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Comparative Effects of Mulligan Mobilization With and Without Myofascial Release Technique in Management of Post Traumatic Elbow Stiffness

13 mai 2026 mis à jour par: Maryam Safdar, University of Faisalabad
The Randomize Clinical Trial will involve 30 participants with post traumatic elbow stiffness recruited from Madinah Teaching Hospital and Chiniot General hospital Faisalabad. Consecutive sampling technique will be used. Study will include individuals with >30° extension loss and <120° flexion, 50° in both directions for pronation-supination, who are 3-6 weeks post-POP removal from radiograph confirmation of skeletal/bone healing will be insured, who have elbow pain from 3 to 5/10 on NPRS and have fully healed fractures. Both intra-articular and extra-articular injuries will be accepted. DASH Score with 45 to 50 points. Study will exclude pathological or acute fractures, burns, brain trauma, neurological or psychological disorders, history of pre-operative osteoarthritis. Consent will be taken written and verbal from participants before including into study. Patients will be allocated with online randomization generator method into 2 groups. Group A will receive Mulligan Mobilization with Myofascial release technique, while Group B will receive Mulligan Mobilization alone. Hot pack for 20 minutes before treatment and static stretching after treatment will apply in both groups. Each stretch is performed 10 repetition with hold duration of 30 sec and rest period 15 sec between each stretch. Total 3 sessions per week for 4 weeks (12 sessions) on alternative days will be given. Outcome of study will be elbow pain, elbow range of motion (flexion and extension) and functional disability will be measure by using Numerical Pain Rating Scale, Universal Goniometer and Dash Questionnaire Score respectively. Data will be investigated by using SPSS version 2023.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Description détaillée

Elbow stiffness is a disabling condition that interferes in daily living activities after trauma. The study's goal is to compare the results of Mulligan Mobilization with and without Myofascial Release Technique in management of post traumatic elbow stiffness. The Randomize Clinical Trial will involve 30 participants with post traumatic elbow stiffness recruited from Madinah Teaching Hospital and Chiniot General hospital Faisalabad. Consecutive sampling technique will be used. Study will include individuals with >30° extension loss and <120° flexion, 50° in both directions for pronation-supination, who are 3-6 weeks post-POP removal from radiograph confirmation of skeletal/bone healing will be insured, who have elbow pain from 3 to 5/10 on NPRS and have fully healed fractures. Both intra-articular and extra-articular injuries will be accepted. DASH Score with 45 to 50 points. Study will exclude pathological or acute fractures, burns, brain trauma, neurological or psychological disorders, history of pre-operative osteoarthritis. Consent will be taken written and verbal from participants before including into study. Patients will be allocated with online randomization generator method into 2 groups. Group A will receive Mulligan Mobilization with Myofascial release technique, while Group B will receive Mulligan Mobilization alone. Hot pack for 20 minutes before treatment and static stretching after treatment will apply in both groups. Each stretch is performed 10 repetition with hold duration of 30 sec and rest period 15 sec between each stretch. Total 3 sessions per week for 4 weeks (12 sessions) on alternative days will be given. Outcome of study will be elbow pain, elbow range of motion (flexion and extension) and functional disability will be measure by using Numerical Pain Rating Scale, Universal Goniometer and Dash Questionnaire Score respectively. Data will be investigated by using SPSS version 2023.

Type d'étude

Interventionnel

Inscription (Estimé)

30

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

  • Nom: Dr Muhammad Ateeb, PhD Public Health
  • Numéro de téléphone: +92-3357333383
  • E-mail: mateeb.oric@tuf.edu.pk

Lieux d'étude

  • Pakistan
    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 38000
        • Outdoor Patient Department (OPD) of Madinah Teaching Hospital and Chiniot General Hospital, Faisalabad.

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Participants aged between 17 and 44 years will be included in the study (Sun et al., 2025).
  • Both male and female patients experiencing mild to moderate elbow pain (3/10 to 5/10 on NPRS) along with restricted range of motion will be eligible (Zulfqar et al., 2021).
  • Subjects having elbow movement limitation of more than 30° in extension, flexion less than 120°, and 50° restriction in both pronation and supination will be included (Masci et al., 2020).
  • Participants will be recruited 3 to 6 weeks after POP removal, and radiographic confirmation of bone/skeletal healing will be ensured before inclusion (Morrey et al., 2017).
  • Patients with both intra-articular and extra-articular fractures will be considered eligible.
  • Individuals with DASH scores ranging from 45 to 50 points will be included.
  • Only patients willing to participate in the study will be enrolled.

