Comparative Study Between Different Mobilization Techniques for Patients With Chronic Tennis Elbow

NCT ID: NCT06812377

Last Updated: 2025-11-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-08-05
• Study Completion Date: 2025-10-20

Brief Summary

Background: Tennis elbow is a common musculoskeletal disorder affecting the functional activities of daily living through common extensor tendinopathy. There is a limited knowledge about neural restriction as a source of movement limitation in patients with tennis other than enriched joint mobilization techniques knowledge.

Objectives: This study will be designed to determine the efficacy of adding different mobilization techniques along with eccentric exercises on elbow pain intensity, functional disability, hand grip strength and pain pressure in patients with chronic tennis elbow.

Methods: Forty five patients with lateral epicondylitis with their ages ranged from 18 and 45 more than six weeks will be randomly assigned into three groups. Group A will receive Maitland joint mobilization techniques. Patients in group B will receive Mulligan mobilization techniques while patient in group C will receive radial nerve mobilization.. Both groups will receive eccentric exercises for wrist extensors . Patients will be treated three session per week for four week and they will be evaluated pre and post treatment for pain severity using by visual analogue scale, level of functionality by DASH questionnaire, hand grip strength by hand held dynamometer and pressure pain threshold(PPT) by pressure algometer.

Results: All the outcome variables will be assessed at baseline and 4weeks following the treatment period.

Conditions

Tennis Elbow

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

group A

maitland mobilization Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain

Group Type: ACTIVE_COMPARATOR

Maitland joint mbilization

Intervention Type: OTHER

Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain

Group (B)

mulligan mobilization Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between \[44\].

Group Type: ACTIVE_COMPARATOR

mulligan mobilization

Intervention Type: OTHER

Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between

Group (c)

radial nerve mobilization

Group Type: EXPERIMENTAL

radial nerve mobilization

Intervention Type: OTHER

The subjects will be placed in a reclining supine position. The arm will be internally rotated, the wrist, thumb, and fingers will be flexed, the shoulder girdle will be depressed, and the elbow will be stretched. Elbow flexion and wrist extension will be used to maintain shoulder depression after the radial nerve will be strained by these motions. Before beginning the gentle elbow extension test, the subject's wrist and fingers will be stabilized. The elbow will be then gently extended for about two seconds, just into the range where the participant felt tension but no pain, and then flexed. In a single session, three sets of six to eight oscillations will be executed

Interventions

radial nerve mobilization

The subjects will be placed in a reclining supine position. The arm will be internally rotated, the wrist, thumb, and fingers will be flexed, the shoulder girdle will be depressed, and the elbow will be stretched. Elbow flexion and wrist extension will be used to maintain shoulder depression after the radial nerve will be strained by these motions. Before beginning the gentle elbow extension test, the subject's wrist and fingers will be stabilized. The elbow will be then gently extended for about two seconds, just into the range where the participant felt tension but no pain, and then flexed. In a single session, three sets of six to eight oscillations will be executed

Intervention Type: OTHER

Maitland joint mbilization

Posteroanterior mobilization of the radial head in motion. This method is gliding over the radial head posteriorly to anteriorly while the patient executes (and relaxes) the painful action (e.g., clutching). Repeat the method six to ten times if there is a noticeable increase in your ability to grip without pain

Intervention Type: OTHER

mulligan mobilization

Using this approach, the patient performs (and relaxes) the painful action (e.g., clutching) while a lateral humeroulnar auxiliary glide is applied and maintained. If you notice a noticeable increase in your ability to grip without pain, repeat the method six to ten times. You can use a belt to help you glide.Three sets of it were performed, with a 30-second break in between

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• This study will include individuals between the ages of 18 and 45 who have been diagnosed with lateral epicondylitis based on positive results from the Mill's and Cozen's tests. The participants must also have complaints of local tenderness at the elbow that lasts longer than six weeks. Additionally, to complete the assessment and get treatment, the participants' elbow must have a full extension range of motion

Exclusion Criteria

• Individuals diagnosed with cervical radiculopathy, upper thoracic outlet syndrome, rheumatoid arthritis, myositis ossificans, carpal tunnel syndrome, recent upper limb trauma, elbow immobilization, steroid injection administration within the previous six months, and any history of physical therapy administered within the previous six months were excluded from the study. Furthermore, participation will not be permitted for anyone who has previously experienced discomfort because of their profession

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Prince Sattam Bin Abdulaziz University

OTHER

Sponsor Role: lead

Responsible Party

Mohammad Moustafa Aldosoukki Hegazy

dr

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Prince Sattam bin Abdulaziz University

Al Kharj, , Saudi Arabia

Countries

Saudi Arabia

References

Dorf ER, Chhabra AB, Golish SR, McGinty JL, Pannunzio ME. Effect of elbow position on grip strength in the evaluation of lateral epicondylitis. J Hand Surg Am. 2007 Jul-Aug;32(6):882-6. doi: 10.1016/j.jhsa.2007.04.010.

Reference Type: BACKGROUND

PMID: 17606071 (View on PubMed)

Coombes BK, Bisset L, Vicenzino B. Management of Lateral Elbow Tendinopathy: One Size Does Not Fit All. J Orthop Sports Phys Ther. 2015 Nov;45(11):938-49. doi: 10.2519/jospt.2015.5841. Epub 2015 Sep 17.

Reference Type: BACKGROUND

PMID: 26381484 (View on PubMed)

Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. doi: 10.1016/j.math.2006.07.012. Epub 2006 Sep 7.

Reference Type: BACKGROUND

PMID: 16959529 (View on PubMed)

Other Identifiers

2024/03/31970

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

SCBR-393/2024

Identifier Type: -

Identifier Source: org_study_id