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Completed

NCT Number: NCT07028840

Physiotherapy Applications in Lateral Epicondylitis

This study aims to compare the effectiveness of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) in improving pain, grip strength, and function in patients with lateral epicondylitis. A total of 42 volunteer patients aged 18-65 were enrolled at Balıkesir Private Sevgi Hospital physical medicine polyclinic. Participants were randomly assigned into three groups: group 1 received conventional physiotherapy, group 2 received physiotherapy plus ESWT, and group 3 received physiotherapy plus HILT. Physiotherapy was applied for 2 weeks, totaling 10 sessions. ESWT and HILT were each administered twice weekly for 2 weeks, totaling 4 sessions. Pain was measured using the visual analog scale (VAS), grip strength with a hand dynamometer, and function using the Duruöz Hand Index and PRTEE-T questionnaire. Evaluations were performed before treatment, after 2 weeks, and one month post-treatment.

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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–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Pamukkale University

Denizli, Turkey (Türkiye)

About this study

This randomized controlled clinical trial investigates the effects of extracorporeal shock wave therapy (ESWT) and high-intensity laser therapy (HILT) on pain, grip strength, and function in patients diagnosed with lateral epicondylitis. The study was conducted at the physical medicine polyclinic of Balıkesir Private Sevgi Hospital and included 42 patients aged 18 to 65 who were referred for therapeutic physical therapy after being diagnosed for the first time with lateral epicondylitis.

Participants were randomly divided into three groups:

Group 1: received conventional physiotherapy including hot pack application, transcutaneous electric nerve stimulation (TENS), and stretching/strengthening exercises. Physiotherapy was administered 5 times per week for 2 weeks (total of 10 sessions).

Group 2: received the same physiotherapy as group 1, plus extracorporeal shock wave therapy (ESWT) administered twice per week for 2 weeks (total of 4 sessions).

Group 3: received the same physiotherapy as group 1, plus high-intensity laser therapy (HILT) administered twice per week for 2 weeks (total of 4 sessions).

Pain severity was evaluated using the visual analog scale (VAS), grip strength using a hand dynamometer, and functional status using the Duruöz Hand Index and patient-rated tennis elbow evaluation (PRTEE-T). All outcome measures were assessed at three time points: baseline (before treatment), post-treatment (after 2 weeks), and at 1-month follow-up. The primary objective was to assess whether either ESWT or HILT offers additional benefit over standard physiotherapy and whether one modality is superior to the other in treating lateral epicondylitis.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Being over the age of 18,
  • Being diagnosed with lateral epicondylitis,
  • Not having received lateral epicondylitis treatment in the last 3 months

Exclusion criteria

  • Stopping the treatment,
  • Those who have been traumatized in the last 3 months,
  • Those who use drugs that can affect muscle strength or pain level (muscle relaxants, analgesics, gabapentinoids, etc.)
  • Those with open wounds in the elbow area, Those with elbow fractures, Those with drug allergies, Pregnant and breastfeeding women.

Treatment and study plan

Physiotherapy

Other

10 sessions over 2 weeks, including TENS, cold therapy, ultrasound, and exercise therapy, 5 sessions per week.

Extracorporeal Shock Wave Therapy (ESWT)

Device

4 sessions total, applied 2 times per week for 2 weeks.

High-intensity laser therapy (HILT)

Device

4 sessions total, applied 2 times per week for 2 weeks.

Primary outcomes

  1. Pain Severity - Visual Analog Scale (VAS)

    Time frame: Baseline (Day 1), at the end of 2-week treatment, 4 weeks after treatment completion

    Pain intensity will be evaluated using the visual analog scale (VAS), a 10 cm line ranging from 0 (no pain) to 10 (worst imaginable pain). Continuous scale (0-10), higher scores indicate worse outcome.

  2. Grip Strength - Hand Dynamometer

    Time frame: Baseline (Day 1), at the end of 2-week treatment, 4 weeks after treatment completion

    Grip strength will be measured in kilograms using a hand dynamometer. Continuous scale, higher scores indicate better outcome

  3. Upper Extremity Function - Duruöz Hand Index

    Time frame: Baseline (Day 1), at the end of 2-week treatment, 4 weeks after treatment completion

    The Duruöz Hand Index is a functional scale that assesses hand-related disability. Scores range from 0 to 90, with higher scores indicating worse functional impairment.

  4. Functional Evaluation - PRTEE-T (Patient-Rated Tennis Elbow Evaluation)

    Time frame: Baseline (Day 1), at the end of 2-week treatment, 4 weeks after treatment completion

    The PRTEE-T is a 15-item patient-rated questionnaire for lateral epicondylitis. Total scores range from 0 (no disability) to 100 (maximum disability). Continuous scale (0-100), higher scores indicate worse outcome.

Sponsors and collaborators

Lead sponsor

Pamukkale University

Other

Registry information

Official study title

A Comparison of Extracorporeal Shockwave Therapy (ESWT) and High-intensity Laser Therapy (HILT) in Terms of Pain, Function and Grip Strength in Lateral Epicondilitis: a Randomized Controlled Study

Important dates

Study start
2020
Primary completion
2020
Study completion
2020
First posted
Jun 19, 2025
Registry last updated
Jun 25, 2025

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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