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Microvascular response in the ECRB muscle of patients with lateral epicondylitis
Örebro University, School of Health and Medical Sciences. (Research in musculoskeletal health and disease)
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

The microvascular response in extensor carpi radialis brevis (ECRB) muscle was studied in thirteen patients with unilateral epicondylitis. At rest the intramuscular blood flow was significantly lower in the affected arm than in the unaffected (P = 0.006). During dorsal extension for 1 min at 40% maximal voluntary contraction (MVC) and 2 min at 20% MVC, blood flow increased significantly in both arms (P = 0.02). Microcirculation remained above resting level both 1 and 2 min after contraction at 40% MVC but was back to the precontraction level 2 min after contraction at 20 % MVC. The reactive hyperaemic response after occlusion of the brachial artery for 5 min, showed no significant difference between the arms. The reason for the hampered microcirculation in ECRB at rest does not seem to be due to a decreased ability of the vessel wall to dilate. Other plausible reasons merits further investigation.

Keyword [en]
tennis elbow, laser Doppler flowmetry, muscle perfusion, static contraction, muscle force, post-occlusive reactive hyperaemia
National Category
Physiology Sport and Fitness Sciences
Research subject
Sports Science
Identifiers
URN: urn:nbn:se:oru:diva-10889OAI: oai:DiVA.org:oru-10889DiVA: diva2:321741
Available from: 2010-06-02 Created: 2010-06-02 Last updated: 2017-10-18Bibliographically approved
In thesis
1. Lateral epicondylitis: intramuscular blood flow, pressure and metabolism in the ECRB muscle
Open this publication in new window or tab >>Lateral epicondylitis: intramuscular blood flow, pressure and metabolism in the ECRB muscle
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Lateral epicondylitis is classified as an overuse injury and the main symptom is pain from the lateral side of the elbow. There is general agreement that the extensor carpi radialis brevis (ECRB) muscle and its proximal tendon play a central role in the development of lateral epicondylitis. However, the pathophysiology is to a large extent unclear. The aim of the thesis was to investigate the intramuscular blood flow, the muscle metabolism as well as the vascular reactivity and the intramuscular pressure (IMP). Patients having chronic unilateral epicondylitis were investigated, with the unaffected arm serving as a control. Measurements were performed during rest, before and 3 and 12 months after an injection of botulinum toxin type A to cause relaxation of the muscle as well as after muscle contraction and occlusion of blood flow.

Initial intramuscular blood flow in the affected ECRB was lower compared with the unaffected muscle and anaerobic metabolism was recorded. The dif­ference in intramuscular blood flow between the affected and the unaffected arm was reduced after injection of botulinum toxin type A and muscle metabolism was aerobic. Perceived pain (VAS-score) was reduced and functional daily activity was improved, evaluated using the instrument Canadian Occupational Performance Measure (COMP) and the Disability of Arm, Shoulder and Hand instrument (DASH). Vascular reactivity during recovery after muscle contraction tended to be faster on the unaffected side than on the affected side. No difference in the post-occlusive reactive hyperaemia response between the affected and the unaffected ECRB was observed. The intramuscular pressure tended to be elevated in affected muscle.

In conclusion, decreased microcirculation and an anaerobic metabolism in ECRB may contribute to the symptoms in chronic lateral epicondylitis, which has not previously been showed. The impaired blood flow in the affected arm does not seem to be caused by impaired vascular reactivity but may partly be due to an elevated IMP probably due to an increased tension in the affected ECRB.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2010. 59 p.
Series
Örebro Studies in Sport Sciences, ISSN 1654-7535 ; 7
Keyword
Lateral epicondylitis, ECRB, intramuscular microcirculation, intramuscular pressure, botulinum toxin, muscle metabolism, pain
National Category
Medical and Health Sciences
Research subject
Sports Science
Identifiers
urn:nbn:se:oru:diva-10892 (URN)978-91-7668-731-4 (ISBN)
Public defence
2010-09-03, HSP1, Prismahuset, Örebro universitet, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-06-07 Created: 2010-06-02 Last updated: 2017-10-18Bibliographically approved

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Oskarsson, Eva

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