Frontiers in rehabilitation sciences最新文献

{"title":"A systematic review: impact of dry needling, isometric, and eccentric exercises on pain and function in individuals with patellar tendinopathy.","authors":"Faiza Sharif, Ashfaq Ahmad, Syed Amir Gilani, Dania Mahmood","doi":"10.3389/fresc.2024.1263295","DOIUrl":"10.3389/fresc.2024.1263295","url":null,"abstract":"<p><p>This systematic review aims to evaluate the existing body of evidence and provide a comprehensive analysis of the effects of dry needling, isometric, and eccentric exercises on pain severity and functional impairment in individuals diagnosed with patellar tendinopathy. The review was conducted in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases including the Cochrane Library, PubMed, PEDro, and Google Scholar were systematically searched for relevant literature from 2010 to August 2022. The therapeutic effects of dry needling, isometric exercises, and eccentric exercises on patellar tendinopathy were critically assessed. The risk of bias was determined using the McMaster Critical Review Form for Quantitative Studies, while the level of evidence and recommendation grades were assigned based on the Oxford Centre for Evidence-Based Medicine guidelines. The primary outcomes of interest were pain severity and functional impairment, particularly among elite volleyball and basketball athletes suffering from patellar tendinopathy. The systematic review incorporated nine clinical trials, including two on dry needling, four on isometric exercises, and three on eccentric exercises. The quality of the included studies ranged from 70% to 93%, as evaluated through the McMaster Critical Review Form. The two dry needling trials were deemed to be of high quality (93%), while the four isometric trials were classified as moderate quality (75%). Similarly, the three trials on eccentric exercises were rated at an average of 78%, indicating moderate quality. Of the nine trials, six were randomized controlled trials, with a 1B level of evidence (Grade A recommendation), while three trials, comprising two cross-over trials and one controlled clinical trial, were categorized as 2B evidence (Grade B recommendation). The findings from this review suggest that dry needling and eccentric exercises are more effective for long-term pain reduction and improvement in knee function, whereas isometric exercises appear to provide greater benefit for short-term pain relief, particularly during athletic activity. Although physical therapy-based interventions show promise for sustained management, the limited data underscores the need for further high-quality research in this domain.</p><p><strong>Systematic review registration: </strong>www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022360057, identifier (CRD42022360057).</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1263295"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenting practices in occupational justice lens in the post-genocide context: more than 31 years after a genocide against the Tutsi in Rwanda.","authors":"Emmanuel Biracyaza, Samuel Habimana","doi":"10.3389/fresc.2025.1498419","DOIUrl":"10.3389/fresc.2025.1498419","url":null,"abstract":"","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1498419"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balance rehabilitation and Long Covid syndrome: effectiveness of thermal water treatment vs. home-based program.","authors":"Maria Chiara Maccarone, Paola Contessa, Edoardo Passarotto, Gianluca Regazzo, Stefano Masiero","doi":"10.3389/fresc.2025.1588940","DOIUrl":"10.3389/fresc.2025.1588940","url":null,"abstract":"<p><strong>Introduction: </strong>Balance concerns are increasingly recognized as a common presentation in patients with Long Covid. This study investigates the effects of two distinct rehabilitation programs on balance in a cohort of sixty participants experiencing medium-to-long-term symptoms following SARS-CoV-2 infection.</p><p><strong>Methods: </strong>Individuals were enrolled and randomly assigned to either a spa resort rehabilitation program or a supervised home-based rehabilitation program. The study assessed balance and proprioception by analyzing the center of pressure trajectory during a standing task performed with eyes open and closed before, after, and at a 3- and 6-month follow-up after the rehabilitation program.</p><p><strong>Results: </strong>Results indicated that, right after rehabilitation, participants who enrolled in the home-based program demonstrated more significant improvements in mean stay time and in the standard deviation of oscillations in the antero-posterior direction than those who enrolled in a spa-resort program. On the other hand, at the 3-month follow-up, individuals who enrolled in the spa-resort program exhibited improvements in the standard deviation of oscillations in the antero-posterior direction, indicating ongoing benefits over time.</p><p><strong>Discussion: </strong>These findings suggest that appropriate rehabilitation programs, whether at home or in spa resorts, can contribute to enhancing overall physical function in these patients.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1588940"},"PeriodicalIF":1.