Clinical Research Directory

Effects of Eccentric Exercises Along With Muscle Energy Technique in Lateral Epicondylitis

This study is intended to find the effects of Eccentric exercises along with muscle energy technique (MET) on pain, functional disability, range of motion and grip strength in Lateral Epicondylitis. For this trial, participants will be enrolled with their consent after assessing on basis of inclusion \& exclusion criteria from orthopedic workshop, Jinnah post graduate medical center Karachi. Total of 66 participants will be recruited and will be equally randomized into three groups consisting of 22 participants in each group. They would recruit into either Eccentric exercise (EE) along with MET group (group A) or MET group (group B) or EE group (group C). Participants will be allocated to intervention by sealed envelope method and will undergo a total of 8 treatment sessions within 2 weeks. Baseline assessment will carry out before treatment on 1st session and follow-up assessment on 8th session after treatment through tool named as Numeric Pain-Rating Scale (NPRS), Patient Rated Tennis Elbow Evaluation (PRTEE), Goniometer and Handheld dynamometer.

Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis

This randomized controlled trial aims to compare the effectiveness of Mobilization with Movement (MWM) and Cyriax techniques in athletes diagnosed with lateral epicondylitis (tennis elbow). Lateral epicondylitis commonly causes pain, reduced grip strength, and impaired proprioception, particularly in racquet and throwing sports players. A total of 56 participants aged 25-40 years with symptoms of less than three months will be randomly assigned to either the MWM group or the Cyriax group. Both groups will receive treatment five times per week for four weeks. Outcomes including elbow proprioception (Joint Position Sense test), pain and functional disability (Patient-Rated Tennis Elbow Evaluation), and grip strength (Handheld Dynamometer) will be assessed at baseline, at 2 weeks, and at 4 weeks. The study aims to determine which treatment method provides superior improvement in pain reduction, functional recovery, and proprioceptive enhancement.

Comparison of the Efficacy of Mesotherapy and Extracorporeal Shock Wave Therapy in Patients With Lateral Epicondylitis

The goal of this clinical trial is to investigate the efficacy of mesotherapy in patients with lateral epicondylitis and to determine whether it is as effective as extracorporeal shock wave therapy (ESWT). Is mesotherapy an effective method in patients with lateral epicondylitis? Researchers will compare Mesotherapy to extracorporeal shock wave therapy (ESWT) in patient with Lateral epicondylitis. Patients will be randomly assigned to either the Mesotherapy group or the ESWT group using a closed envelope method. * Group 1 (Mesotherapy group): Patients will receive a total of 5 sessions of mesotherapy, with one session every 7 days. * Group 2 (ESWT group): Patients will receive a total of 5 sessions of Extracorporeal Shock Wave Therapy (ESWT), with one session every 7 days. Patients will be assessed at three time points: before treatment, 30 minutes after the completion of the treatment, and 12 weeks after the completion of the treatment

Hyaluronic Acid and Amino Acid Combination Versus Exercise for Chronic Lateral Epicondylitis

This retrospective, controlled clinical study aims to evaluate the effectiveness of a targeted biological support injection containing a hyaluronic acid and amino acid combination in patients with chronic lateral epicondylitis (tennis elbow). Medical records will be reviewed to compare outcomes between patients treated in routine clinical practice with a 3-dose injection regimen (weeks 0, 2, and 4) plus a home exercise program and those treated with a home exercise program alone. Key outcome measures include pain intensity (VAS), functional status (PRTEE), grip strength, and pressure pain threshold.

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

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.

High and Low Dose High-intensity Laser Therapy Lateral Epicondylitis

High-intensity laser therapy has gained increasing attention in recent years as a therapeutic modality. It is a non-invasive treatment that can reduce pain, increase local blood circulation, and promote tissue repair. The higher energy output of high-intensity laser therapy also have deeper tissue penetration. Several studies have investigated the effects of high-intensity laser therapy on lateral epicondylitis, and the existing literature indicates that, compared with other treatment modalities, high-intensity laser therapy is more effective in improving pain and quality of life in patients with lateral epicondylitis. However, the dosage, duration, and treatment frequency applied in previous studies vary considerably. The therapeutic effects of high-intensity laser therapy may therefore be influenced by treatment dosage. Consequently, the purpose of this study is to compare the effects of two different dosages of high-intensity laser therapy on patients with lateral epicondylitis.

