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...

Full description

Saved in:
Bibliographic Details
Main Authors: Kazuhiro Ikeda, Akira Ikumi, Shinzo Onishi, Takeshi Ogawa, Sho Kohyama, Yuichi Yoshii
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-025-08902-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849428589626261504
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
collection DOAJ
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
record_format Article
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
work_keys_str_mv AT kazuhiroikeda predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy
AT akiraikumi predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy
AT shinzoonishi predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy
AT takeshiogawa predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy
AT shokohyama predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy
AT yuichiyoshii predictingrefractorinessinlateralepicondylitisusinginitialgripstrengthandquickdasharetrospectivecohortstudy