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of proprioceptive exercise for knee osteoarthritis: a systematic review and meta-analysis.","authors":"Yaoyu Lin, Debiao Yu, Xiaoting Chen, Peng Chen, Nan Chen, Bin Shao, Qiuxiang Lin, Fuchun Wu","doi":"10.3389/fresc.2025.1596966","DOIUrl":"10.3389/fresc.2025.1596966","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite the extensive utilization of proprioceptive exercise in the management of knee osteoarthritis (KOA), the therapeutic efficacy of this approach remains inconclusive. The present study sought to systematically evaluate the effects of proprioceptive exercise on symptoms and functional outcomes in patients with KOA, with a particular focus on balance performance.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive search was conducted across six electronic databases from the establishment of the database to January 21, 2025. The inclusion criteria were randomized controlled trials investigating proprioceptive exercise interventions for KOA. The primary outcome measures encompassed balance function assessment (Timed Up and Go test), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score and its pain, stiffness, and function subscales, and pain intensity (Numerical Rating Scale and Visual Analog Scale). Subgroup analyses were stratified by intervention duration (≤8 weeks vs. >8 weeks).</p><p><strong>Results: </strong>A comprehensive analysis of 22 randomized controlled trials revealed that proprioceptive exercise significantly improved performance of the Timed Up and Go test [MD = 1.53, 95% CI (1.09, 1.97), <i>I</i> ² = 0%, <i>P</i> < 0.00001]. Additionally, a significant improvement in WOMAC-total scores was observed [MD = 3.37, 95% CI (1.58, 5.16), <i>I</i> ² = 44%, <i>P</i> = 0.0002]. However, individual WOMAC subscales for pain (<i>P</i> = 0.11, <i>I</i> ² = 85%), stiffness (<i>P</i> = 0.97, <i>I</i> ² = 0%), and function (<i>P</i> = 0.16, <i>I</i> ² = 86%) showed no significant improvements. For pain assessment, Numerical Rating Scale scores showed a significant improvement [MD = 0.85, 95% CI (0.56, 1.15), <i>I</i> ² = 46%, <i>P</i> < 0.00001]. Notably, Visual Analog Scale scores exhibited a significant reduction, but only in the short-term intervention subgroup (≤8 weeks) [MD = 0.27, 95% CI (0.11, 0.42), <i>I</i> ² = 0%, <i>P</i> = 0.0008], whereas longer interventions (>8 weeks) showed no significant benefit [MD = -0.49, 95% CI (-1.10, 0.11), <i>I</i> ² = 0%, <i>P</i> = 0.11].</p><p><strong>Conclusion: </strong>Based on low-certainty evidence, proprioceptive exercise has been demonstrated to be efficacious in improving balance function and overall clinical status in patients with KOA. Optimal benefits have been observed during short-term intervention periods.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1596966"},"PeriodicalIF":1.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal cord injury and electrical stimulation: analysis of neuroplasticity in a case report.","authors":"Orcizo Francisco Silvestre, Julia Silva E Lima Schleder, Bruna Valentina Zuchatti, Cintia Kelly Bittar, Carla Alves Fakih, Marina Squarizi Simões Chagas, Vinicius Taboni Lisboa, Alberto Cliquet Junior","doi":"10.3389/fresc.2025.1557010","DOIUrl":"10.3389/fresc.2025.1557010","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal Cord Injury (SCI) is a highly prevalent condition, with just below 1 million new cases yearly, deriving for traumatic and non-traumatic causes. It is a significant cause for disability, greatly impacting quality of life of affected individuals, and as such, requires effective rehabilitation methods in order to maintain daily function. Neuromuscular Electrical Stimulation (NMES) is a helpful treatment, stimulating muscle contraction and plasticity through electrical currents.</p><p><strong>Methods: </strong>This is a Case-Report of two cases with different SCI causes, submitted to a 1-year treatment with NMES under identical protocols. ASIA neurological examination with AIS classification was performed before and after treatment, as well as surface Electromyographic assessment for the Vastus Lateralis and Rectus Femoris muscles bilaterally.</p><p><strong>Results: </strong>Neurological recovery was remarkable after 1 year, with AIS increasing from a score of A to C in the first case and B to C in the second. EMG assessment showed a bilateral increase of peak values as well as successful Quadriceps muscle contraction generating knee extension.</p><p><strong>Conclusion: </strong>Neuromuscular electrical stimulation may be a promising strategy in the rehabilitation of spinal cord injuries, with the potential to aid in functional recovery and modulation of neuroplasticity. Preliminary observations, such as those in this case report, suggest that the technique may be associated with improvements in mobility and quality of life in patients, although controlled studies are needed to confirm these effects.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1557010"},"PeriodicalIF":1.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical classification of fatigue-induced physiological tremor in robot-assisted manipulation tasks using BiLSTM-GRU network.","authors":"Poongavanam Palani, Siddhant Panigrahi, Gunarajulu Renganathan, Yuichi Kurita, Asokan Thondiyath","doi":"10.3389/fresc.2025.1474203","DOIUrl":"10.3389/fresc.2025.1474203","url":null,"abstract":"<p><strong>Introduction: </strong>Physiological tremor arises due to stress, anxiety, fatigue, alcohol or caffeine. Under conventional circumstances, the physiological tremor would not be detrimental. Still, the mere presence of such a tremor during any microsurgical procedure can be catastrophic. In these instances, it is necessary to predict the progression of the tremor. This article proposes a novel sensing methodology and adds a distinctive feature to aid in classification. The classification of the progressive stages of fatigue-induced physiological tremor (FIPT) is based on the hybrid bidirectional long short-term memory neural network with a Gated Recurrent Unit (BiLSTM-GRU) presented in this work.