Effectiveness of Low-Load Resistance Training With Blood Flow Restriction in Lateral Epicondylitis

Lateral epicondylitis, commonly known as tennis elbow, is a frequent musculoskeletal condition that causes pain, reduced grip strength, and functional limitations in daily activities. Exercise-based rehabilitation is a key component of treatment; however, the optimal exercise approach remains uncertain. Low-load resistance training combined with blood flow restriction (LLRT-BFR) has emerged as a promising method that may enhance training effects while using lower exercise loads, potentially reducing mechanical stress on the affected tissues while providing benefits comparable to high-load resistance training. The purpose of this study is to evaluate the clinical and ultrasonographic effects of LLRT-BFR in patients with lateral epicondylitis. Adults aged 18-65 years with a recent diagnosis of lateral epicondylitis who meet predefined inclusion and exclusion criteria will be enrolled and randomly assigned to one of two exercise-based treatment groups. Both groups will participate in the same supervised low-load resistance exercise program, while one group will perform the exercises with blood flow restriction and the other group will receive a sham application without meaningful blood flow restriction. Participants will undergo supervised exercise sessions twice weekly for six weeks. Outcomes will be assessed at baseline, on the first day after completion of treatment, and at 4 and 12 weeks during follow-up. The primary outcome will focus on functional status, while secondary outcomes will include pain intensity, pain sensitivity, grip strength, ultrasonographic measurements of tendon and muscle structure, and patient-reported treatment satisfaction. By comparing these two exercise approaches, this study aims to provide evidence regarding the effectiveness and safety of LLRT-BFR and to clarify its potential role in the rehabilitation of patients with lateral epicondylitis.

Ultrasonographic Examination of Other Enthesitis Sites in Patients With Lateral Epicondylitis

Lateral epicondylitis (LE) is the tendinopathy of the common extensor tendon. Although exact etiology remains unclear, it is believed to be caused by overuse. Even though, genetics factor related to tendinopathies were defined accompanying tendinopathies in patients with LE is yet to be studied. Madrid sonographic enthesitis index (MASEI) is an ultrasound based scoring system, developed for the evaluation of the enthesitis. Initially developed for ankylosing spondylitis, its usage has also become widespread in other musculoskeletal diseases. The aim of this study is to calculate the MASEI score in patients diagnosed with LE, and compare it to healthy volunteers.

Doxycycline for Elbow Tendinopathy

To evaluate the feasibility of subantimicrobial -dose (SD) doxycycline to improve outcomes of nonsurgical management of elbow tendinopathy via matrix metalloproteinase (MMP) inhibition as well as evaluate if participants will be compliant to with prescribed medication and exercise treatment. Our working hypothesis is that patients with elbow tendinopathy will be receptive to treatment with SD-doxycycline and compliant with the prescribed treatment.

Shockwave Therapy Plus Exercise for Lateral Epicondylitis

The primary objective of this study is to compare the clinical effectiveness of exercise therapy alone versus exercise combined with Extracorporeal Shock Wave Therapy (ESWT) in individuals with lateral epicondylitis, focusing on changes in pain, grip strength, functional status, and overall treatment success.

Effect of Scapular Stabilization Exercises and ESWT in Patients With Lateral Epicondylitis

We aim to investigate the effects of adding scapular stabilization exercises to the extracorporeal shock wave therapy (ESWT) protocol in the treatment of lateral epicondylitis on pain, muscle strength, functional status, and quality of life.

Ultrasound Evaluation of Blind Dry Needling in Lateral Epicondylitis

The aim of this clinical study is to evaluate the accuracy and consistency of the blinded needling procedure by evaluating the dry needling procedure under ultrasound guidance in patients diagnosed with lateral epicondylitis and with at least one active trigger point (MTrP) in the forearm extensor muscles. The study is a prospective, double-blind validation study. Participants: Volunteers aged 18-70 years, who have pain in the lateral epicondyle region for at least 6 weeks and who have active trigger points in the forearm extensor muscles detected by physical examination will be included in the study. Written informed consent will be obtained from all participants.

Blood Flow Restriction Training For The Treatment Of Lateral Epicondylopathy

The study aims to evaluate the effectiveness of Blood Flow Restriction Training for the treatment of lateral elbow epicondylopathy.

Understanding Patient Preferences When Deciding on a Voluntary Musculoskeletal Test

The goal of this clinical trial is to understand how people make decisions about imaging tests for common musculoskeletal problems (like arthritis, tendon problems, or nerve compression). The study involves adult patients attending a musculoskeletal specialty clinic. The main questions it aims to answer are: 1. Does having a structured conversation about the pros and cons of a test affect how much a person wants to have that test? 2. Does that conversation help people feel more confident and less conflicted about their decision? Researchers will compare patients who have a values-based discussion with a researcher to those who receive brief written information about the test, to see if these approaches affect how people feel about having the test. Participants will: * Read a brief scenario about a proposed diagnostic imaging test (like an X-ray, MRI, CT, or ultrasound). * Either take part in a short structured conversation or read brief information about the test. * Answer a short survey about their thoughts on the test. This study does not involve actual medical testing or affect your clinical care. It is for research purposes only.

Safety and Preliminary Efficacy of iEVs Injection in Treating Lateral Epicondylitis of Humerus

Evaluate the safety and preliminary efficacy of human induced pluripotent stem cell-derived extracellular vesicle (iEV) injection in the treatment of lateral epicondylitis of the humerus.

Effects of Neuromuscular Reeducation Versus Friction Massage in Lateral Epicondylitis

This study is a randomised control trial and the purpose of this study is to determine the effects of neuromuscular reeducation versus friction massage in lateral epicondylitis.

