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

13 de maio de 2026 atualizado por: 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.

Visão geral do estudo

Status

Ainda não está recrutando

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Estimado)

30

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Estude backup de contato

  • Nome: Dr Muhammad Ateeb, PhD Public Health
  • Número de telefone: +92-3357333383
  • E-mail: mateeb.oric@tuf.edu.pk

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Filho
  • Adulto

Aceita Voluntários Saudáveis

Não

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Outro: 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.
Comparador Ativo: 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.
Outro: 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.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Elbow pain
Prazo: 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
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Functional disability
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

University of Faisalabad

Investigadores

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

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

20 de maio de 2026

Conclusão Primária (Estimado)

20 de setembro de 2026

Conclusão do estudo (Estimado)

20 de setembro de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

13 de maio de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

13 de maio de 2026

Primeira postagem (Real)

20 de maio de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

20 de maio de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

13 de maio de 2026

Última verificação

1 de maio de 2026

Mais Informações

Termos relacionados a este estudo

Palavras-chave

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • TUF/EIRB/179/26

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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