Exclusion Criteria:

  • Patients with a history of previous surgical excision will be excluded from the study (Zheng et al., 2018).
  • Participants presenting with pathological fractures will not be included (Zulfqar et al., 2021).
  • Patients in the acute stage of fracture will be excluded from participation (Zulfqar et al., 2021).
  • Individuals with metabolic or malignant conditions causing elbow stiffness, such as gout or osteosarcoma, will not be eligible (Fusaro et al., 2014).
  • Patients with elbow fractures associated with a history of metal implants will be excluded (Zheng et al., 2018).
  • Individuals who have already received physiotherapy treatment or medication for the condition will not be included.
  • Patients diagnosed with psychological illnesses that may interfere with following instructions will be excluded.
  • Participants with brain trauma or referred neurological symptoms, including numbness, dizziness, or hyperesthesia, will not be considered (Fusaro et al., 2014).
  • Patients with structural or postural abnormalities involving the shoulder or wrist will be excluded.
  • Individuals with open skin wounds or burn injuries around the affected area will not be included.
  • Patients with a pre-operative history of arthritis will also be excluded from the study.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Seul

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Group A (Mulligan Mobilization with Myofascial Release Technique)
Participants in Group A will receive a structured treatment program including Mulligan mobilization along with myofascial release techniques aimed at reducing pain, improving functional disability, and enhancing elbow range of motion. Each session will last 40-45 minutes and will be administered three times per week for four weeks.
Autre: Group A (Mulligan Mobilization with Myofascial Release Technique)
The patient will be positioned supine at the edge of the table with the shoulder abducted to 90°, elbow flexed, and forearm supinated. The therapist will stabilize the distal humerus and use a belt around the pelvis while applying a sustained glide through the forearm. Active elbow flexion/extension will be performed with gentle, pain-free overpressure at end range. The technique will be repeated 6-10 times for 1-3 sets with 15-second rest intervals. Myofascial release will be applied with the patient supine, elbow slightly flexed and forearm pronated. The therapist will treat from lateral epicondyle to wrist extensors while the patient performs small elbow movements. Both groups will receive a hot pack application for 20 minutes as a baseline treatment prior to the intervention, followed by static stretching after the session. Each stretch will be performed for 10 repetitions, with a 30-second hold and a 15-second rest interval between stretches.
Comparateur actif: Group B (Mulligan Mobilization alone)
Participants in Group B will be treated with Mulligan Mobilization alone to help reduce pain and improve elbow range of motion. The intervention will be delivered in 40-45 minute sessions, three times per week, for four consecutive weeks.
Autre: Group B (Mulligan Mobilization alone)
The patient will be positioned supine at the edge of the table with the shoulder abducted to 90°, elbow flexed, and forearm supinated. The therapist will stabilize the distal humerus and use a belt around the pelvis while applying a sustained glide through the forearm. Active elbow flexion/extension will be performed with gentle, pain-free overpressure at end range. The technique will be repeated 6-10 times for 1-3 sets with 15-second rest intervals. Both groups will receive a hot pack application for 20 minutes as a baseline treatment prior to the intervention, followed by static stretching after the session. Each stretch will be performed for 10 repetitions, with a 30-second hold and a 15-second rest interval between stretches.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Elbow pain
Délai: Baseline and week 4
The Numeric Pain Rating Scale (NPRS) is an 11-point scale used to assess pain intensity. The scale ranges from 0, indicating no pain, to 10, representing the worst imaginable pain. It is considered a reliable and valid tool for evaluating changes in pain severity over time
Baseline and week 4
Elbow range of motion
Délai: Baseline and week 4
The universal goniometer is a reliable and effective instrument commonly used to assess elbow joint range of motion
Baseline and week 4

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Functional disability
Délai: Baseline and Week 4
The DASH questionnaire is designed to evaluate upper limb function and related symptoms. It assesses the level of difficulty an individual experiences while performing daily activities involving the arm, shoulder, and hand due to pain, weakness, or movement limitations. The questionnaire contains 30 items, and scores range from 0 (no disability) to 100 (maximum disability), with higher scores indicating greater functional impairment
Baseline and Week 4

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

University of Faisalabad

Les enquêteurs

  • Chercheur principal: Dr Maryam Safdar, The University of Faisalabad

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

20 mai 2026

Achèvement primaire (Estimé)

20 septembre 2026

Achèvement de l'étude (Estimé)

20 septembre 2026

Dates d'inscription aux études

Première soumission

13 mai 2026

Première soumission répondant aux critères de contrôle qualité

13 mai 2026

Première publication (Réel)

20 mai 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

20 mai 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

13 mai 2026

Dernière vérification

1 mai 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • TUF/EIRB/179/26

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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