How effective is proprioception exercise on pain, grip force, dexterity and proprioception of elbow joint in patients with tennis elbow? A randomized controlled trial

Background: Patients with tennis elbow (TE) disorder suffer from proprioception deficits alongside other symptoms, which usually is neglected to be targeted in different physiotherapy protocols. This study aimed to investigate the effects of proprioception exercises on treatment outcomes. Methods: In this RCT, 14 males and 30 females TE volunteered patients were randomly divided into two intervention (IG) and control (CG) groups, in which CG received routine physiotherapy, while IG underwent further proprioception exercises for 18 sessions within six weeks. Pain, function, grip force, dexterity, and proprioception of elbow joint were evaluated using Patient-Rated Elbow Evaluation (PREE) questionnaire, handheld dynamometer, Purdue Pegboard, and isokinetic dynamometer, respectively. Results: A significant within group improvement was observed in terms of pain (IG: 49.93%, CG: 42.75%), function (IG: 61.9%, CG: 48.95%), grip force (IG: 22.1% CG: 16.9%), dexterity (IG: 18.96% CG: 11.82%), active joint position error (IG: 32.99, CG: 7.33 %), and the threshold to detection of passive motion (TTDPM) for both groups (IG: 24.35, CG: 24.86%) in both groups after treatment as compared to before treatment (p < .0001), with no statistically significant differences between the groups for these variables except for active joint position error, which showed a significant reduction in the IG (p < .02). Conclusion: It could be concluded that proprioception exercises has a limited added value on routine physiotherapy it terms of pain, function, grip force, and dexterity. However, adding proprioception exercises found to be beneficial for improving variables determining joint position sense.