</p><p><strong>Methodology: </strong>Twenty healthy participants volunteered in the study, where a teleoperation stage was set up using the Geomagic Haptic device-Touch. On the master end, the participants were seated comfortably and asked to trace the patterns embedded over an image of an organ that was displayed on the screen. The EMG and MMG_ACC signals from the Mindrove Armband and cross-sectional area changes, MMGCSAC, calculated from area measurement using the vision sensor, were recorded. The pattern-tracing task (PTT) was carried out over five repetitions, with fatigue-inducing exercise occurring between task epochs, thus accumulating fatigue throughout the data collection process. The extracted features from human movement aid the classification of the stages of tremor using BiLSTM-GRU, showing the significance of a cross-sectional area informed model.</p><p><strong>Results: </strong>The stages of progression of tremor are classified into five levels in this study, and classified using BiLSTM GRU with four different input feature sets. The performance evaluation metrics, such as the accuracy, precision, recall and F1 score, have been reported to ascertain the efficiency of the proposed feature group. The proposed feature set and classification strategy are capable of estimating stages of FIPT with 99% classification accuracy. This can be used to design state-of-the-art movement training platforms for both experienced and novice surgeons that allow informed decision making to attend to their tremor condition, either by taking a break or including a limb support to minimize its effects. At the same time, the identification methodology can be extended to pathological tremor rehabilitation and any other movement disorder diagnostics.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1474203"},"PeriodicalIF":1.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of game design characteristics of a virtual reality serious game for upper-limb prosthesis control training on motor learning.","authors":"Jack Tchimino, Bart Maas, Bram van Dijk, Alessio Murgia, Corry K van der Sluis, Raoul M Bongers","doi":"10.3389/fresc.2025.1520184","DOIUrl":"10.3389/fresc.2025.1520184","url":null,"abstract":"<p><strong>Introduction: </strong>Rehabilitation outcomes of hand prosthesis control training generally benefit from an early start in the rehabilitation regimen as well as the use of modern technologies, like serious games, in lieu of more conventional methods. In this study, we tested a virtual reality based myoelectric prosthesis training serious game, specifically how the game design elements affected different aspects of motor control and training.</p><p><strong>Methods: </strong>Ten able-bodied participants were asked to execute a series of tasks by controlling an LDA-controlled 1-DoF virtual hand prosthesis within a virtual reality environment (VRE) serious game. The tasks included grasping and manipulating virtual objects and controlled force modulation, the latter facilitated by artificial feedback communicated to participants in the VRE.</p><p><strong>Results: </strong>The results indicated that the game physics affected the way that the participants completed the tasks, while the tasks themselves appeared to be approached and executed in different ways by the participants. Contrary to expectations, however, the force feedback did not influence the participants' ability to precisely modulate the grasping force applied with the virtual prosthesis.</p><p><strong>Discussion: </strong>Based on these results, it can be concluded that users can be trained within the proposed framework to develop motor skills that might be translated into the use of a real prosthesis, in a more engaging and timely manner.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1520184"},"PeriodicalIF":1.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective gait analysis using Kinect v2® for the prognosis of walking during the acute phase of rehabilitation after proximal femoral fracture surgery.","authors":"Kohki Matsubara, Gen Kuroyanagi, Atsushi Imamura, Yuichiro Mizuno, Shintaro Tsukada, Ruido Ida, Haruhiko Tokuda, Hideki Murakami, Hideki Okamoto, Yoshino Ueki","doi":"10.3389/fresc.2025.1527825","DOIUrl":"10.3389/fresc.2025.1527825","url":null,"abstract":"<p><strong>Objective: </strong>While factors affecting gait post-surgery for proximal femoral fracture (PFF) have been studied, the prognostic value of objective gait analysis during acute postoperative rehabilitation remains unclear. Microsoft Kinect for Windows v2® (Kinect) is a noninvasive, low-cost, and easy-to-implement posture estimation device. However, its application in analyzing gait for these patients is underreported. This study aims to analyze gait during acute postoperative rehabilitation using Kinect, identifying key gait evaluation metrics and prognostic indicators.