Balance and response time in patients with chronic tennis elbow.

Tennis elbow is a common condition that is easy to diagnose however, the optimal approach to management is still an area of considerable debate with limited evidence to support current practice. This is due to the ambiguous nature of its aetiology and pathology, which remain poorly understood. Bilateral sensorimotor deficits in the upper limb have been found in patients with unilateral tennis elbow, as they had slower response time and slower speed of movement. Research suggests that these patients could also have generalised sensorimotor deficits due to peripheral and central sensitisation. However, only bilateral sensorimotor deficits have been investigated suggesting that research is warranted to investigate the generalised sensorimotor deficits in patients with chronic tennis elbow. Therefore, it is the intention of this research to provide new knowledge in the area of sensorimotor function in these patients. This PhD programme consisted of two phases, the first phase involved healthy participants (n=22) and the second phase involved patients with chronic tennis elbow (n=11). This study was quasi experimental and investigated sensorimotor function by measuring balance and response time of the upper and lower limbs. The outcome measure for balance was time to boundary (TtB) in the anterio-posterior (ap) and medio-lateral (ml) directions. For the response time, the outcome measures were 1-choice response time and 2-choice response time. The test-retest reliability was assessed for these outcome measures using the intraclass correlation coefficient (ICC) and the standard error of measurement and yielded good to excellent reliability estimates. Following descriptive analysis and tests for normality and homogeneity of variance, the data was analysed using a mixed design ANOVA. Results showed that patients with chronic tennis elbow have more balance instability when compared to healthy participants as they were closer to reach their stability boundary in the anterioposterior direction. The findings of this research add new knowledge to the field of sensorimotor function in patients with chronic tennis elbow and enhance the understanding of this condition between health professionals.