Blood Flow Restriction & Tennis Elbow Rehab

Lateral epicondylitis (LE), often referred to as "tennis elbow" is a common and debilitating overuse injury affecting 1-3% of adults annually. LE is most often defined as a syndrome of pain near the area of the lateral epicondyle of the elbow commonly effecting the origin of the extensor carpi radialis brevis with associated weakness; it most commonly effects the dominant arm. The best treatment for LE is unknown and research to support current treatment methods are insufficient. A common limitation in functional recovery experienced by this population is pain at the lateral aspect of the elbow. As such, innovative therapeutic interventions directed at quickly reducing pain may address this unmet need and allow for improved outcomes, as well as earlier return to function.

Efficacy Bioinductive Implant for Tennis Elbow (Lateral Epicondylitis)

The investigators are testing the efficacy of a new, FDA-approved bioinductive patch in lateral epicondylitis (tennis elbow) patients. A bioinductive patch is an implant that may foster tendon regrowth and healing following surgery. Patients will be randomize into one of two groups: control and investigational. Patients in the "control group" will receive the normal surgery for patients who do not respond to physical therapy, lifestyle changes, and anti-inflammatory treatment. Patients in the "experimental group" will receive the same surgical treatment, with the addition of the bioinductive patch. This patch will be implanted during surgery. Then, using a combination of ultrasound studies and other measures, the investigators will assess how well the patch works compared to surgery alone.

Efficacy of One or Two Botulinum Toxin Injections in the Treatment of Chronic Lateral Epicondylalgia: a Retrospective Study (EPITOX)

Despite being a self-limiting injury, lateral epicondylitis (LE) can be difficult to manage. In cases of refractory LE, conservative treatment fails and symptoms persist over 6 months. Previous studies have investigated the role of botulinum Toxin Type A (BoNT-A) injections in LE with controversial results. There is some evidence that repeating the BoNT-A injection could be beneficial for refractory cases. The objective is to assess the success rate of one or two BoNT-A injections for refractory LE.

Exercise Therapy and Orthoses in Lateral Elbow Tendinopathy: Comparative Effects

The aim of this study is to address the inconsistencies in the literature by investigating the effects of a forearm counterforce brace and a wrist splint, used in addition to exercise therapy, on pain, functionality, and grip strength in individuals diagnosed with lateral elbow tendinopathy, compared to those receiving exercise therapy alone.The findings aim to provide valuable insights into clinical practice by highlighting the roles of both orthosis use and exercise in the treatment of lateral elbow tendinopathy.

Multimodal Rehabilitation Approach in Patients of Lateral Epicondylitis

Literature is scarce for high quality evidence regarding multimodal rehabilitation in lateral epicondylitis. By making comparisons with the conventional treatment of patients with lateral epicondylitis, the current study aims to further establish the efficacy of the multimodal rehabilitation protocol through a RCT in order to generalize the results, using dynamometer as an additional tool for pre and post assessments against the outcome measures. Remarks A randomized control trial was conducted at Physical therapy departments of twin cities. The sample size was 40 calculated through G- power tool. The participants were divided into two interventional groups each having 20 participants. The study duration was eight months. Sampling technique applied was non- probability convience sampling. People of age 18-45 years, with localized point tenderness at lateral epicondyle with Mills, Cozen and Maudselys test positive were included in this research. Tools used in this study are Visual Analogue Scale, Dynamometer, Patient Rated Tennis Elbow Questionnaire. Data was collected before and immediately after the application of interventions. Data analyzed through SPSS version 23.

Upper Extremity-based Exercises and Elbow-focused Exercises in LET

The aim of the study is to investigate the effects of rotator cuff and scapular muscle strengthening exercises applied in addition to the 8-week elbow focused rehabilitation program in lateral elbow tendinopathy, by comparing it with the elbow focused rehabilitation program.

Effect of Vibrotactile Stimulation in Lateral Epicondylitis

It is aimed to investigate the immediate effect of vibrotactile stimulation on pain, sense and functionality in patients with lateral epicondylitis.

Comparative Effects of Sustained Stretch and Mobilization With Movement in Patient With Tennis Elbow

Tennis elbow, clinically known as lateral epicondylitis, is a prevalent musculoskeletal issue marked by pain and tenderness on the outer part of the elbow. It primarily affects the extensor tendon at the lateral epicondyle and is commonly linked to repetitive arm movements and overuse. Various treatment options are available for this condition, with two notable methods being sustained stretching and Mobilization with Movement (MWM). Sustained stretching involves holding the affected muscles and tendons in an extended position for a prolonged time to ease muscle tightness and enhance flexibility. Conversely, MWM integrates specific joint movements with the active involvement of the patient to improve joint mobility and reduce pain. Muscle strength plays a crucial role in the overall function of the upper limb, and enhancing this can positively affect daily activities. Furthermore, functional disability indicates how tennis elbow impacts a person's capacity to carry out everyday tasks.