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Comparative Effects of Multiple Angle Isometrics vs Standard Isometric Exercise in Lateral Epicondylitis

28 de septiembre de 2026 actualizado por: Ibadat International University, Islamabad

Comparative Effects of Multiple Angle Isometrics vs Standard Isometric Exercise in Lateral Epicondylitis:A Randomized Controlled Trial

Lateral Epicondylitis is one of the most common musculoskeletal conditions affecting 1-3% of population.Various terminologies are used to describe the disease like tendinitis of extensor carpi radialis brevis muscle (ECRB), periostitis and radial epicondylitis, lateral epicondylitis is still the most used terminology in literature. Research shows that LE mainly targets population which is active with poor nutrition habits and biomechanical faults thus affecting their job and social life. Pain is seen to be activity dependent and is triggered via excessive muscle activity.

Descripción general del estudio

Descripción detallada

Lateral epicondylitis (tennis elbow) is a frequent musculoskeletal condition, which involves pain, decreased grip strength and functional impairments due to a degeneration of the common extensor tendon. Despite the fact that isometric exercises are widely applied in the conservative treatment of lateral epicondylitis for their analgesic and strengthening properties, the most effective way of isometric training is not known. Multiple Angle Isometric (MAI) exercises are designed to engage a larger number of muscle fibres, increase neuromuscular activation and strengthen muscles across their entire range of motion than single angle isometric exercises.

The objective of this randomized controlled trial is to determine the effectiveness of the Multiple Angle Isometric (MAI) exercise to reduce pain, strengthen the wrist extensor muscles and increase upper limb function in patients with lateral epicondylitis when compared with the Standard Isometric (SI) exercise. The total number of participants is 36 with acute and sub acute lateral epicondylitis and will be sampled by non-probability purposive sampling and divided into two intervention groups by random allocation. All subjects will then be given the same initial treatment (hot pack and Transcutaneous Electrical Nerve Stimulation [TENS]) and then their respective exercise protocols. The intervention will take place three times a week for four weeks.

The Numeric Pain Rating Scale (NPRS) will be used to assess pain intensity, Camry digital hand dynamometer to assess wrist extensor grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire will be used to assess functional disability. Measurements will be taken pre- and post- and post-4 weeks after completion of the intervention. This study's results will give physiotherapists evidence for comparative effectiveness of the Multiple Angle Isometric and Standard Isometric exercise protocols to choose the most effective rehabilitation approach for lateral epicondylitis and optimal patient outcomes.

Tipo de estudio

Intervencionista

Inscripción (Actual)

36

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Punjab Province
      • Islamabad, Punjab Province, Pakistán, 4000
        • Akbar Niazi Teaching Hospital

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

25 años a 35 años (Adulto)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

  • Inclusion Criteria:
  • Adults aged 25-35 years.
  • Clinically diagnosed with acute or subacute lateral epicondylitis.
  • Patients with ≥3 out of the following 5 positive clinical tests:
  • Pain on palpation over the lateral epicondyle.
  • Cozen's test positive.
  • Mill's test positive.
  • Maudsley's test positive.
  • Acute or subacute clinical presentation.
  • Willing to participate and provide written informed consent.
  • Exclusion Criteria:
  • Cervical spine disorders.
  • Chronic lateral epicondylitis.
  • Elbow deformity (fracture, previous surgery, contracture, etc.).
  • Diabetes mellitus.
  • Steroid injection at the lateral epicondyle within the previous 3 months.
  • Rheumatoid arthritis or other neurological or muscular disorders.
  • Previous elbow injury.
  • Arthritic changes or calcifications around the elbow joint on radiographs. Malignancy.
  • Pregnancy.
  • Corticosteroid injection to the lateral epicondyle within the previous 6 weeks.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Group A-Multiple Angle Isometrics (MAI)

Participants will be given baseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total.

Baseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total.

Comparador activo: Group B - Standard Isometric Exercise

Participants will get the same baseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks).

Baseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks).

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Numeric Pain Rating Scale (NPRS)
Periodo de tiempo: Baseline, Week2 , Week 4

Assesses pain intensity using an 11-point numerical scale (0-10).

Baseline, Week2 , Week 4
Grip Strength (Camry Digital Hand Dynamometer)
Periodo de tiempo: Baseline, 2 Week, 4 Week

Assess wrist extensor grip strength using a digital hand dynamometer.

Baseline, 2 Week, 4 Week
Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire
Periodo de tiempo: Baseline, 2 Week, 4 Week

Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a standardized tool that relies on patient-reported outcomes to evaluate function and disability in the upper limbs. It includes 30 questions designed to assess how symptoms affect daily tasks and physical abilities. Scores are calculated on a scale from 0 to 100, where higher values reflect more severe disability.

Baseline, 2 Week, 4 Week

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Maria Fatima Mughees, DPT, Akbar Niazi Teaching Hospital

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

11 de enero de 2026

Finalización primaria (Actual)

10 de marzo de 2026

Finalización del estudio (Actual)

10 de junio de 2026

Fechas de registro del estudio

Enviado por primera vez

23 de septiembre de 2026

Primero enviado que cumplió con los criterios de control de calidad

28 de septiembre de 2026

Publicado por primera vez (Actual)

29 de septiembre de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

29 de septiembre de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

28 de septiembre de 2026

Última verificación

1 de septiembre de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Otros números de identificación del estudio

  • Ref no: IIUI/RERC/ADT/2026/02/

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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