Deep Oscillation ® Therapy in the Treatment of Lateral Epicondylalgia: A Pilot Randomized Control Trial

Abstract

Introduction: DEEP OSCILLATION® therapy has been shown to improve wound healing, inflammation, pain and most prominently its effect on lymphoedema. It has been indicated for use in musculoskeletal injuries but few studies on its effectiveness exist. Therefore, the purpose of this study was to measure the effect DEEP OSCILLATION® (DOT) had on patients with lateral epicondylalgia (LE). Methods: Twenty subjects aged between 18-55 years who had a diagnosis of LE took part in this trial. Group A (Control) underwent the protocol of injection therapy with 5 mg of Adcortyl and Lignocaine, topical Diclofenac antiinflammatory gel applied three times per day and supervised rest over a two week period. Patients were then referred for physiotherapy where they completed a baseline PRTEE and were instructed on a home exercise program (HEP) for 4 weeks. Group B, test, received the same protocol from the physician as Group A and referred for physiotherapy where they completed a baseline PRTEE and received the same HEP as Group A. Group B also received DOT consisting of two-25 minute sessions per week for 4 weeks, eight treatment sessions in total. Outcome measures were the PRTEE and VAS to measure pain at baseline and end of treatment at 6 weeks. Further follow-up was performed at 6 months post treatment. Results: The baseline mean of pain for Group A was 18.9 (SD 4.5) and at 6 weeks the mean was 13(3.09). The baseline mean of pain in Group B was 18.4 (4.5) and at 6 weeks it was 10.3(3.8). Repeated measure ANOVA on Pain showed significant difference between measurement from baseline to 6 weeks (F (1,18)=530.52, p ≤ 0.001). Results for the Time x Group interaction effect was not significant (F (1,18)=1.76, p=0.20), indicating that the changes in Pain measurements from baseline to 6 weeks were not significantly different for Control and Test groups. The mean function baseline for Group A was recorded as 13 (3.09) and 12.95 (2.76) at 6 weeks. The mean function for Group B was recorded as 22.5 (3.9) and 11.35 (4.10) at 6 weeks. Repeated measure ANOVA on Function showed significant difference between measurement from baseline to 6 weeks (F (1,18)=98.82, p ≤ 0.001). Time x Group interaction effect were found significant (F (1,18)=10.59, p=0.004), indicating that the changes in measurement from baseline to 6 weeks was significantly different for Control and Test groups. Conclusion: A significant improvement in patients function at 6 weeks post treatment was found with 70% of the treatment group requiring no further treatment from 6 weeks to 6 months post treatment. DOT is beneficial in the treatment of TE and may further enhance the benefit from local steroid injection. Further research on the use of DOT in musculoskeletal injury and relevant protocols are needed.