</p><p><strong>Methods: </strong>This study included 17 patients who were admitted to our hospital with PFF and underwent surgery. Rehabilitation began the day after surgery, with weekly Kinect-recorded gait videos from postoperative weeks 1 to 4. Gait parameters were analyzed thereafter. Participants were divided into two groups: those unable to walk with a walker one week after surgery were classified as having a poor prognosis (<i>n</i> = 7), while those who could were classified as having a good prognosis (<i>n</i> = 10). Various gait parameters were then compared between the groups to examine factors predicting gait prognosis. Furthermore, the hip joint pain/activities of daily living (ADL) index Oxford Hip Score (OHS) and the dynamic balance indicator timed up and go test (TUG) were evaluated, and the correlation with each gait parameter was examined. Key gait parameters were analyzed in both groups after equivalent rehabilitation periods.</p><p><strong>Results: </strong>Increased gait velocity, decreased gait cycle time, increased swing phase, decreased stance phase, and increased maximum hip joint flexion angle were observed during the postoperative rehabilitation in both study groups. Compared with the good prognosis group, the poor gait prognosis group showed worse swing/stance phases of either healthy or affected limb, TUG, and OHS. The mean TUG value and OHS correlated with each gait parameter. Even after the same rehabilitation gait training period, the good prognosis group showed greater improvements in gait velocity, swing phase, stance phase, hip and knee joint flexion angles, and OHS compared to the poor prognosis group.</p><p><strong>Conclusion: </strong>During the acute phase of rehabilitation after PFF surgery, adequate hip pain control and early weight bearing of the operated limb are important for favorable gait prognosis.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1527825"},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Promoting health management in rehabilitation.","authors":"Jaclyn Schwartz, Elena Donoso Brown, Scott Bleakley","doi":"10.3389/fresc.2025.1626049","DOIUrl":"10.3389/fresc.2025.1626049","url":null,"abstract":"","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1626049"},"PeriodicalIF":1.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of extracorporeal shock wave therapy and nutraceutical supplementation in the treatment of lateral epicondylitis: a randomized controlled trial.","authors":"Dalila Scaturro, Domenico Migliorino, Sofia Tomasello, Michele Vecchio, Antimo Moretti, Giovanni Iolascon, Giulia Letizia Mauro","doi":"10.3389/fresc.2025.1593909","DOIUrl":"10.3389/fresc.2025.1593909","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous scientific papers have compared different treatment options in the management of lateral epicondylitis. Our study evaluated the efficacy of focal extracorporeal shock wave treatment (ESWT) combined with an integrative nutraceutical treatment of hyaluronic acid, collagen, vitamin C, and manganese, compared with single treatment in patients with lateral epicondylitis in terms of improvement of pain, functional capacity, muscle strength, and reduction of inflammation on ultrasound images.</p><p><strong>Methods: </strong>A single-center, randomized controlled trial (RCT) was conducted in a population of patients with lateral epicondylitis. Patients were enrolled and randomly divided into 3 groups: Group A, consisting of 15 patients who were treated with twenty sessions of therapeutic exercise and five focal ESWT sessions (one session every six days); Group B, consisting of 15 patients who performed twenty sessions of therapeutic exercise and took daily a dietary supplement consisting of Hyaluronic Acid 200 mg, Collagen 5,000 mg, Vitamin C 250 mg and Manganese 10 mg for thirty days; and Group C, consisting of 15 patients, who received a combined treatment of therapeutic exercise, focal ESWT and nutraceutical supplementation The Numerical Rating Scale (NRS) and Patient-Rated Tennis Elbow Evaluation Scale (PRTEE) were administered during the first physiatric examination (T0), at 15 days after the start of treatment (T1), and at a 30-day follow-up (T2). In addition, muscle strength (Handgrip strength) was analyzed by means of a dynamometer, and common extensor tendon thickness (CET Thickness) by ultrasound examination.</p><p><strong>Results: </strong>Data analysis showed that NRS scale scores decreased significantly only in group B at T1 (<i>P</i> < 0.05), and in the three groups at T2 (<i>P</i> < 0.05). Grip strength increased significantly after 30 days only in group C (<i>P</i> < 0.05), while PRTEE scores and CET Thickness decreased significantly at T2 in the three groups (<i>P</i> < 0.05). The comparison among the various groups also showed that the Group C showed statistically significant improvements of function and grip strength at T2, compared with the other groups (<i>P</i> < 0.05).</p><p><strong>Discussion: </strong>Our study demonstrated that the combination of focal ESWT, therapeutic exercise, and nutraceutical supplementation, represent a viable therapeutic option for the management of lateral epicondylitis; likewise, the proposed treatments resulted in a synergistic effect for pain relief and functional recovery in the short term, providing a decrease in the inflammatory state and an increase in muscle strength.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1593909"},"PeriodicalIF":1.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}