ESWT vs HILT in Chronic Lateral Epicondylitis

Summary

This randomized controlled trial aims to compare the effectiveness of Extracorporeal Shock Wave Therapy (ESWT) and High-Intensity Laser Therapy (HILT) in patients with chronic lateral epicondylitis.

Conditions

• Chronic Lateral Epicondylitis

Interventions

DEVICE

Extracorporeal shock wave therapy

The Group will receive ESWT plus conventional physiotherapy treatment program. Regarding ESWT protocol, the group will receive 1,000, 1,500, and 2,000 pulses during the first, second, and third through fifth treatments, respectively (pressure, 2.5 bar; frequency, 8 Hz; energy density, 0.4 mJ/mm2). The patients received 5 ESWT treatments once per week. The treatments were performed using a Rosetta ESWT (CR Technology, Korea). Ultrasound gel was applied between the apparatus head and skin. The procedure was performed in the area with the most intense pain. Treatment was administered at the anterior aspect of the LE and three points around it at a radius of 1.5-2 cm. The treatment time did not exceed 10 minutes. During the treatments, the patients did not receive any drugs (Lizis, 2015).

OTHER

Conventional Physical Therapy

The conventional program will include TENS for twenty minutes in elbow region; the use of pulse ultrasound with duty cycle 80% on the lateral epicondyle for five minutes with an intensity of 0.8 W per every cm'; the use of ice for ten minutes; training for correcting the daily activities to minimize pressure on the elbow (preferentially, holding, lifting and pressing the objects will be asked to be carried out in supination); and, stretch and strain wrist muscle strengthening exercises (Fekri et al., 2019). The exercise therapy method involved six elbow joint exercises. They are a total of six exercises (Fig. 2) for patients with tennis elbow. Each exercise will be performed three times a day, with each session involving five repetitions of the movement, over four weeks, gradually increasing weight until the movement is effective but below the pain threshold. Painful movements will be avoided, and exercises causing pain or discomfort will be discontinued following consultation from a p

DEVICE

High-power intinsty laser

The Group will receive HILT plus conventional physiotherapy treatment program. High-power laser used in the present research paper was MLS Laser, Model M6 (ASA), that will be included in class four lasers device, with maximum 25-Watt power, average power of 3.3 Watts, wavelength of 808 nm in a continuous state. The target region diameter in this device will be 5 cm and the energy used for treating the patients will be 272.4 Jules, and the energy density will be 13.89 Jules per cm' with a 700-hertz frequency for a period of three minutes on the lateral epicondyle and the origin of the wrist's extensor muscles (Fekri et al., 2019).

Sponsors & Collaborators

• Kafrelsheikh University

  lead OTHER

Principal Investigators

• MAHMOUD MOHAMMED EWIDA, PHD · Professor of Basic Sciences for Physical Therapy Department of Basic Sciences for Physical Therapy Faculty of Physical Therapy Kafrelsheikh University

• MOHAMMED FATHY ABDEL-GALIL · Lecturer of Basic Sciences for Physical Therapy Department of Basic Sciences for Physical Therapy Faculty of Physical Therapy Kafrelsheikh University

• HOSSAM MOHAMMED GAD, PHD · Professor of Orthopaedic Surgery Department of Orthopaedic Surgery Faculty of medicine Kafrelsheikh University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-08-01

Primary Completion

2026-10-30

Completion

2027-04-01