also prevent disuse atrophy or muscle weakness resulting from less or no activity due to pain and disability caused by tennis elbow. It has been assumed that the underlying
mechanism of pain relief secondary to friction massage may be due to modulation of pain impulses at the spinal cord level [43]. At present, no published evidence exists to support the proposed mechanism as to what actually occurs during and following manual treatment with Cyriax physiotherapy [33].The hypothesized mechanism of Mill’s manipulation is the lengthening of scar tissue following the rupture of adhesions
due to the manipulation [33]. In comparing the results of these trials to those experienced by the supervised exercise treatment group in the present study, two points must be considered. First, none of the above-mentioned trials used a true control group, thereby not controlling for the natural course of the disorder or spontaneous recovery. Second, the present study did not assign patients to receive supervised exercise as an isolated treatment. Therefore, comparisons between our results and those of previous trials should be made with caution as it is not possible to determine which intervention made the greatest contribution to the treatment effect.
also prevent disuse atrophy or muscle weakness resulting from less or no activity due to pain and disability caused by tennis elbow. It has been assumed that the underlyingmechanism of pain relief secondary to friction massage may be due to modulation of pain impulses at the spinal cord level [43]. At present, no published evidence exists to support the proposed mechanism as to what actually occurs during and following manual treatment with Cyriax physiotherapy [33].The hypothesized mechanism of Mill’s manipulation is the lengthening of scar tissue following the rupture of adhesionsdue to the manipulation [33]. In comparing the results of these trials to those experienced by the supervised exercise treatment group in the present study, two points must be considered. First, none of the above-mentioned trials used a true control group, thereby not controlling for the natural course of the disorder or spontaneous recovery. Second, the present study did not assign patients to receive supervised exercise as an isolated treatment. Therefore, comparisons between our results and those of previous trials should be made with caution as it is not possible to determine which intervention made the greatest contribution to the treatment effect.
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