Effects of Mobilization With Movement and Active Release Technique in Patients With Lateral Epicondylitis

NCT07576140 | Completed DMC

• 1 other identifier: REC/02293 Sadia
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a randomized controlled trial (RCT) investigating the effectiveness of Mobilization with Movement (MWM) combined with Active Release Technique (ART) in the management of lateral epicondylitis. A total of 44 participants, aged 18-55 years with a clinical diagnosis of lateral epicondylitis (duration ≥6 weeks), will be randomly assigned into two groups. The intervention group will receive MWM, applied as sustained lateral glides during active, pain-free movements, along with ART targeting the wrist extensor muscles, with both techniques administered three sessions per week for four weeks in combination with conventional treatment. The control group will receive conventional treatment only. The primary outcome measures will include pain intensity assessed using the Numeric Pain Rating Scale (NPRS), functional disability using the Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength measured with a hand dynamometer, and range of motion assessed using a goniometer. Assessments will be conducted at baseline, at the end of week 2, and at the end of week 4. The study aims to determine whether the addition of MWM and ART provides significant improvements in pain reduction, correction of joint mechanics, and functional performance compared to conventional therapy alone.

Conditions

Lateral Epicondylitis (Tennis Elbow)

Keywords

Lateral Epicondylitis; MWM for LE; ART

Outcome Measures

Primary Outcomes (2)

• Numeric Pain rating scale

  Level of pain measured by Numeric Pain rating scale (NPRS), 0 means no pain and 10 means severe pain

  From enrollment to the end of treatment at 1 week]

• Functional Disability

  Pain and functional disability of tennis elbow patients can be measured using a patient-rated tennis elbow evaluation (PRTEE) questionnaire. The PRTEE consists of 15 questions: Pain has 5 items, Sum of the 5 pain items. Function has 6 items (specific activities) + 4 items (usual activities), Sum of the 10 function items, divided by 2. PRTEE items are graded from 0 to 10, with zero indicating no discomfort or handicap and 10 indicating the worst or unable

  From enrollment to the end of treatment at 1 week]

Secondary Outcomes (1)

• Range of motion

  From enrollment to the end of treatment at 1 week

Study Arms (2)

Intervention Group

EXPERIMENTAL

MWM+ ART+ Conventional therapy

Other: MWM+ ART

Control Group

ACTIVE COMPARATOR

Conventional Therapy for lateral epicondylitis

Other: Conventional therapy group

Interventions

MWM+ ART OTHER

Participants allocated to the experimental group will receive a combined intervention consisting of Mobilization with Movement (MWM), Active Release Technique (ART), and conventional rehabilitation. MWM will be applied as a sustained lateral glide to the elbow joint while the participant performs pain-free active movements such as gripping or wrist extension, aiming to correct joint positional faults and reduce pain. ART will be administered to the wrist extensor muscle group, particularly targeting the extensor carpi radialis brevis, using manual tension combined with active or passive muscle movement to release soft tissue adhesions and improve tissue mobility. Both MWM and ART will be delivered at a frequency of three sessions per week for four weeks. In addition, participants will perform a conventional rehabilitation program including eccentric strengthening exercises for the wrist extensors, stretching exercises, and activity modification advice.

Intervention Group

Conventional therapy group OTHER

Participants allocated to Arm 2 (control group) will receive conventional physiotherapy treatment only for the management of lateral epicondylitis. The treatment protocol will include the application of a hot pack for 15 minutes, placed over the lateral aspect of the elbow to help reduce pain, improve local circulation, and prepare the tissues for exercise. Following this, participants will perform post-treatment dynamic stretching exercises, including dynamic wrist flexor stretches and forearm supination/pronation swings to improve flexibility and mobility of the forearm musculature.This treatment will be administered three sessions per week for four weeks and will serve as the standard care protocol against which the experimental intervention will be compared.

Control Group

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Duration of symptoms ≥ 6 weeks. Pain intensity of NPRS ≥ 4 at baseline. Elbow pain during specific tests, i.e., Cozen's Test (resisted wrist extension with the elbow extended) and Mill's Test (passive wrist flexion with the elbow extended). Presence of clinical symptoms such as lateral elbow pain, tenderness over the lateral epicondyle, reduced grip strength, and pain aggravated by wrist extension or gripping activities

You may not qualify if:

• Subjects with pain at the wrist, neck, or shoulder; bilateral elbow pain; previous elbow surgery in the last 12 months; or any arthritic changes of the elbow joint.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ali Ahmad Physiocare

Islamabad, 44010, Pakistan

Location

Related Publications (4)

• Uttamchandani SR, Phansopkar P. Efficacy of PowerBall Versus Mulligan Mobilization With Movement on Pain and Function in Patients With Lateral Epicondylitis: A Randomized Clinical Trial. Cureus. 2024 Mar 19;16(3):e56444. doi: 10.7759/cureus.56444. eCollection 2024 Mar.

  PMID: 38638770 BACKGROUND

• Reyhan AC, Sindel D, Dereli EE. The effects of Mulligan's mobilization with movement technique in patients with lateral epicondylitis. J Back Musculoskelet Rehabil. 2020;33(1):99-107. doi: 10.3233/BMR-181135.

  PMID: 31104005 BACKGROUND

• Nagore A, Samal S, Thakre VM. Effectiveness of Active Release Technique With Conventional Therapy in the Management of Lateral Epicondylitis: A Case Report. Cureus. 2023 Dec 21;15(12):e50926. doi: 10.7759/cureus.50926. eCollection 2023 Dec.

  PMID: 38249180 BACKGROUND

• Tosti R, Jennings J, Sewards JM. Lateral epicondylitis of the elbow. Am J Med. 2013 Apr;126(4):357.e1-6. doi: 10.1016/j.amjmed.2012.09.018. Epub 2013 Feb 8.

  PMID: 23398951 BACKGROUND

MeSH Terms

Conditions

Tennis Elbow

Condition Hierarchy (Ancestors)

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

Study Officials

• Sadia Sameen

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 4, 2026
• First Posted: May 8, 2026
• Study Start: November 2, 2025
• Primary Completion: April 22, 2026
• Study Completion: April 27, 2026
• Last Updated: May 8, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)