- ICH GCP
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- Sperimentazione clinica NCT07604454
Muscle Energy Technique Combined With Mulligan Technique in Tennis Elbow
Effectiveness of Muscle Energy Technique Combined With Mulligan Mobilization Among Patients With Lateral Epicondylitis: A Randomized Controlled Trial
Panoramica dello studio
Stato
Condizioni
Descrizione dettagliata
Lateral epicondylitis, commonly known as tennis elbow, is a musculoskeletal disorder characterized by pain and reduced functional ability affecting the lateral aspect of the elbow. It commonly results from repetitive wrist extension and forearm movements leading to overuse of the extensor tendons.
Conservative physiotherapy management including manual therapy and therapeutic exercises is widely used for the treatment of lateral epicondylitis. Mulligan Mobilization With Movement (MWM) has shown beneficial effects in reducing pain and improving grip strength and functional mobility. Muscle Energy Technique (MET) is another manual therapy approach that may help improve joint mobility, muscle flexibility, and pain reduction through controlled isometric contractions.
This study aims to determine whether combining MET with Mulligan technique provides superior clinical outcomes compared to Mulligan technique alone in patients with tennis elbow.
Participants will be randomly allocated into two groups:
Experimental Group: MET + MWM + Routine Physical Therapy Control Group: MWM + Routine Physical Therapy
Treatment will be provided five sessions per week for four weeks. Outcomes will be assessed at baseline and after completion of the intervention period.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Punjab Province
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Lahore, Punjab Province, Pakistan
- University of Lahore Teaching Hospital, Lahore
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Age between 18 and 45 years
- Both genders
- Unilateral lateral epicondylitis
- Diagnosed by senior physiotherapist
- Pain duration of at least 6 weeks
- Pain score ≥7 on NPRS/VAS
- Positive symptoms during extensor carpi radialis brevis and longus isometric contraction
Exclusion Criteria:
- Previous elbow or shoulder surgery
- Manual therapy within previous 6 months
- History of fracture, dislocation, or tendon tear
- Steroid or pain medication use
- Peripheral nerve entrapment
- Cervical radiculopathy
- Osteoporosis or metastasis involving elbow
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Sperimentale: Experimental Group (MET + MWM + Routine Physical Therapy)
Participants in this group will receive Muscle Energy Technique combined with Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises for wrist extensors.
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Muscle Energy Technique will be applied using resisted isometric contractions of forearm supination and pronation.
Mulligan Mobilization With Movement will be applied using sustained lateral glide during pain-free gripping activity.
Treatment sessions will be conducted five times weekly for four weeks.
|
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Comparatore attivo: Control Group (MWM + Routine Physical Therapy)
Participants in this group will receive Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises.
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Mulligan Mobilization With Movement technique will be applied using sustained glide of the forearm while participants perform pain-free gripping activities.
Sessions will be conducted five times weekly for four weeks.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)
Lasso di tempo: Baseline and after 4 weeks of intervention
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Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
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Baseline and after 4 weeks of intervention
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Functional Disability Measured by PRTEE Questionnaire
Lasso di tempo: Baseline and after 4 weeks of intervention
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Functional disability will be assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire.
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Baseline and after 4 weeks of intervention
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Quality of Life Measured by SF-8 Questionnaire
Lasso di tempo: Baseline and after 4 weeks of intervention
|
Quality of life will be assessed using the Short Form-8 (SF-8) questionnaire.
The SF-8 is an 8-item questionnaire that evaluates physical functioning, general health, pain, vitality, social functioning, emotional role, mental health, and physical role limitations.
Higher scores indicate better quality of life.
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Baseline and after 4 weeks of intervention
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Collaboratori e investigatori
Sponsor
Collaboratori
Pubblicazioni e link utili
Pubblicazioni generali
- Ahmed A, Ibrar M, Arsh A, Wali S, Hayat S, Abass S. Comparing the effectiveness of Mulligan mobilization versus Cyriax approach in the management of patients with subacute lateral epicondylitis. J Pak Med Assoc. 2021 Jan;71(1(A)):12-15. doi: 10.47391/JPMA.186.
- Aben A, De Wilde L, Hollevoet N, Henriquez C, Vandeweerdt M, Ponnet K, Van Tongel A. Tennis elbow: associated psychological factors. J Shoulder Elbow Surg. 2018 Mar;27(3):387-392. doi: 10.1016/j.jse.2017.11.033.
- Bagcaci S, Unuvar BS, Gercek H, Ugurlu I, Sert OA, Yilmaz K. A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. J Back Musculoskelet Rehabil. 2023;36(2):419-427. doi: 10.3233/BMR-220061.
- Bowman EN. Current concepts: pathology in the overhead athlete's lateral elbow. J Shoulder Elbow Surg. 2024 Feb;33(2):507-511. doi: 10.1016/j.jse.2023.08.017. Epub 2023 Sep 27.
- Blanchette MA, Normand MC. Augmented soft tissue mobilization vs natural history in the treatment of lateral epicondylitis: a pilot study. J Manipulative Physiol Ther. 2011 Feb;34(2):123-30. doi: 10.1016/j.jmpt.2010.12.001.
- Bazancir Z, Firat T. A potential factor in the pathophysiology of lateral epicondylitis: The long sarcomere length of the extensor carpi radialis brevis muscle and implications for physiotherapy. Med Hypotheses. 2019 Sep;130:109278. doi: 10.1016/j.mehy.2019.109278. Epub 2019 Jun 12.
- Alagaesan, J., & Nirmala, J. G. (2024). Effectiveness of Mulligan Mobilization Technique Versus Cyriax Technique for Lateral Epicondylitis: A Pilot Study. Indian Journal of Physiotherapy & Occupational Therapy, 18.
- Akbar H, Akbar S, Saddique MN, Sarfraz MS. Prevalence of lateral epicondylitis among housewives in Lahore: a cross-sectional study. BMC Musculoskelet Disord. 2024 Oct 15;25(1):815. doi: 10.1186/s12891-024-07889-x.
- Afzal, M., Zakaullah, S., Memon, S. I., Nisar, A., Touqeer, H., & Shabir, H. (2021). Prevalence and risk factors of lateral epicondylitis among restaurant cooks at district Gujranwala: A cross-sectional study. Rawal Medical Journal, 46(2), 338.
- Abd Elrahim, R. M., Ali, M. F., Elwerdany, S. H., Salama, A. M., & Elsayed, M. (2022). Mulligan mobilisation with movement versus deep friction massage in patients with lateral epicondylitis. J Pharm Negat Results, 13, 5184-5192.
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Altri numeri di identificazione dello studio
- UOL/IREB/25/12/0027
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