Effectiveness of Combined Super Inductive System (SIS) Therapy With Therapeutic Physical Therapy Exercise and Health Education in Lateral Elbow Tendinopathy
Phase: NA
Conditions: Lateral Epicondylitis (Tennis Elbow), Lateral Epicondylalgia, Lateral Elbow Tendinopathy
Sponsor: University of Vic - Central University of Catalonia

 
 
 
 
 
 
 
 
 
MODEL PROTOCOL FOR SUBMITTING PROJECTS 
TO THE CEIm OF 
L'IDIAP JORDI GOL 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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RESEARCH PROJECT TO BE EVALUATED BY THE CLINICAL RESEARCH 
ETHICS COMMITTEE 
 
 
Title and details 
 
PROJECT NAME: Effectiveness of a combined therapy of the Super Inductive 
System (SIS) with a therapeutic exercise program of physiotherapy and health 
education in lateral tendinopathies of the elbow.  
 
PRINCIPAL INVESTIGATOR: M. Carmen Sánchez Mato. 
Profession: Physiotherapist. 
Work center: Rehabilitation Service CAP-II Mataró-Maresme. North Metropolitan 
Territorial Management. Catalan Institute of Health (ICS). 
 
COLLABORATIVE RESEARCHER COLLABORATOR: Dr. Anna Escribà Salvans. 
Profession: Physiotherapist. 
Work centre: University of Vic – Central University of Catalonia (UVIC-UCC). 
 
COLLABORATIVE RESEARCHER COLLABORATOR: Dr. Ramon Arroyo Aljaro. 
Profession: Rehabilitation Doctor. 
Work centre: Sant Andreu Rehabilitation and Physiotherapy Unit, Drassanes, 
Numancia. Territorial Management of Barcelona. ICS. 
 
COLLABORATIVE RESEARCHER COLLABORATOR: Luisa Acosta Moreno. 
Profession: Physiotherapist. 
Work centre: Sant Andreu Rehabilitation and Physiotherapy Unit. Territorial 
Management of Barcelona. ICS. 
 
COLLABORATIVE RESEARCHER COLLABORATORS: Mario Martín Sánchez. 
Profession: Physiotherapist. 
Work centre: Drassanes Rehabilitation and Physiotherapy Unit. Coastal Territorial 
Management / Left of Barcelona. ICS. 
 
 
Date: 17/05/2025 
Document version: Version 02 
 
 
 
 

 
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Structured summary of the project 
 
Background: Lateral epicondyalgia is the most common cause of lateral elbow 
pain, affecting between 1% and 3% of the population. It affects strength, functionality 
and quality of life and causes limitations in work and activities of daily living. 
Therefore, it constitutes a major public health problem. 
Scientific evidence suggests the application of conservative physiotherapeutic 
treatment, as the first line of action; although there is heterogeneity and treatment 
guidelines are not clear. 
Rest and drug administration provide short-term pain relief. They are usually the first 
therapeutic step, although it does not solve the problem and can promote relapses. 
Kinesitherapy can improve pain, strength, and functionality. Evidence advises it as 
a first-line conservative treatment. Its cost-benefit ratio is very favorable. The 
application of thermotherapy and electrotherapy reduce pain and improve 
functionality compared to placebo. 
This study aims to assess the efficacy of the Super Inductive System (SIS), 
combined with a conventional kinesitherapy protocol. 
Hypothesis: The combined therapy of the SIS, with a therapeutic exercise program 
of upper limb physiotherapy and health education, will promote the reduction of pain, 
improve the mobility and functionality of the affected limb, increase grip strength, 
facilitate the return to activities of daily living (ADL), as well as the perception of 
improved quality of life in people with lateral elbow tendinopathies. 
Objective: To evaluate the effectiveness of SIS combined with a therapeutic 
exercise program of physiotherapy and health education in cases of lateral 
tendinopathy of the elbow in people aged 18 years or older, compared to the 
application of SIS with a non-therapeutic dose and the performance of conventional 
therapeutic exercise and health education treatment. 
Methodology: Interventional, experimental, prospective study. Randomized 
Clinical Trial, with triple blind of the principal investigator, the evaluator and the user. 
With control group (SIS with non-therapeutic dose, therapeutic exercise and health 
education) and intervention group (SIS with therapeutic dose, therapeutic exercise 
and health education). The study will be multicenter, with a quantitative 
methodology, carried out in three Rehabilitation and Physiotherapy Services 
(Mataró, Sant Andreu (Barcelona) and Drassanes (Barcelona)). The three centres 
are in the field of Primary Care, of the Catalan Institute of Health (ICS).  
Data collection will be carried out before and after the intervention and controls 3 
and 6 months after the end of the processing. 
Variables of interest: pain (VAS/Algometry), mobility (goniometer), function 
(QuickDASH), strength (Dynamometry) and quality of life (EQ-5D-5L). 

