Adding Neural Mobilization to Mulligan Technique for Treatment of Patients With Chronic Tennis Elbow
NCT ID: NCT06765798
Last Updated: 2025-12-19
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
60 participants
INTERVENTIONAL
2025-01-01
2025-06-01
Brief Summary
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Detailed Description
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Patients with tennis elbow usually report pain or tenderness at the lateral epicondyle of the humerus, decreased gripping strength, and weakness when turning their palms up and straightening their wrists. Pain and inflammation of make it difficult to move the elbow joint through its full range of motion because of the pain and affect function of joint (ECRB)
Radial nerve mobilization exercises, has been used to treat musculoskeletal problems, including LE. Nerve mobilization or neurodynamic mobilization, defined by David Butler, is aimed at restoring homeostasis in and around the nervous system through facilitating movement between neural structures and their surroundings. It is stated that neural shifting reduces adhesions between the nerve and surrounding tissue, improves neural vascularity, and improves the axoplasmic flow Mulligan mobilization with movement (MWM) is a form of manual therapy that includes a sustained lateral glide to the elbow joint with concurrent physiological movement. This mobilization technique is often used to correct the faulty position of the elbow joint. It is the primary modality for the correction of positional fault of the elbow joint complex mimicking a contractile element pathology of the common extensor bundle." Which result in reducing pain, improvement of pain-free grip strength (PFGS), and increased ability to tolerate resisted isometric wrist extension
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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group A
Group A received neural mobilization for radial nerve, mulligan mobilization with movement and conventional therapy
Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy
Group A :Neural Mobilization for radial nerve, Mulligan Mobilization with Movement and Conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for
group B
Group B received neural mobilization for radial nerve and conventional therapy
Group B receive neural mobilization for radial nerve and conventional
Group B receive neural mobilization for radial nerve and conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group C
Group C received mulligan mobilization with movement and conventional therapy
Group C receive Mulligan mobilization with movement and conventional
Group C receive Mulligan mobilization with movement and conventional
Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group D
Group D received conventional therapy
Group D receive conventional
Group D receive conventional :
Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Interventions
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Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy
Group A :Neural Mobilization for radial nerve, Mulligan Mobilization with Movement and Conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for
Group B receive neural mobilization for radial nerve and conventional
Group B receive neural mobilization for radial nerve and conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group C receive Mulligan mobilization with movement and conventional
Group C receive Mulligan mobilization with movement and conventional
Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group D receive conventional
Group D receive conventional :
Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Eligibility Criteria
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Inclusion Criteria
* . Diagnosed with chronic tennis elbow
* experienced discomfort in their dominant arm, tenderness over the lateral epicondyle of the elbow joint, and exhibited signs and symptoms of tennis elbow persisting for three months
* Increased pain with resistant elbow extension, wrist extension, gripping, and supination
* ULTT 2 b (radial nerve) should be positive ) pain referral throughout the dorsal and radial aspect of the forearm and, sometimes, an "electrical shock-like" pain on the radial side of the right wrist (
Exclusion Criteria
* acute strain, fractures of the humerus, radius, and ulna,
* History of Rheumatoid diseases
* Subjects on steroids or any other medications for pain at present were excluded
* severe edema, infection
* malignancy
* osteoporosis
* unstable joints
* severe neck or shoulder pain, neurological conditions \\ impacting the upper extremity Cervical radiculopathy
* Bilateral Symptoms of Tennis elbow
20 Years
60 Years
ALL
Yes
Sponsors
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Safaa Radi Saber
OTHER
Responsible Party
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Safaa Radi Saber
Master degree student .Basic Science . Physical therapy . Cairo university
Principal Investigators
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Maher Ahmed Elkeblawy Professor of physical Therapy,Department of Basic Science, Professor of physical Therapy
Role: STUDY_DIRECTOR
Professor of physical Therapy ,Department of Basic Science , Faculty of Physical Therapy Cairo University
Mariam Omran Grace Lecturer of Physical Therapy .Basic Science . cairo university, Lecturer of Physical Therapy .
Role: STUDY_DIRECTOR
Lecturer of Physical Therapy .Basic Science . cairo university
Mohamed Ali Hashish Lecturer of orthopedic and spine surgery, Cairo university,, Lecturer
Role: STUDY_DIRECTOR
Lecturer of orthopedic and spine surgery , Cairo university ,kasr Al-ainy
Locations
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Delta University
Gamasa, , Egypt
Countries
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Other Identifiers
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P.T.REC/012/005457
Identifier Type: -
Identifier Source: org_study_id