Lateral Epicondylitis (Tennis Elbow)
Conditions
Keywords
Lateral Epicondylitis, MWM for LE, ART
Brief summary
This study is a randomized controlled trial (RCT) investigating the effectiveness of Mobilization with Movement (MWM) combined with Active Release Technique (ART) in the management of lateral epicondylitis. A total of 44 participants, aged 18-55 years with a clinical diagnosis of lateral epicondylitis (duration ≥6 weeks), will be randomly assigned into two groups. The intervention group will receive MWM, applied as sustained lateral glides during active, pain-free movements, along with ART targeting the wrist extensor muscles, with both techniques administered three sessions per week for four weeks in combination with conventional treatment. The control group will receive conventional treatment only. The primary outcome measures will include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), functional disability using the Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength measured with a hand dynamometer, and range of motion assessed using a goniometer. Assessments will be conducted at baseline, at the end of week 2, and at the end of week 4. The study aims to determine whether the addition of MWM and ART provides significant improvements in pain reduction, correction of joint mechanics, and functional performance compared to conventional therapy alone.
Interventions
OTHERMWM+ ART
Participants allocated to the experimental group will receive a combined intervention consisting of Mobilization with Movement (MWM), Active Release Technique (ART), and conventional rehabilitation. MWM will be applied as a sustained lateral glide to the elbow joint while the participant performs pain-free active movements such as gripping or wrist extension, aiming to correct joint positional faults and reduce pain. ART will be administered to the wrist extensor muscle group, particularly targeting the extensor carpi radialis brevis, using manual tension combined with active or passive muscle movement to release soft tissue adhesions and improve tissue mobility. Both MWM and ART will be delivered at a frequency of three sessions per week for four weeks. In addition, participants will perform a conventional rehabilitation program including eccentric strengthening exercises for the wrist extensors, stretching exercises, and activity modification advice.
OTHERConventional therapy group
Participants allocated to Arm 2 (control group) will receive conventional physiotherapy treatment only for the management of lateral epicondylitis. The treatment protocol will include the application of a hot pack for 15 minutes, placed over the lateral aspect of the elbow to help reduce pain, improve local circulation, and prepare the tissues for exercise. Following this, participants will perform post-treatment dynamic stretching exercises, including dynamic wrist flexor stretches and forearm supination/pronation swings to improve flexibility and mobility of the forearm musculature.This treatment will be administered three sessions per week for four weeks and will serve as the standard care protocol against which the experimental intervention will be compared.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Duration of symptoms ≥ 6 weeks. Pain intensity of NPRS ≥ 4 at baseline. Elbow pain during specific tests, i.e., Cozen's Test (resisted wrist extension with the elbow extended) and Mill's Test (passive wrist flexion with the elbow extended). Presence of clinical symptoms such as lateral elbow pain, tenderness over the lateral epicondyle, reduced grip strength, and pain aggravated by wrist extension or gripping activities
Exclusion criteria
* Subjects with pain at the wrist, neck, or shoulder; bilateral elbow pain; previous elbow surgery in the last 12 months; or any arthritic changes of the elbow joint.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric Pain rating scale | From enrollment to the end of treatment at 1 week] | Level of pain measured by Numeric Pain rating scale (NPRS), 0 means no pain and 10 means severe pain |
| Functional Disability | From enrollment to the end of treatment at 1 week] | Pain and functional disability of tennis elbow patients can be measured using a patient-rated tennis elbow evaluation (PRTEE) questionnaire. The PRTEE consists of 15 questions: Pain has 5 items, Sum of the 5 pain items. Function has 6 items (specific activities) + 4 items (usual activities), Sum of the 10 function items, divided by 2. PRTEE items are graded from 0 to 10, with zero indicating no discomfort or handicap and 10 indicating the worst or unable |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion | From enrollment to the end of treatment at 1 week | Range of motion at ankle joint measured using goniometer |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORSadia Sameen
Riphah International University
Outcome results
None listed