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Completed

NCT Number: NCT07576140

Effects of Mobilization With Movement and Active Release Technique in Patients With Lateral Epicondylitis

This study is a randomized controlled trial (RCT) investigating the effectiveness of Mobilization with Movement (MWM) combined with Active Release Technique (ART) in the management of lateral epicondylitis. A total of 44 participants, aged 18-55 years with a clinical diagnosis of lateral epicondylitis (duration ≥6 weeks), will be randomly assigned into two groups. The intervention group will receive MWM, applied as sustained lateral glides during active, pain-free movements, along with ART targeting the wrist extensor muscles, with both techniques administered three sessions per week for four weeks in combination with conventional treatment. The control group will receive conventional treatment only. The primary outcome measures will include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), functional disability using the Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength measured with a hand dynamometer, and range of motion assessed using a goniometer. Assessments will be conducted at baseline, at the end of week 2, and at the end of week 4. The study aims to determine whether the addition of MWM and ART provides significant improvements in pain reduction, correction of joint mechanics, and functional performance compared to conventional therapy alone.

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Key information

Age range

18 year–55 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Ali Ahmad Physiocare

Islamabad, 44010, Pakistan

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Duration of symptoms ≥ 6 weeks. Pain intensity of NPRS ≥ 4 at baseline. Elbow pain during specific tests, i.e., Cozen's Test (resisted wrist extension with the elbow extended) and Mill's Test (passive wrist flexion with the elbow extended). Presence of clinical symptoms such as lateral elbow pain, tenderness over the lateral epicondyle, reduced grip strength, and pain aggravated by wrist extension or gripping activities

Exclusion criteria

  • Subjects with pain at the wrist, neck, or shoulder; bilateral elbow pain; previous elbow surgery in the last 12 months; or any arthritic changes of the elbow joint.

Treatment and study plan

MWM+ ART

Other

Participants allocated to the experimental group will receive a combined intervention consisting of Mobilization with Movement (MWM), Active Release Technique (ART), and conventional rehabilitation. MWM will be applied as a sustained lateral glide to the elbow joint while the participant performs pain-free active movements such as gripping or wrist extension, aiming to correct joint positional faults and reduce pain. ART will be administered to the wrist extensor muscle group, particularly targeting the extensor carpi radialis brevis, using manual tension combined with active or passive muscle movement to release soft tissue adhesions and improve tissue mobility. Both MWM and ART will be delivered at a frequency of three sessions per week for four weeks. In addition, participants will perform a conventional rehabilitation program including eccentric strengthening exercises for the wrist extensors, stretching exercises, and activity modification advice.

Conventional therapy group

Other

Participants allocated to Arm 2 (control group) will receive conventional physiotherapy treatment only for the management of lateral epicondylitis. The treatment protocol will include the application of a hot pack for 15 minutes, placed over the lateral aspect of the elbow to help reduce pain, improve local circulation, and prepare the tissues for exercise. Following this, participants will perform post-treatment dynamic stretching exercises, including dynamic wrist flexor stretches and forearm supination/pronation swings to improve flexibility and mobility of the forearm musculature.This treatment will be administered three sessions per week for four weeks and will serve as the standard care protocol against which the experimental intervention will be compared.

Primary outcomes

  1. Numeric Pain rating scale

    Time frame: From enrollment to the end of treatment at 1 week]

    Level of pain measured by Numeric Pain rating scale (NPRS), 0 means no pain and 10 means severe pain

  2. Functional Disability

    Time frame: From enrollment to the end of treatment at 1 week]

    Pain and functional disability of tennis elbow patients can be measured using a patient-rated tennis elbow evaluation (PRTEE) questionnaire. The PRTEE consists of 15 questions: Pain has 5 items, Sum of the 5 pain items. Function has 6 items (specific activities) + 4 items (usual activities), Sum of the 10 function items, divided by 2. PRTEE items are graded from 0 to 10, with zero indicating no discomfort or handicap and 10 indicating the worst or unable

Secondary outcomes

  1. Range of motion

    Time frame: From enrollment to the end of treatment at 1 week

    Range of motion at ankle joint measured using goniometer

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
May 8, 2026
Registry last updated
May 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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