Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2019.1603898 · Published: January 1, 2021

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This study compares the prevalence of lateral epicondylosis (LE), or tennis elbow, in different groups: wheelchair users who play tennis, wheelchair users who don't, able-bodied tennis players, and able-bodied non-tennis players. The study used ultrasound to examine the elbows of participants, looking for signs of LE. The goal was to see if wheelchair use and playing wheelchair tennis increase the risk of developing tennis elbow. The findings suggest that the length of time someone uses a wheelchair is linked to a higher risk of developing LE, but playing tennis itself doesn't seem to increase the risk, regardless of whether someone is able-bodied or a wheelchair user.

Study Duration

Not specified

Participants

83 subjects: wheelchair users, able-bodied controls, tennis players, non-tennis players

Evidence Level

Level II

Key Findings

1
There was no significant difference in the diagnosis of lateral epicondylosis (LE) between the groups based on tennis playing or wheelchair use when looking at prevalence, unadjusted odds ratios, and predicted probabilities.
2
When adjusted for age, able-bodied tennis players and non-tennis players showed a similar increase in the probability of LE with age, but this effect was not observed in wheelchair users.
3
Wheelchair users diagnosed with LE on ultrasound had spent significantly more time using a wheelchair (23 years vs. 13 years) than those without an LE diagnosis.

Research Summary

The study aimed to evaluate the association between manual wheelchair use, wheelchair tennis, and the risk of lateral epicondylosis (LE) by comparing four groups: wheelchair tennis players, wheelchair users, able-bodied tennis players, and able-bodied individuals. The results showed no significant difference in LE diagnosis rates between groups based on tennis participation or wheelchair use. However, the duration of wheelchair use was identified as a significant predictor of LE in wheelchair users. The study concludes that while tennis playing did not increase the risk of LE in able-bodied individuals, the length of wheelchair use appears to be a significant factor in the development of LE among wheelchair users.

Practical Implications

Clinical Guidance

When evaluating wheelchair users, elbow pain should not deter participation in wheelchair tennis.

Screening Considerations

Regular follow-up and screening for elbow pain should be part of the yearly care for chronic wheelchair users.

Future Research

Further studies should investigate elbow biomechanics and pushrim forces in wheelchair users to better understand the development of LE.

Study Limitations

1
The study could not be completely blinded.
2
Demographic differences between the four groups may have created confounding bias.
3
The study relied on self-reporting in the questionnaire, which introduces recall bias.

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