| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 105 === Background Tennis elbow (TE) is a common upper-extremity musculoskeletal disorder with 8.5% recurrent rate within 1.5 years. Several studies showed that clinical symptoms are not only related to local tissue damage but also the alteration of the nervous system. Clinical features include pain, decreased grip strength, sensorimotor deficit and functional limitation. Common treatments mainly focus on pain relief and muscle strength training. However, previous studies showed that sensorimotor deficit persists despite that resolution of pain relief and strength improvement along with treatments. Sensorimotor deficits could disturb functional ability due to poor gripping mechanism, poor hand-arm coordination and muscle fatigue. Elastic taping is used as a treatment option for musculoskeletal problems in recent years. Some researchers suggested that elastic taping provides sensory input and helps sensorimotor deficit in several kinds of patient populations. However, the effects of elastic taping on sensorimotor control, grip strength, pain and functional ability in TE patients remain unclear, and more direct evidence of sensorimotor integration with elastic taping is needed. Corticomuscular coherence (CMC) indicates the functional connectivity between cortical activity and contralateral muscle during voluntary movements. It’s used to help monitor sensorimotor integration in our study.
Purpose There were two aims in this study. First one was to determine whether elastic taping is feasible for improving sensorimotor control, grip strength, pain and functional ability in TE patients. Second, to discuss how elastic taping modulates sensorimotor control by observing functional outcomes and CMC with and without elastic taping.
Methods This was an experimental study composed of 2 parts of crossover trials. 12 healthy and 12 TE patients were recruited. Primary outcome for each part was sensorimotor control. Secondary outcome was grip strength. Subjects were measured under 2 conditions: (1) without taping; (2) with elastic taping. In part 2, pain and functional ability were also recorded as secondary outcomes using Patient-rated Tennis Elbow Evaluation Questionnaire in TE patients.
Statistic Wilcoxon signed-rank test was used to compare outcomes between conditions. Spearman's rank correlation coefficient was used to find out the relationship between CMC and sensorimotor control. Significant level is set at 0.05.
Results After taping, joint position sense matching error significantly decreased and the steadiness of joint position significantly increased in both groups. No significant relationship between sensorimotor control and CMC was observed.
Discussion and conclusion In this present study, we conclude that elastic taping improve joint position sense and joint stability during isometric contraction of wrist extensor. However, other related outcome wasn’t change significantly such as reaction time, force sense, CMC, grip strength, pain and functions in patients. This might because of the small sample size and insufficient sensory input. Further research is needed to find out the mechanism of elastic taping on sensorimotor system.
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