The immediate effect of orthotic management on grip strength of patients with lateral epicondylosis

J Orthop Sports Phys Ther. 2009 Jun;39(6):484-9. doi: 10.2519/jospt.2009.2988.


Study design: Controlled laboratory study using a randomized crossover design.

Objective: To determine the immediate effect of 3 common types of orthoses (2 elbow counterforce orthoses and a wrist splint) on grip strength in individuals with lateral epicondylosis.

Background: Lateral epicondylosis is a common cause of pain and upper limb dysfunction. Although the effectiveness of orthoses has been reported, comparisons of effectiveness among orthoses are limited.

Methods and measures: Fifty-two subjects with lateral epicondylosis were recruited (20 men, 32 women; mean +/- SD age, 41 +/- 8 years). Maximum and pain-free grip strength were assessed using a digital hand grip dynamometer immediately after the application of each orthosis. The 4 testing conditions included a placebo orthosis as a control condition, an elbow strap orthosis, an elbow sleeve orthosis, and a wrist splint. Data were analyzed using a 1-way analysis of variance for each outcome measure.

Results: Pain-free grip-strength was greater when using the elbow strap or the elbow sleeve orthosis compared to when using the placebo control orthosis or the wrist splint (P<.02), but there was no difference between the elbow sleeve and strap orthoses (P>.05), nor between the wrist splint and placebo orthosis (P>.05). Maximum grip strength was less when using the wrist splint compared to when tested with the elbow sleeve or the elbow strap (P< or =.003). Use of the elbow strap, elbow sleeve, or wrist splint did not change maximum grip strength compared to the control placebo orthosis condition (P>.05). There was also no difference in maximum grip strength between the elbow strap and the elbow sleeve conditions (P>.05).

Conclusion: The use of the 2 types of elbow orthoses (strap and sleeve) resulted in an immediate increase in pain-free grip strength. No differences between the 2 orthoses were found, suggesting that either can be used. A wrist splint produced no immediate change in pain-free or maximum grip-strength, indicating that it should not be used as a first-choice orthosis based on those outcome measures.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analysis of Variance
  • Cross-Over Studies
  • Female
  • Hand Strength*
  • Humans
  • Male
  • Muscle, Skeletal / physiology
  • Orthotic Devices*
  • Pain Measurement
  • Tennis Elbow / physiopathology
  • Tennis Elbow / rehabilitation*
  • Treatment Outcome
  • Wrist / physiology