The purpose of the study is to compare the mobilization with movement and progressive
      strengthening exercises in individuals with lateral epicondylitis on VAS, PRTEE and Hand Grip
      strength . A randomized clinical trial was conducted at Bone and Joint center and Khyaban
      medical center, Rawalpindi. The sample size was 40 calculated through open-epi tool . The
      participants were divided into two groups each having 20 participants. The study duration was
      six months. Sampling technique applied was Purposive sampling for recruitment and group
      randomization using enveloped sealed. Only 20 to 60 years participants with chronic lateral
      epicondylitis included in that study . Tools used in this study are SELF STRUCTURE
      QUESTIONNAIRE, VAS visual analogue scale range is 0 TO 10 O is no pain 10 is unbearable pain
      , PRTEE patient ratted tennis elbow evaluation 15 questionnaire form 3 sub-scale total 100
      scores 0 is best 100 is worst, hand held Dynamo-meter , Data was collected before and
      immediately after the application of interventions. Data analyzed through SPSS version 21.

Mobilization With Movement and Progressive Strengthening Exercises in Lateral Epicondylitis

Lateral Epicondylitis

Epicondylitis is common in persons who frequently overuse the upper arm, particularly with
      activities that involve rotation of the arm with flexion and extension.

      Anyone who performs repetitive movements involving extension of the wrist or hand for at
      least two hours a day, which can include anyone sitting at a computer and using a mouse.
      Professional who are commonly effected are Tennis Players, Squash Players, Badminton Players
      ,Painters, Plumbers, Computer user and Musician.

      Lateral Epicondylitis affect the extensor muscle around elbow also common for extensor type
      pathology.

      Evidence suggests that Prevalence of Tennis elbow generally affects about 1 to 3 % general
      population from 35 to 50 years .

      Lateral epicondylitis of young age around 20 years is usually due to overused sustained
      pressure during laptop working and it mainly effect the dominant hand usually right hand.

      The condition tends to affect men and women equally. The annual incidence is one to three
      percent in the United States. Despite the condition being commonly referred to as tennis
      elbow, tennis players make up only 10% of the patient population. Half of the tennis players
      develop pain around the elbow, of which 75% represent true tennis elbow.

      Diagnosis of Lateral Epicondylitis is based on the palpation around lateral elbow region ,
      found local tenderness around lateral epicondyle region and Cozen test , Mill,s test.

      Literature review: A systematic and evidence based search of relevant literature was
      performed by utilizing PubMed and Google Scholar as search engines and the key words used
      were Lateral Epicondylitis , Tennis Elbow, PRE, Strengthening exercises ,VAS, exercises
      programme for tennis elbow, .The purpose of the literature review is to find out the
      pre-existing literature regarding the mobilization with movement and PRE interventions for
      Lateral Epicondylitis .

      In 2020, The Effects of Mulligan's Mobilization with movement technique in patients with
      lateral epicondylitis. MWM is secure and shows efficacy in terms of outcomes at elbow pain
      (VAS) , Functional Capacity( FC) PRTEE, and Pain less maximized grip strength, these all
      parameters showed significant improvement.

      An experimental study was conducted in 2017 Effects of progressive strengthening exercises in
      chronic lateral epicondylitis. The group receiving PRE showed significant improvement in
      study variables (VAS, PRTEE, Grip Strength). The group which performed PRE and conventional
      physiotherapy showed greater improvement than alone conventional treatment for lateral
      epicondylitis .

      RCT was conducted in 2016 MWM compared to supervised exercises in patients with lateral
      epicondylitis. This study showed that the group with mulligan technique's showed
      effectiveness in term of reduction of pain and improved Grip Hand Strength (GHS) as compared
      with supervised exercise program group.

      An Intervention Comparative study was conducted in 2013 Effectiveness of MWM compared with
      manipulation of wrist in lateral epicondylitis . The variables were pain , Functional
      disability recorded by VAS, PRTEE, and Hand Dynamo-meter .This study showed that mulligan
      mobilization plus conventional treatment was much more effective in treatment of tennis elbow
      .

      RCT was conducted in 2012 MWM as adjunct to conventional physiotherapy in treatment of
      chronic lateral epicondylitis stated that Mobilization with movement group showed significant
      improvement in pain reduction at VAS and improved Pain Free Grip Strength .

Mobilization with movement lateral Glides and Conventional Physiotherapy

Progressive Resistance Exercises and Conventional Physiotherapy

Comparison of Mulligan Mobilization With Movement and Progressive Strengthening Exercises in Patients With Lateral Epicondylitis

A Visual Analogue Scale is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured.The VAS is pain numeric scale to find out pain intensity and pain level perceived by patients. The VAS is a subjective type pain scale measured the acute and chronic level pain. Score are marked between no pain and worst pain ( zero to 10)

Measurements the patient functional status its 15 questionnaires In PRTEE First subscale is The Pain Subscale detail is 5 items Maximum or best score is 0 and worst score is 50 The Second Subscale or PRTEE is The Specific Activities detail is 6 items with finest score is 0 and least score is 60 The third one subscale of PRTEE the Usual Activities sub part 4 items with superior score is 0 and least score is 40. Third Fourth Part of PRTEE is The Function Subscale detail is performance bases specific activities and usual or regular activities Add up to specific or regular activities divided by 2 Maximum best score or prime score is 0 and least score is 50 Total detail Score of PRTEE is = Pain Subscale + Function Subscale Best Score= 0 Worst Score = 100 (pain and disability contribute equally to score)

A dynamometer with high accuracy and sensitivity has recently been developed to assess grip strength. It provides maximal isometric grip strength measured.Many sports activities hand dynamometer is used to find out athlete performance around hand and forearm muscle strength.
Sports, like baseball and tennis, where the hand is utilized for tossing or lifting make use of dynamometers to test hand strength

Mobilization With Movement and Progressive Strengthening Exercises in Lateral Epicondylitis

About this trial

Study ID

Status

Type

Phase

Placebo

Accepting

Trial Timing

What is this trial about?

What are the participation requirements?

Locations

Location

Status