Trial Outcomes & Findings for Prolotherapy for the Treatment of Chronic Lateral Epicondylitis (NCT NCT00674622)

NCT ID: NCT00674622

Last Updated: 2016-05-16

Results Overview

This is a pain severity rating. 15 adjectival descriptors of pain are scored on a 0-3 scale for a total score of 0-45 with a high score reflecting greater pain severity.

Recruitment status

COMPLETED

Study phase

PHASE2/PHASE3

Target enrollment

67 participants

Primary outcome timeframe

6 weeks and 12 weeks post intervention

Results posted on

2016-05-16

Participant Flow

Recruitment took place between 3/17/2008 to 3/15/2010. All patients were seen at the University of Pittsburgh Medical Center outpatient clinics.

105 subjects completed informed consent. 38 subjects were ineligible, based on absence of diagnosis of lateral epicondylitis, insufficient severity of symptoms, or presence of an exclusion. 1 subject completed all assessments but declined participation and was not randomized.

Participant milestones

Participant milestones
Measure
Group 1-Prolotherapy
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
Superficial injection with saline/lidocaine
Overall Study
STARTED
22
22
22
Overall Study
COMPLETED
21
18
22
Overall Study
NOT COMPLETED
1
4
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Prolotherapy for the Treatment of Chronic Lateral Epicondylitis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
Total
n=66 Participants
Total of all reporting groups
Age, Continuous
49 years
n=5 Participants
50 years
n=7 Participants
50 years
n=5 Participants
49 years
n=4 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
10 Participants
n=7 Participants
11 Participants
n=5 Participants
28 Participants
n=4 Participants
Sex: Female, Male
Male
15 Participants
n=5 Participants
12 Participants
n=7 Participants
11 Participants
n=5 Participants
38 Participants
n=4 Participants
Race/Ethnicity, Customized
White
18 participants
n=5 Participants
22 participants
n=7 Participants
22 participants
n=5 Participants
62 participants
n=4 Participants
Race/Ethnicity, Customized
Black
2 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
2 participants
n=4 Participants
Race/Ethnicity, Customized
Asian
1 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
1 participants
n=4 Participants
Race/Ethnicity, Customized
Hispanic
1 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
1 participants
n=4 Participants
Region of Enrollment
United States
22 participants
n=5 Participants
22 participants
n=7 Participants
22 participants
n=5 Participants
66 participants
n=4 Participants

PRIMARY outcome

Timeframe: 6 weeks and 12 weeks post intervention

This is a pain severity rating. 15 adjectival descriptors of pain are scored on a 0-3 scale for a total score of 0-45 with a high score reflecting greater pain severity.

Outcome measures

Outcome measures
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
McGill Pain Questionnaire
Baseline
16.6 units on a scale
Standard Deviation 9.0
15.7 units on a scale
Standard Deviation 6.4
14.3 units on a scale
Standard Deviation 6.2
McGill Pain Questionnaire
End of Phase 1
8.2 units on a scale
Standard Deviation 7.7
8.4 units on a scale
Standard Deviation 6.0
6.0 units on a scale
Standard Deviation 6.4
McGill Pain Questionnaire
End of Phase 2
5.6 units on a scale
Standard Deviation 5.5
3.7 units on a scale
Standard Deviation 3.9
5.4 units on a scale
Standard Deviation 4.8

SECONDARY outcome

Timeframe: 6 weeks and 12 weeks post-intervention

The QuickDASH is an abbreviated form of the rating scale DASH or Disabilities of the Arm, Shoulder, \& Hand. This is a self-report rating of function for individuals with problems of the upper extremity. The Institute for Work and Health, in collaboration with the American Academy of Orthopaedic Surgeons developed a self-report questionnaire "Disabilities of the Arm, Shoulder, \& Hand". It is seen as a valid and reliable measure of upper extremity functional impairment, is in widespread use in the States and abroad, having been translated into multiple languages and has been used for studies on LE. 11 items are scored on this self-rating instrument on a 1-5 Likert scale with higher score reflecting greater disability. The scores are averaged and then converted to a 100 point scale (0-100), with higher score reflecting greater disability.

