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

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

44

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 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

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
Intervention / Treatment
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

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

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

Riphah International University

Investigators

  • 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)

November 2, 2025

Primary Completion (Actual)

April 22, 2026

Study Completion (Actual)

April 27, 2026

Study Registration Dates

First Submitted

May 4, 2026

First Submitted That Met QC Criteria

May 4, 2026

First Posted (Actual)

May 8, 2026

Study Record Updates

Last Update Posted (Actual)

May 8, 2026

Last Update Submitted That Met QC Criteria

May 4, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID 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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