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. 2018 Aug;62(2):98-104.

Tendon neuroplastic training for lateral elbow tendinopathy: 2 case reports

Patrick Welsh  1
Affiliations

Tendon neuroplastic training for lateral elbow tendinopathy: 2 case reports

Patrick Welsh. J Can Chiropr Assoc. 2018 Aug.

Abstract
in English, French

Objective: To report 2 cases of lateral elbow tendinopathy treated with a novel adaptation of tendon neuroplastic training (TNT).

Clinical features: Patient 1: A 61-year-old male machine operator presented with one year of bilateral lateral elbow pain related to his occupation of using torque wrenches.Patient 2: A 37-year-old male electrician presented with two months of recurrent left lateral elbow pain related to repetitive motions of gripping and pulling at work.

Intervention and outcome: Both patients underwent 8 weeks of a novel rehabilitation program, including TNT, which involved pacing their resistance exercises to a metronome. Both patients experienced clinically meaningful improvements in pain and functional outcome scores that were sustained at the 3-month follow-up.

Summary: Recent evidence suggests that the central nervous system may play a role in chronic tendinopathies. It is possible that TNT may address the central nervous system component of chronic/recurrent tendinopathy that is not addressed by traditional passive therapies. However, further research is needed.

Objectif: Présenter 2 cas de tendinopathie latérale du coude traitée par un nouveau type d’entraînement neuroplastique tendineux (ENT).

Caractéristiques cliniques: Patient 1: Un opérateur de machines de 61 ans se plaignait d’une douleur latérale aux deux coudes, apparue il y a un an, et qui était liée à l’utilisation de clés dynamométriques sur les lieux de travail.Patient 2: Un électricien de 37 ans se plaignait d’une douleur latérale récurrente au coude gauche, qui était apparue il y a deux mois et qui était reliée à des mouvements répétitifs de serrage et de traction effectués au travail.

Intervention et résultat: Les deux patients ont suivi un nouveau type de programme de rééducation, d’une durée de 8 semaines, y compris un ENT, qui consistait à exécuter des exercices de résistance avec un métronome. Les deux patients ont éprouvé un soulagement cliniquement significatif de la douleur et les scores obtenus sur l’échelle d’évaluation des capacités fonctionnelles se sont maintenus durant le suivi de 3 mois.

Résumé: Des preuves récentes semblent indiquer que le système nerveux central pourrait jouer un rôle dans les tendinopathies chroniques. L’ENT pourrait permettre d’intervenir sur la composante neurologique des tendinopathies chroniques ou récurrentes associée au système nerveux central, alors que les traitements passifs classiques ne le permettent pas. Mais d’autres travaux de recherche pourraient s’avérer nécessaires.

Keywords: chiropractic; elbow; tendinopathy; tendon neuroplastic training; tennis elbow.

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Conflict of interest statement

The authors has no disclaimers, competing interests, or sources of support or funding to report in the preparation of this manuscript.

Figures

Figure 1
Figure 1
Wrist extension exercise paced to an audiovisual metronome (see supplementary video). (ProMetronome; http://eumlab.com/pro-metronome/)
See this image and copyright information in PMC

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