Outcome measures

Outcome measures
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
QuickDASH
Baseline
40.2 units on a scale
Standard Deviation 16.2
39.7 units on a scale
Standard Deviation 15.6
32.5 units on a scale
Standard Deviation 16.0
QuickDASH
End of Phase 1
18.5 units on a scale
Standard Deviation 18.6
21.2 units on a scale
Standard Deviation 17.3
16.7 units on a scale
Standard Deviation 17.5

SECONDARY outcome

Timeframe: 6 weeks and 12 weeks post-intervention

Maximal pain-free grip strength has been used as a physical correlate of disability associated with LE. Grip strength was obtained using a Jamar Dynamometer set in the 2nd position. 3 trials were recorded and the average pain-free grip strength was noted.

Outcome measures

Outcome measures
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
Grip Strength
Baseline
52.18 pounds
Standard Deviation 26.03
57.31 pounds
Standard Deviation 34.96
60.89 pounds
Standard Deviation 25.09
Grip Strength
End of Phase 1
65.28 pounds
Standard Deviation 20.89
67.87 pounds
Standard Deviation 30.38
78.54 pounds
Standard Deviation 27.07
Grip Strength
End of Phase 2
66.87 pounds
Standard Deviation 20.90
78.70 pounds
Standard Deviation 30.76
82.17 pounds
Standard Deviation 28.83

SECONDARY outcome

Timeframe: 6 and 12 weeks post-intervention

The Nirschl Pain Phase Scale (NPPS), which has been used to describe functional impairment related to tendinopathies such as lateral epicondylitis. This scale provides a global rating of impairment associated with sports and musculoskeletal injuries. A rating from 0-7 describes the phase of overuse injuries, with Phase 0 noting "No stiffness or soreness after activity" and Phase 7 corresponding with "Pain that also disrupts sleep consistently. Pain is aching in nature and intensifies with activity". It was used as an indication of severity for entry into the study and as the criterion for treatment response.

Outcome measures

Outcome measures
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
Nirschl Pain Phase Scale
Baseline
5.18 units on a scale
Standard Deviation 0.66
5.18 units on a scale
Standard Deviation 0.85
5.23 units on a scale
Standard Deviation 0.92
Nirschl Pain Phase Scale
End of Phase 2
2.10 units on a scale
Standard Deviation 1.51
2.19 units on a scale
Standard Deviation 0.91
2.09 units on a scale
Standard Deviation 1.31
Nirschl Pain Phase Scale
End of Phase 1
2.86 units on a scale
Standard Deviation 1.96
3.17 units on a scale
Standard Deviation 1.86
2.32 units on a scale
Standard Deviation 1.39

SECONDARY outcome

Timeframe: 6 and 12 weeks post-intervention

Pressure pain threshold (PPT) has been noted to correlate with pain and disability associated with LE. PPT was determined by applying pressure with a digital algometer over the area of maximal tenderness corresponding with the common extensor tendon area. Only 1 determination was obtained as the 1st application of pressure can lower the pain threshold for subsequent testing.

Outcome measures

Outcome measures
Measure
Group 1-Prolotherapy
n=22 Participants
Deep injection with 15% dextrose in lidocaine
Group 2-Deep Saline/Lidocaine
n=22 Participants
Deep injection with saline/lidocaine
Group 3-Superficial Saline/Lidocaine
n=22 Participants
Superficial injection with saline/lidocaine
Pain Threshold on Dolorimetry
Baseline
6.34 Pounds
Standard Deviation 2.71
6.37 Pounds
Standard Deviation 2.72
7.67 Pounds
Standard Deviation 2.85
Pain Threshold on Dolorimetry
End of Phase 1
8.26 Pounds
Standard Deviation 3.08
7.87 Pounds
Standard Deviation 3.75
9.81 Pounds
Standard Deviation 4.57
Pain Threshold on Dolorimetry
End of Phase 2
9.68 Pounds
Standard Deviation 3.05
10.13 Pounds
Standard Deviation 4.44
11.57 Pounds
Standard Deviation 5.45

Adverse Events

Group 3-Superficial Saline/Lidocaine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group 1-Prolotherapy

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Group 2-Deep Saline/Lidocaine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Ronald Glick, MD

University of Pittsburgh School of Medicine Department of Psychiatry

Phone: 412-623-3023

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place