Comparative Effects of Sustained Stretch and Mobilization With Movement in Patient With Tennis Elbow

November 3, 2024 updated by: Riphah International University

Comparative Effects of Sustained Stretch and Mobilization With Movement on Pain, Range of Motion, Muscle Strength and Functional Disability in Patient With Tennis Elbow.

Tennis elbow, clinically known as lateral epicondylitis, is a prevalent musculoskeletal issue marked by pain and tenderness on the outer part of the elbow. It primarily affects the extensor tendon at the lateral epicondyle and is commonly linked to repetitive arm movements and overuse. Various treatment options are available for this condition, with two notable methods being sustained stretching and Mobilization with Movement (MWM). Sustained stretching involves holding the affected muscles and tendons in an extended position for a prolonged time to ease muscle tightness and enhance flexibility. Conversely, MWM integrates specific joint movements with the active involvement of the patient to improve joint mobility and reduce pain. Muscle strength plays a crucial role in the overall function of the upper limb, and enhancing this can positively affect daily activities. Furthermore, functional disability indicates how tennis elbow impacts a person's capacity to carry out everyday tasks.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This randomized clinical trial will be conducted at Riphah Rehab center over duration of eight months. The sample size will consist of 58 participants. Participants which meet the inclusion criteria will be taken through non-probability convenience sampling technique. 29 Participants will be assigned to Group A 29 to group B. Data will be collected using various assessment tools, including NPRS, ULFI, Universal Goniometer, Hand Held Dynamometer. Pre-intervention assessments will be conducted for groups. Data analysis will be performed by using SPSS 26 software.

Study Type

Interventional

Enrollment (Estimated)

30

Phase

  • 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 Contact

Study Contact Backup

Study Locations

  • Pakistan
    • Punjab
      • Lahore, Punjab, Pakistan, 54500
        • Riphah Rehab center.
        • Contact:
        • Principal Investigator:
          • Laiba Manzoor, MS-OM

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

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Both males and females are affected. diagnosed with tennis elbow, characterized by pain and weakness on the outer side of the elbow.
  • The pain has persisted for at least 4 to 6 months.
  • Individuals experience difficulty gripping and lifting objects due to elbow pain.
  • Positive results were observed in both the Mills and Cozen tests.

Exclusion Criteria:

  • Presence of nerve injuries or neuropathies in the arm or hand.
  • No history of recent trauma or fracture to the elbow.
  • No neurological conditions affecting the arm or hand
  • Acute inflammation or signs of infection in the elbow joint.
  • Presence of cervical radiculopathy, thoracic outlet syndrome any systemic diseases

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
Intervention / Treatment
Experimental: Group A
The group will engage in traditional tennis elbow exercises and mobilization through movement.
Other: Mobilization with Movement
Mobilization with Movement (MWM) is a manual therapy technique that combines active, patient-directed movements with passive joint mobilization to treat tennis elbow. To find joint restrictions or dysfunctions, a comprehensive patient assessment is the first step in the process. While the patient was in a supine position with the elbow fully extended and the forearm pronated, the therapist applied a sustained lateral glide of the forearm and stabilized the distal portion of the arm. While the patient asked to make a fist, the therapist kept up the lateral glide. Each session included three sets of movement-based mobilizations, each with ten repetitions. The entire course of treatment consists of twelve sessions.
Active Comparator: Group B
The group will be given a prolonged stretch along with conventional tennis elbow exercises.
Other: Sustained Stretch
The basic concept of stretching involves lengthening the tendon during a state of relaxation. To stretch the Extensor Carpi Radialis Brevis tendon, the following position should be adopted: the elbow should be extended, the forearm in a pronated position, the wrist flexed, and the wrist should also be ulnar deviated, based on the patient's comfort level. This position should be maintained for 30 to 45 seconds and repeated three times before and after exercises in each treatment session, with a 30-second rest period in between.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain: Numeric Pain Rating Scale (NPRS)
Time Frame: 4th week
The most widely used pain rating scale, the Numeric Rating Scale (NPRS), has a range of 0 (no pain) to 10 (worst pain). The NPRS will be used to measure the degree of pain. For patients with tennis elbow, it will serve as an outcome measure. The NPRS is regarded as a valid, responsive, and dependable pain scale.
4th week
Function: Upper Limb Functional Index (ULFI)
Time Frame: 4th week
Twenty-five items on the ULFI measure how patients with ULMSDs perceive their own limitations in their activities. Three possible answers are provided for each item: "Yes" (1 point), "Partly" (0.5 points), and "No" (0 points). The maximum disability is determined by multiplying the total points (ranging from 0 to 25) by 4. The patient's functional score in relation to their maximum or pre-injury function is then calculated by subtracting this total score from 100 (0% represents maximum limitation, 100% represents normal or pre-injury function). The total rating can be calculated with no more than two missing responses.
4th week
ROM: Universal Goniometer
Time Frame: 4th week
A double-arm plastic goniometer with a semicircular scale is the most common goniometer for determining range of motion. We will measure the following wrist and elbow movements: wrist flexion, extension, radial and ulnar deviation, and elbow extension and pronation. Three measurements of each movement will be made, and the average will be computed for the outcome analysis.
4th week
Strength: Handheld Dynamometer:
Time Frame: 4th week
A handheld dynamometer (CAMRY EH 101 Electronic Handheld Dynamometer) was used to measure grip strength. The American Society of Hand Therapists' measurement protocols were modified to place participants in a high sitting position, maintain an elbow at a slight 40° flexion, and adjust the handle to the second position. After thoroughly explaining the procedure, the patient was instructed to exert the greatest amount of force possible on the handle and maintain that position for three to five seconds.
4th week

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Ali Raza, MS, 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 (Estimated)

November 1, 2024

Primary Completion (Estimated)

February 1, 2025

Study Completion (Estimated)

March 1, 2025

Study Registration Dates

First Submitted

November 3, 2024

First Submitted That Met QC Criteria

November 3, 2024

First Posted (Estimated)

November 5, 2024

Study Record Updates

Last Update Posted (Estimated)

November 5, 2024

Last Update Submitted That Met QC Criteria

November 3, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/ RCR & AHS/24/0133

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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