Effects of Nerchal Exercises on Lateral Epicondylitis.

Effects of Nirschl Exercises With and Without Mulligan Taping in Lateral Epicondylitis

Painful condition of lateral epicondyle of the humerus characterized by the inflammation of the tendons during loading of the wrist extensor muscles is a common musculoskeletal presentation in men and women between 35 and 54 years of age. The above symptom is associated with a clinical diagnosis of lateral elbow tendinopathy (LET), also known as tennis elbow or lateral epicondylalgia the two effective treatment approaches for lateral epicondylitis are Nirschl exercises and Mulligan taping. This study aims to evaluate the effectiveness of Nirschl exercises with or without Mulligan taping in treating lateral epicondylitis. The study design for this project employs a randomized controlled trial and a sample of individuals with lateral epicondylitis randomly assigned in one of the two groups i.e., Nirschl exercises only and Nirschl exercises with Mulligan taping. Nirschl exercises involve the eccentric strengthening of the wrist extensor muscles and forearm. The participants in both groups will receive Nirschl exercises while the second group will also receive Mulligan taping, which involves the application of tape to the lateral aspect of the elbow to offload stress during movement of the extensor tendons. Different outcome measures including pain intensity, functional disability, grip strength, range of motion will be evaluated using, PRTEE Scale, Visual Analogue Scale (VAS) and Calibrated Jammer hand held dynamometer. Statistical analysis, including independent t-tests or chi-square tests, will be conducted to compare the outcomes between the two groups. The significance level will be set at p < 0.05. This study will contribute to the evidence base regarding the efficacy of Nirschl exercises and Mulligan taping in managing lateral epicondylitis and will help the clinicians and patients in deciding the best treatment approach for lateral epicondylitis.

Study Overview

• Status: Completed
• Conditions: Lateral Epicondylitis
• Intervention / Treatment: Other: Mulligan Taping

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab
    • Multan, Punjab, Pakistan, 60000
      • BARKI Advanced Physiotherapy Center
    • Multan, Punjab, Pakistan, 60000
      • KAIMS Physiotherapy and Rehabilitation Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Pain and tenderness over lateral epicondyle
• at least two out of three tests for the lateral epicondylitis including Cozen's test, Mill's maneuver, or resisted middle finger extension positive

Exclusion Criteria:

• Individuals with a history of recent trauma of upper limbs
• Recent administration of platelet-rich plasma containing growth factors,
• Patients which had taken physical therapy of any sort in the past 6 months
• occupation-related pain were ruled out.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Nirshl exercise with Mulligan Taping; This group will be treated with Nirshl exercises with Mulligan taping	Other: Mulligan Taping; Mulligan taping involves the application of tape to the lateral aspect of the elbow to offload stress during movement of the extensor tendons.
No Intervention: Nirshl exercise without Mulligan taping; This group will be treated with Nirshl exercises only.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Pain will be measured using Visual Analogue Scale (VAS), min0 and max 10	3 week consist of 6 sessions
Grip strength	It will be measured using calibrated Jammer hand-held dynamometer.	3 week consist of 6 sessions

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Disability	It will be measured using PRTEE scale. 0-10 scale	3 week consist of 6 sessions

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Sana ullah, MSPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Actual): November 1, 2023
• Primary Completion (Actual): March 28, 2024
• Study Completion (Actual): March 28, 2024

Study Registration Dates

• First Submitted: January 28, 2024
• First Submitted That Met QC Criteria: March 17, 2024
• First Posted (Actual): March 19, 2024

Study Record Updates

• Last Update Posted (Actual): April 19, 2024
• Last Update Submitted That Met QC Criteria: April 18, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Musculoskeletal Diseases; Muscular Diseases; Tendon Injuries; Tendinopathy; Arm Injuries; Elbow Tendinopathy; Elbow Injuries; Tennis Elbow
• Other Study ID Numbers: REC/RCR&AH/23/0167/shan ali

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