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

NCT07236554 | Completed

• 1 other identifier: P.T.REC/012/006094
• Study Type: interventional
• Target: 177
• Locations: 1 country
• Sites: 1

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).

Conditions

Lateral Epicondylitis (Tennis Elbow)

Outcome Measures

Primary Outcomes (3)

• Grip strength

  The patients' maximal grip strength will be measured with a hand dynamometer dynamometer.

  4 weeks

• Pain intensity

  Measured using an 11-point numeric rating scale.

  4 weeks

• Elbow pain and intensity

  Measures pain and disability by Patient-Rated Elbow Evaluation （PREE） Score (0-100 scale, with 100 = worst pain \& disability).

  4 weeks

Study Arms (3)

BFRT Group (A)

EXPERIMENTAL

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

Device: blood flow restriction

MWM Group (B)

ACTIVE COMPARATOR

In addition to home exercises, the MWM group performed MWM

Other: Mulligan's with mobilization

Control group (C)

PLACEBO COMPARATOR

Stretching and strengthening exercises for the forearm extensors

Other: Exercise

Interventions

blood flow restriction 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

BFRT Group (A)

Mulligan's with mobilization 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.

MWM Group (B)

Exercise 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.

Control group (C)

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• \) 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.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of Physical Therapy, Cairo University

Cairo, Egypt

Location

MeSH Terms

Conditions

Tennis Elbow

Interventions

Blood Flow Restriction Therapy; Exercise

Condition Hierarchy (Ancestors)

Elbow Tendinopathy; Tendinopathy; Muscular Diseases; Musculoskeletal Diseases; Elbow Injuries; Arm Injuries; Wounds and Injuries; Tendon Injuries

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Prof.Dr.Nasr A Abdelkader, professor

  Cairo Univesity

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor of physical therapy

Study Record Dates

• First Submitted: November 15, 2025
• First Posted: November 19, 2025
• Study Start: September 15, 2025
• Primary Completion: March 10, 2026
• Study Completion: March 15, 2026
• Last Updated: March 31, 2026

Record last verified: 2025-11

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)