASH scores significantly predicted refractoriness risk with a 30-point cut-off value. Meeting either of these cutoff values achieved a sensitivity of 1.0 for predicting refractoriness. Conclusions The patients with a grip strength ratio ≤ 0.5 on the affected side or a QuickDASH score ≥ 30 at initial consultation continued having symptoms 6 months after conservative treatment. |
| format | Article |
| id | doaj-art-2ec6bd0bcae641bf80eac01f590e5b3b |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-2ec6bd0bcae641bf80eac01f590e5b3b2025-08-20T03:28:40ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-012611810.1186/s12891-025-08902-7Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort studyKazuhiro Ikeda0Akira Ikumi1Shinzo Onishi2Takeshi Ogawa3Sho Kohyama4Yuichi Yoshii5Institute of Clinical Medicine, Department of Orthopedic Surgery, University of TsukubaInstitute of Clinical Medicine, Department of Orthopedic Surgery, University of TsukubaInstitute of Clinical Medicine, Department of Orthopedic Surgery, University of TsukubaDepartment of Orthopedic Surgery, NHO, Mito Medical CenterDepartment of Orthopedic Surgery, Kikkoman General HospitalDepartment of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical CenterAbstract Background Lateral epicondylitis is a self-limited disease and refractory condition; thus providing optimal treatment is challenging. This study investigated a method for predicting cases that would not improve sufficiently under a wait-and-see policy using clinical indicators obtained during the initial consultation. Methods Twenty-two patients with lateral epicondylitis prescribed a resting orthosis and followed up for 6 months were included. Grip strength ratios for affected/unaffected side; quick disabilities of the arm, shoulder, and hand (QuickDASH) scores were measured at 6-week intervals. Receiver operating characteristic curves for predicting refractory cases were created from the initial measurement items to determine the cut-off values and prediction accuracy. Results The 6-month post-treatment QuickDASH scores for the 14 improved patients and 8 refractory patients were 2.3 ± 4.7 and 25.9 ± 15.4, respectively. Grip strength ratios significantly predicted refractoriness risk with a 0.54 cut-off value. The QuickDASH scores significantly predicted refractoriness risk with a 30-point cut-off value. Meeting either of these cutoff values achieved a sensitivity of 1.0 for predicting refractoriness. Conclusions The patients with a grip strength ratio ≤ 0.5 on the affected side or a QuickDASH score ≥ 30 at initial consultation continued having symptoms 6 months after conservative treatment.https://doi.org/10.1186/s12891-025-08902-7Lateral epicondylitisRefractoryChronicGrip strength |
| spellingShingle | Kazuhiro Ikeda Akira Ikumi Shinzo Onishi Takeshi Ogawa Sho Kohyama Yuichi Yoshii Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study BMC Musculoskeletal Disorders Lateral epicondylitis Refractory Chronic Grip strength |
| title | Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study |
| title_full | Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study |
| title_fullStr | Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study |
| title_full_unstemmed | Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study |
| title_short | Predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash: a retrospective cohort study |
| title_sort | predicting refractoriness in lateral epicondylitis using initial grip strength and quickdash a retrospective cohort study |
| topic | Lateral epicondylitis Refractory Chronic Grip strength |
| url | https://doi.org/10.1186/s12891-025-08902-7 |
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