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NCT Number: NCT07604454

Muscle Energy Technique Combined With Mulligan Technique in Tennis Elbow

This randomized controlled trial aims to evaluate the effectiveness of Muscle Energy Technique (MET) combined with Mulligan Mobilization With Movement (MWM) in patients with lateral epicondylitis (tennis elbow). The study compares the combined intervention with Mulligan technique and routine physical therapy alone. Outcomes including pain intensity, functional disability, and quality of life will be assessed using NPRS, PRTEE, and SF-8 questionnaires over a four-week treatment period.

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Key information

Conditions

Lateral Epicondylitis Arm Injuries Elbow Injuries Elbow Tendinopathy Muscular Diseases Musculoskeletal Diseases Tendinopathy Tendon Injuries Tennis Elbow Wounds and Injuries

Age range

18 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Lahore Teaching Hospital, Lahore

Lahore, Punjab Province, Pakistan

About this study

Lateral epicondylitis, commonly known as tennis elbow, is a musculoskeletal disorder characterized by pain and reduced functional ability affecting the lateral aspect of the elbow. It commonly results from repetitive wrist extension and forearm movements leading to overuse of the extensor tendons.

Conservative physiotherapy management including manual therapy and therapeutic exercises is widely used for the treatment of lateral epicondylitis. Mulligan Mobilization With Movement (MWM) has shown beneficial effects in reducing pain and improving grip strength and functional mobility. Muscle Energy Technique (MET) is another manual therapy approach that may help improve joint mobility, muscle flexibility, and pain reduction through controlled isometric contractions.

This study aims to determine whether combining MET with Mulligan technique provides superior clinical outcomes compared to Mulligan technique alone in patients with tennis elbow.

Participants will be randomly allocated into two groups:

Experimental Group: MET + MWM + Routine Physical Therapy Control Group: MWM + Routine Physical Therapy

Treatment will be provided five sessions per week for four weeks. Outcomes will be assessed at baseline and after completion of the intervention period.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Age between 18 and 45 years
  • Both genders
  • Unilateral lateral epicondylitis
  • Diagnosed by senior physiotherapist
  • Pain duration of at least 6 weeks
  • Pain score ≥7 on NPRS/VAS
  • Positive symptoms during extensor carpi radialis brevis and longus isometric contraction

Exclusion criteria

  • Previous elbow or shoulder surgery
  • Manual therapy within previous 6 months
  • History of fracture, dislocation, or tendon tear
  • Steroid or pain medication use
  • Peripheral nerve entrapment
  • Cervical radiculopathy
  • Osteoporosis or metastasis involving elbow

Treatment and study plan

Muscle Energy Technique Combined With Mulligan Technique

Procedure

Muscle Energy Technique will be applied using resisted isometric contractions of forearm supination and pronation. Mulligan Mobilization With Movement will be applied using sustained lateral glide during pain-free gripping activity. Treatment sessions will be conducted five times weekly for four weeks.

Mulligan Mobilization With Movement

Procedure

Mulligan Mobilization With Movement technique will be applied using sustained glide of the forearm while participants perform pain-free gripping activities. Sessions will be conducted five times weekly for four weeks.

Primary outcomes

  1. Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)

    Time frame: Baseline and after 4 weeks of intervention

    Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).

Secondary outcomes

  1. Functional Disability Measured by PRTEE Questionnaire

    Time frame: Baseline and after 4 weeks of intervention

    Functional disability will be assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire.

  2. Quality of Life Measured by SF-8 Questionnaire

    Time frame: Baseline and after 4 weeks of intervention

    Quality of life will be assessed using the Short Form-8 (SF-8) questionnaire. The SF-8 is an 8-item questionnaire that evaluates physical functioning, general health, pain, vitality, social functioning, emotional role, mental health, and physical role limitations. Higher scores indicate better quality of life.

Sponsors and collaborators

Lead sponsor

University of Lahore

Other

Collaborators

  • University of Lahore Hospital (ULH)

Registry information

Official study title

Effectiveness of Muscle Energy Technique Combined With Mulligan Mobilization Among Patients With Lateral Epicondylitis: A Randomized Controlled Trial

Important dates

Study start
2025
Primary completion
2025
Study completion
2026
First posted
May 22, 2026
Registry last updated
May 22, 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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