Comparative Effects of Mulligan Mobilization With and Without Myofascial Release Technique in Management of Post Traumatic Elbow Stiffness
2026年5月13日 更新者：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.
研究概览
地位
尚未招聘
详细说明
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.
研究类型
介入性
注册 (估计的)
30
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Maryam Safdar Dr, MS Physical Therapy (MSK)
- 电话号码：+92-3217978088
- 邮箱：maryamsafdar.DPT@tuf.edu.pk
研究联系人备份
- 姓名：Dr Muhammad Ateeb, PhD Public Health
- 电话号码：+92-3357333383
- 邮箱：mateeb.oric@tuf.edu.pk
学习地点
-
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Punjab Province
-
Faisalābad、Punjab Province、巴基斯坦、38000
- Outdoor Patient Department (OPD) of Madinah Teaching Hospital and Chiniot General Hospital, Faisalabad.
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 孩子
- 成人
接受健康志愿者
不
描述
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.
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：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.
|
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.
|
|
有源比较器：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.
|
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.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Elbow pain
大体时间：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
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Baseline and week 4
|
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Elbow range of motion
大体时间：Baseline and week 4
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The universal goniometer is a reliable and effective instrument commonly used to assess elbow joint range of motion
|
Baseline and week 4
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Functional disability
大体时间：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
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Dr Maryam Safdar、The University of Faisalabad
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Pourahmadi MR, Mohsenifar H, Dariush M, Aftabi A, Amiri A. Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review. Clin Rehabil. 2018 Oct;32(10):1289-1298. doi: 10.1177/0269215518778321. Epub 2018 May 30.
- Kain J, Martorello L, Swanson E, Sego S. Comparison of an indirect tri-planar myofascial release (MFR) technique and a hot pack for increasing range of motion. J Bodyw Mov Ther. 2011 Jan;15(1):63-7. doi: 10.1016/j.jbmt.2009.12.002. Epub 2010 Jan 27.
- Masci G, Cazzato G, Milano G, Ciolli G, Malerba G, Perisano C, Greco T, Osvaldo P, Maccauro G, Liuzza F. The stiff elbow: Current concepts. Orthop Rev (Pavia). 2020 Jun 25;12(Suppl 1):8661. doi: 10.4081/or.2020.8661. eCollection 2020 Jun 29.
- Zhang D, Nazarian A, Rodriguez EK. Post-traumatic elbow stiffness: Pathogenesis and current treatments. Shoulder Elbow. 2020 Feb;12(1):38-45. doi: 10.1177/1758573218793903. Epub 2018 Aug 8.
- Sevik Kacmaz K, Unver B. Immediate Effects of Mulligan Mobilization on Elbow Proprioception in Healthy Individuals: A Randomized Placebo-Controlled Single-Blind Study. J Manipulative Physiol Ther. 2023 Jan;46(1):59-64. doi: 10.1016/j.jmpt.2023.05.001. Epub 2023 Jul 7.
- Birinci T, Razak Ozdincler A, Altun S, Kural C. A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial. Clin Rehabil. 2019 Feb;33(2):241-252. doi: 10.1177/0269215518802886. Epub 2018 Oct 10.
- van Rijn SF, Zwerus EL, Koenraadt KL, Jacobs WC, van den Bekerom MP, Eygendaal D. The reliability and validity of goniometric elbow measurements in adults: A systematic review of the literature. Shoulder Elbow. 2018 Oct;10(4):274-284. doi: 10.1177/1758573218774326. Epub 2018 Jun 3.
- Zheng W, Liu J, Song J, Fan C. Risk factors for development of severe post-traumatic elbow stiffness. Int Orthop. 2018 Mar;42(3):595-600. doi: 10.1007/s00264-017-3657-1. Epub 2017 Oct 7.
- Young I, Dunning J, Mourad F, Escaloni J, Bliton P, Fernandez-de-Las-Penas C. Clinimetric analysis of the numeric pain rating scale, patient-rated tennis elbow evaluation, and tennis elbow function scale in patients with lateral elbow tendinopathy. Physiother Theory Pract. 2025 Aug;41(8):1712-1720. doi: 10.1080/09593985.2025.2450090. Epub 2025 Jan 10.
- Sun Z, Li J, van Riet R, Ho PC, Hildebrand KA, Puah KL, Shih JT, Li Z, Chanlalit C, Kekatpure AL, Zhang K, Liu S, Gong M, Huang F, Yan H, Mi J, Lu J, Zha Y, Xiang Z, Xiang M, Li F, Jiang S, Liu W, Zhong B, Ding J, Ruan H, Ouyang Y, Wang W, Yu S, Chen S, Qian Y, Xu Y, Hu Y, Xu J, Jiang X, Jeon IH, Fan C. Clinical guideline on the open arthrolysis for post-traumatic elbow stiffness in adult patients. J Shoulder Elbow Surg. 2026 Mar;35(3):811-825. doi: 10.1016/j.jse.2025.07.015. Epub 2025 Aug 25.
- Ling SK, Lui TH, Faan YS, Lui PW, Ngai WK. Post-traumatic elbow rotational stiffness. Shoulder Elbow. 2014 Apr;6(2):119-23. doi: 10.1177/1758573214524935. Epub 2014 Mar 3.
- He X, Fen Q, Yang J, Lei Y, Heng L, Zhang K. Risk Factors of Elbow Stiffness After Open Reduction and Internal Fixation of the Terrible Triad of the Elbow Joint. Orthop Surg. 2021 Apr;13(2):530-536. doi: 10.1111/os.12879. Epub 2021 Feb 22.
- Fusaro I, Orsini S, Stignani Kantar S, Sforza T, Benedetti MG, Bettelli G, Rotini R. Elbow rehabilitation in traumatic pathology. Musculoskelet Surg. 2014 Apr;98 Suppl 1:95-102. doi: 10.1007/s12306-014-0328-x. Epub 2014 Mar 25.
- Fan M, Xu F, Fei C, Liu Y, Yang Z, Song Z. Post-traumatic elbow stiffness: etiology, risk factors and current treatments. Front Surg. 2025 Aug 26;12:1643326. doi: 10.3389/fsurg.2025.1643326. eCollection 2025.
- Akhtar A, Hughes B, Watts AC. The post-traumatic stiff elbow: A review. J Clin Orthop Trauma. 2021 May 19;19:125-131. doi: 10.1016/j.jcot.2021.05.006. eCollection 2021 Aug.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2026年5月20日
初级完成 (估计的)
2026年9月20日
研究完成 (估计的)
2026年9月20日
研究注册日期
首次提交
2026年5月13日
首先提交符合 QC 标准的
2026年5月13日
首次发布 (实际的)
2026年5月20日
研究记录更新
最后更新发布 (实际的)
2026年5月20日
上次提交的符合 QC 标准的更新
2026年5月13日
最后验证
2026年5月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.