Muscle Energy Technique Combined With Mulligan Technique in Tennis Elbow

University of Lahore40 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Lateral Epicondylitis Tennis Elbow

Interventions

Muscle Energy Technique Combined With Mulligan TechniquePROCEDURE

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 MovementPROCEDURE

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.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

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

Locations (1)

University of Lahore Teaching Hospital, Lahore

Lahore, Punjab Province, Pakistan

Outcomes

Primary Outcomes

Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)

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).

Time frame: Baseline and after 4 weeks of intervention

Secondary Outcomes

Functional Disability Measured by PRTEE Questionnaire

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

Time frame: Baseline and after 4 weeks of intervention

Quality of Life Measured by SF-8 Questionnaire

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.

Time frame: Baseline and after 4 weeks of intervention

Data from ClinicalTrials.gov

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