Effects of Mobilization With Movement and Active Release Technique in Patients With Lateral Epicondylitis

May 4, 2026 updated by: Riphah International University
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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
44

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
      • Islamabad, Pakistan, 44010
        • Ali Ahmad Physiocare

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

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.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Intervention Group
MWM+ ART+ Conventional therapy
Other: MWM+ 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.
Active Comparator: Control Group
Conventional Therapy for lateral epicondylitis
Other: Conventional 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.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numeric Pain rating scale
Time Frame: 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
From enrollment to the end of treatment at 1 week]
Functional Disability
Time Frame: 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
From enrollment to the end of treatment at 1 week]

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Range of motion
Time Frame: From enrollment to the end of treatment at 1 week
Range of motion at ankle joint measured using goniometer
From enrollment to the end of treatment at 1 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Sadia Sameen, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 2, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 22, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 27, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
May 4, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 4, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
May 8, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
May 8, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
May 4, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/02293 Sadia

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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