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

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)

Interventions

OTHER

MWM+ ART

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.

OTHER

Conventional therapy group

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.

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Sadia Sameen · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

55 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-11-02

Primary Completion

2026-04-22

Completion

2026-04-27

Countries

• Pakistan

Study Locations