Blood Flow Restriction Training Versus Mulligan Technique in Treatment of Lateral Epicondylitis

NCT ID: NCT07236554

Last Updated: 2026-01-20

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-09-15
• Study Completion Date: 2026-04-30

Brief Summary

The purpose of this study is to evaluate the effectiveness of blood flow restriction training (BFRT) verses Mulligan's technique in improving pain, grip strength, and functional outcomes in patients with lateral epicondylitis (LE).

Detailed Description

Lateral epicondylitis (LE) is a work-related musculoskeletal disorder caused by the tendon's inflammation of either one or both of the extensor carpi radialis longus and extensor carpi radialis brevis. It is often referred to tennis elbow. It manifests as pain on the lateral side of the elbow and reduced range of motion, which results in weakening and impairment in the forearm muscles (Ahmad et al., 2013).With no sex predisposition, LE is a widespread ailment that affects up to 3% of the population (Vaquero-Picado et al., 2017). Etiological factors of LE include overuse, repetitive movements, physically forceful occupational activities, exercise errors, misalignments, flexibility problems, ageing, muscle imbalances and psychological (e.g. job strain) factors. The estimated incidence of LE ranges from 2.0-11.3 per 100 worker-years in specific activity sectors (Herquelot et al., 2013; Bongers et al., 2002).

Conditions

Lateral Epicondylitis (Tennis Elbow)

Study Design

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

Study Groups

BFRT Group (A)

Low-load resistance training with blood flow restriction (BFR)

Group Type: EXPERIMENTAL

blood flow restriction

Intervention Type: DEVICE

The physical therapist will apply the occlusive cuff on the upper arm (brachium) with a pressure of 0.5 times of patient's systolic blood pressure. The physiotherapist will use the BFR cuffs from SAGA

MWM Group (B)

In addition to home exercises, the MWM group performed MWM

Group Type: ACTIVE_COMPARATOR

Mulligan's with mobilization

Intervention Type: OTHER

First, the pain-free angle of application will be determined for each patient. The lateral condyle of the humerus will be fixed by the first bar space of the physiotherapist. The elbow joint will be glided until no pain will be felt in the elbow joint and the hand will be in the contracted position.

Control group (C)

Stretching and strengthening exercises for the forearm extensors

Group Type: PLACEBO_COMPARATOR

Exercise

Intervention Type: OTHER

Eccentric training for the extensor carpi radialis brevis muscle, the most affected wrist extensor tendon, and static stretching exercises for the extensor carpi radialis brevis muscle will be provided as a home exercise program.

Interventions

blood flow restriction

The physical therapist will apply the occlusive cuff on the upper arm (brachium) with a pressure of 0.5 times of patient's systolic blood pressure. The physiotherapist will use the BFR cuffs from SAGA

Intervention Type: DEVICE

Mulligan's with mobilization

First, the pain-free angle of application will be determined for each patient. The lateral condyle of the humerus will be fixed by the first bar space of the physiotherapist. The elbow joint will be glided until no pain will be felt in the elbow joint and the hand will be in the contracted position.

Intervention Type: OTHER

Exercise

Eccentric training for the extensor carpi radialis brevis muscle, the most affected wrist extensor tendon, and static stretching exercises for the extensor carpi radialis brevis muscle will be provided as a home exercise program.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1) 36 subjects of both gender aged between 18 and 50 years with a positive test of LE (Positive Cozen's, Maudsley's, and/or Mill's test), which has been determined based on physical therapy assessment procedures; 2) the presence of pain in the lateral epicondyle of the humeral bone; and 3) show decreased muscle strength and functional ability.

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

Sponsors

Cairo University

OTHER

Sponsor Role: lead

Responsible Party

Nasr Awad Abdelkader Othman

Professor of physical therapy

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Prof.Dr.Nasr A Abdelkader, professor

Role: PRINCIPAL_INVESTIGATOR

Cairo Univesity

Locations

Faculty of Physical Therapy, Cairo University

Cairo, , Egypt

Countries

Egypt

Provided Documents

Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

P.T.REC/012/006094

Identifier Type: -

Identifier Source: org_study_id