{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:15:34Z","timestamp":1790712934327,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":1012,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":33,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate the evidence of an association between occupational and non-occupational exposure to biomechanical risk factors and lateral elbow tendinopathy, medial elbow tendinopathy, and olecranon bursitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We carried out a systematic review of the literature. We searched MEDLINE (up to November 2019) and checked the reference lists of relevant articles\/reviews. We aimed to include studies where (a) the diagnosis was based on physical examination (symptoms plus clinical signs) and imaging data (if any); and (b) the exposure was evaluated with video analysis and\/or direct measurements. A quality assessment of the included studies was performed along with an evaluation of the level of evidence of a causal relationship.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included four studies in the qualitative synthesis: two prospective cohorts and two cross-sectional studies. All the included studies investigated \u201clateral\/medial epicondylitis\u201d, albeit the diagnosis was not supported by imaging techniques. Two cohort studies suggested that a combination of biomechanical risk factors for wrist\/forearm is associated with increased risk of \u201clateral epicondylitis\u201d. This association was not observed in the two included cross-sectional studies. The cohort studies suggested that a Strain Index score higher than 5 or 6.1 could double the risk of \u201clateral epicondylitis\u201d. No association with increased risk of \u201cmedial epicondylitis\u201d was observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is limited evidence of a causal relationship between occupational exposure to biomechanical risk factors and lateral elbow tendinopathy. For medial elbow tendinopathy, the evidence is insufficient to support this causal relationship. No studies on olecranon bursitis and biomechanical overload were identified.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/1348-9585.12186","type":"journal-article","created":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T14:49:52Z","timestamp":1612622992000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Elbow tendinopathy and occupational biomechanical overload: A systematic review with best-evidence synthesis"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4343-8873","authenticated-orcid":false,"given":"Stefania","family":"Curti","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-7430","authenticated-orcid":false,"given":"Stefano","family":"Mattioli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4248-4448","authenticated-orcid":false,"given":"Roberta","family":"Bonfiglioli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2001-2140","authenticated-orcid":false,"given":"Andrea","family":"Farioli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4084-2782","authenticated-orcid":false,"given":"Francesco S","family":"Violante","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,3]]},"reference":[{"issue":"4","key":"2024071808120227600_joh212186-bib-0001","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.mcna.2014.04.002","article-title":"Elbow tendinopathy","volume":"98","author":"Pitzer","year":"2014","journal-title":"Med Clin North Am"},{"issue":"5","key":"2024071808120227600_joh212186-bib-0002","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/1941738112454651","article-title":"Evaluation and management of elbow tendinopathy","volume":"4","author":"Taylor","year":"2012","journal-title":"Sports Health"},{"key":"2024071808120227600_joh212186-bib-0003","first-page":"1117","article-title":"Tennis elbow","volume":"2011","author":"Bisset","year":"2011","journal-title":"BMJ Clin Evid"},{"issue":"11","key":"2024071808120227600_joh212186-bib-0004","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1093\/aje\/kwj325","article-title":"Prevalence and determinants of lateral and medial epicondylitis: a population study","volume":"164","author":"Shiri","year":"2006","journal-title":"Am J Epidemiol"},{"issue":"6","key":"2024071808120227600_joh212186-bib-0005","doi-asserted-by":"crossref","first-page":"348","DOI":"10.5435\/JAAOS-D-14-00145","article-title":"Medial epicondylitis: evaluation and management","volume":"23","author":"Amin","year":"2015","journal-title":"J Am Acad Orthop Surg"},{"issue":"11","key":"2024071808120227600_joh212186-bib-0006","doi-asserted-by":"crossref","first-page":"2325967116670635","DOI":"10.1177\/2325967116670635","article-title":"Lateral elbow tendinopathy: development of a pathophysiology-based treatment algorithm","volume":"4","author":"Bhabra","year":"2016","journal-title":"Orthop J Sports Med"},{"issue":"640","key":"2024071808120227600_joh212186-bib-0007","doi-asserted-by":"crossref","first-page":"610","DOI":"10.3399\/bjgp15X687625","article-title":"Elbow pain: a guide to assessment and management in primary care","volume":"65","author":"Javed","year":"2015","journal-title":"Br J Gen Pract"},{"issue":"5","key":"2024071808120227600_joh212186-bib-0008","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/036354657900700506","article-title":"Olecranon bursitis (dart throwers\u2019 elbow). 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