Eccentric Exercise With Blood Flow Restriction vs Resistance Training for Lateral Epicondylitis

NCT07365033 | Recruiting DMC

• 1 other identifier: UOL/IREB/25/15/03/28
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the effectiveness of eccentric training combined with blood flow restriction (ECC+BFR) versus heavy slow resistance (HSR) training in patients with chronic lateral epicondylitis. The study will recruit 40 participants (accounting for 10% attrition), aged 25-45 years, from Sakina Memorial Hospital Sheikhupura and University of Lahore Teaching Hospital using convenience sampling. Participants will be randomly allocated into two groups: an interventional group receiving ECC+BFR and a control group undergoing HSR training. Both interventions will be administered three times per week for 8 weeks under professional supervision. Outcome measures including pain intensity (NPRS), patient-specific functional performance (PSFS), muscle strength, and hypertrophy will be assessed at baseline, 4 weeks, and 8 weeks. Data will be analyzed using SPSS, with appropriate parametric or non-parametric tests applied after checking data normality. Ethical approval will be obtained, informed consent will be secured, and participant confidentiality will be strictly maintained.

Conditions

Lateral Epicondylitis

Keywords

Lateral Epicondylitis; Blood Flow Restriction Therapy; Eccentric Training; Resistance Training,

Outcome Measures

Primary Outcomes (1)

• Pain Intensity (Numeric Pain Rating Scale)

  Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), a validated 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will rate their average elbow pain during daily activities involving the affected upper limb.

  Baseline, 4 weeks, and 8 weeks

Secondary Outcomes (1)

• Patient-Specific Functional Performance (PSFS)

  Baseline, 4 weeks, and 8 weeks

Study Arms (2)

interventional group A

EXPERIMENTAL

The interventional group will receive eccentric wrist extensor exercises combined with blood flow restriction therapy, using a pneumatic cuff inflated to 50-60% limb occlusion pressure. Exercises will be performed at 20-30% 1-RM using a 30-15-15-15 repetition protocol, emphasizing slow controlled eccentric contractions. Sessions will be conducted three times weekly for 8 weeks, totaling 24 supervised sessions.

Behavioral: interventional group A

Control group B

ACTIVE COMPARATOR

The control group will undergo a heavy slow resistance training protocol, involving wrist extensor exercises performed at 70-85% of 1-RM, with slow concentric and eccentric phases (3 seconds each). Participants will complete 3-4 sets of 6-8 repetitions, with adequate rest intervals, following the same session frequency and duration as the intervention group.

Behavioral: control group b

Interventions

interventional group A BEHAVIORAL

The interventional group will receive eccentric wrist extensor exercises combined with blood flow restriction therapy, using a pneumatic cuff inflated to 50-60% limb occlusion pressure. Exercises will be performed at 20-30% 1-RM using a 30-15-15-15 repetition protocol, emphasizing slow controlled eccentric contractions. Sessions will be conducted three times weekly for 8 weeks, totaling 24 supervised sessions.

Also known as: blood flow resistance training

interventional group A

control group b BEHAVIORAL

The control group will undergo a heavy slow resistance training protocol, involving wrist extensor exercises performed at 70-85% of 1-RM, with slow concentric and eccentric phases (3 seconds each). Participants will complete 3-4 sets of 6-8 repetitions, with adequate rest intervals, following the same session frequency and duration as the intervention group.

Also known as: resistance training

Control group B

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patient aged between 25 and 45 years. Both male and female participants with unilateral symptoms only. Clinically diagnosed unilateral lateral epicondylitis (LE), confirmed by positive Cozen's and Mills' tests. Symptom duration exceeding 12 months, indicating chronic LE.

You may not qualify if:

• Previous history of surgery or injection therapy for LE within the past 6 months.
• Coexisting conditions (e.g., rheumatoid arthritis, cervical radiculopathy, significant tendon tears). Contraindications to BFR (e.g., DVT, vascular disease, uncontrolled hypertension, clotting disorders).
• Use of anticoagulants or long-term pain medications. Pregnant or psychological person.

Sponsors & Collaborators

• Nimra Rafiq: lead

Study Sites (1)

University of Lahore Teaching Hospital, Lahore

Lahore, Punjab Province, 54000, Pakistan

RECRUITING

MeSH Terms

Conditions

Tennis Elbow

Interventions

Resistance Training

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; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Nimra Rafiq, MS MSK

  The University of Lahore, Lahore

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nimra Rafiq, MS MSK

CONTACT

0333 4170217; 701747512@student.uol.edu.pk

Montiha Azeem, MSPTN

CONTACT

03479717317; muntahaazeem9@gmail.com

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: SPONSOR INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: January 15, 2026
• First Posted: January 23, 2026
• Study Start: January 30, 2026
• Primary Completion: March 30, 2026
• Study Completion: March 31, 2026
• Last Updated: February 5, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)