{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T02:31:26Z","timestamp":1769913086138,"version":"3.49.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T00:00:00Z","timestamp":1627344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In painful epicondylitis, previous studies reported deficiencies in elbow proprioception. In line, proprioceptive training of the lower limb has been reported substantial beneficial in a number of indications. Therefore, we have asked if a specified proprioceptive training using training devices that are capable of activating the deep musculature in the upper limb is able to reduce the symptoms of epicondylitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>We included 71 patients with painful lateral epicondylitis &gt; 3 months. Interventions: Group A: Proprioceptive training intervention with a Flexibar\u00ae (9 min daily for 12 weeks). Group B: at least 40 min running or walking\/week with the XCO\u00ae in addition to the proprioceptive training with the Flexibar\u00ae (9 min daily for 12 weeks), follow-up for 12 weeks. Primary end point: Pain on visual analogue scale (VAS, 0-10); secondary end points: DASH-Score (0 = very good, 100 = very poor), grip strength according to Jamar dynamometer (kg), vibration sensation measured with a 128 Hz tuning fork.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The pain on VAS in group A was reduced significantly. 3.6 \u00b1 2.0 to 2.4 \u00b1 2.1 (\u221233%, <jats:italic>p<\/jats:italic> = 0.013), and from 3.7 \u00b1 2.4 to 2.2 \u00b1 1.9 (\u221241%, <jats:italic>p<\/jats:italic> = 0.004) in group B after 12 weeks. There was no significant difference between A and B (<jats:italic>p<\/jats:italic> = 0.899). In both groups, there was a significant improvement of the DASH-Score (A: 32 \u00b1 15 to 14 \u00b1 12, \u221256%, <jats:italic>p<\/jats:italic> &lt; 0.001; B: 27 \u00b1 12 to 12 \u00b1 11, \u221255%, <jats:italic>p<\/jats:italic> = 0.001) without any difference between groups A and B (<jats:italic>p<\/jats:italic> = 0.339). Grip strength improvement in group A from 24 \u00b1 12 to 33 \u00b1 11 kg (+38%, <jats:italic>p<\/jats:italic> &lt; 0.001), and from 29 \u00b1 14 to 34 \u00b1 11 kg (+15%, <jats:italic>p<\/jats:italic> &lt; 0.001) in group B. In line, vibration sensation improved in both groups (A: 6.3 \u00b1 0.6 to 6.5 \u00b1 0.5, <jats:italic>p<\/jats:italic> = 0.0001; B: 6.3 \u00b1 0.7 to 6.6 \u00b1 0.5, <jats:italic>p<\/jats:italic> = 0.003).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>A 12-week proprioceptive training with the Flexibar\u00ae improves pain, quality of life, grip strength and vibration sensation in patients with painful lateral epicondylitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Ib, randomised clinical trial<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>German Clinical Trials Register, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.drks.de\/drks_web\/navigate.do?navigationId=trial.HTML&amp;TRIAL_ID=DRKS00024857\">DRKS00024857<\/jats:ext-link>, registered on 25 March 2021\u2014retrospectively registered, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/apps.who.int\/trialsearch\/\">http:\/\/apps.who.int\/trialsearch\/<\/jats:ext-link><\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13018-021-02602-3","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T06:02:42Z","timestamp":1627365762000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Proprioceptive elbow training reduces pain and improves function in painful lateral epicondylitis\u2014a prospective trial"],"prefix":"10.1186","volume":"16","author":[{"given":"B.","family":"Schiffke-Juh\u00e1sz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Knobloch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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The photos used in Fig.\u00a0 show the main author herself and may be published.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"For our study, we received the training devices for our patients from Flexi-Sports\u00ae and the training devices remained in the property of the patients after the study. Apart from that, we received no further grants or support from Flexi-Sports\u00ae or another company or institution. Conversely, Flexi-Sports\u00ae has not demanded the results of our trial to publish them for advertising. So, we can declare that there is no conflict of interest for us.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"468"}}