 
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Intra- and intergroup inference tests will be carried out on the dependent variables. 
The data will be processed in accordance with current legislation. 
The data will be managed through RedCAP (Research Electronic Data Capture). 
The study will be recorded in the ClinicalTrials.gov. 
Expected results: A statistically significant improvement is expected in the 
intervention group compared to the control group, to extrapolate the treatment to the 
general population with lateral elbow epicondylalgia. It is expected that the use of 
the SIS will lighten recovery time, reduce the number and time of temporary 
disabilities (TD) and pharmacological expenditure for cases of epicondylgia. 
Applicability: SIS is an innovative and non-invasive therapeutic technology. It 
reduces acute and chronic pain, improves joint mobility and promotes muscle 
strengthening in cases of acute and chronic tendinopathies. Its implementation 
could accelerate the recovery of the pathology. The aim is to obtain evidence on its 
effectiveness and cost-efficiency, contributing to the reduction of the number of 
temporary work disabilities and their duration, treatment and recovery times, as well 
as expenditure on pharmacological treatment.  
Relevance: The use of SIS can improve effectiveness and cost-efficiency, 
contributing to the reduction of the number of temporary work disabilities and their 
duration, treatment and recovery time, as well as expenditure on medicines in those 
patients affected by epicondylitis. 
It will provide evidence to incorporate a new therapeutic tool into clinical practice, 
improving treatment efficacy, reducing costs and offering a better patient experience 
in primary care. The SIS will be key to developing a more sustainable and advanced 
healthcare, putting the company at the forefront of innovation in physiotherapy and 
rehabilitation. 
 
Keywords 
 
Lateral Epicondylitis, Super Inductive System, high-intensity electromagnetic 
stimulation, exercises, pain, functionality. 
 
 
 
 
 
 

 
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INDEX 
 
Structured summary of the project ..................................................................... 3 
Keywords............................................................................................................ 4 
List of abbreviations ........................................................................................... 7 
Background and current status of the subject .................................................... 8 
Justification of the project .................................................................................. 11 
Hypothesis........................................................................................................ 13 
Objectives......................................................................................................... 13 
General objective ..................................................................................... 13 
Secondary objectives ............................................................................... 14 
Methodology ..................................................................................................... 14 
Design of the studio ................................................................................. 14 
Scope and period of study ....................................................................... 14 
Reference population ............................................................................... 15 
Study population ...................................................................................... 15 
Inclusion criteria ....................................................................................... 15 
Exclusion criteria ...................................................................................... 15 
Sample size and sampling procedure ...................................................... 16 
Dependent and independent variables .................................................... 17 
Intervention .............................................................................................. 21 
Data collection and sources of information .............................................. 21 
Data analysis, implementation, masking, statistical methods .................. 23 
Pharmacovigilance ........................................................................................... 24 
Ethical considerations and confidentiality of data ............................................. 24 
Data processing and protection ........................................................................ 25 
Additional procedures derived from the study .................................................. 26 
Difficulties and limitations of the study .............................................................. 26 
Work plan ......................................................................................................... 27 
Experience of the research team ...................................................................... 29 
Applicability and practical usefulness of the results of the study ...................... 37 
Means available for the realization of the project ............................................. 38 

 
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Financial report and justification of the aid requested ...................................... 40 
Requested quote .............................................................................................. 40 
Bibliography ...................................................................................................... 41 
Appendices....................................................................................................... 45 
Annex 1: Patient information sheet .......................................................... 45 
Annex 2: Informed consent ...................................................................... 53 
Annex 3: Waiver form ............................................................................... 56 
Annex 4: Data collection sheet................................................................. 58 
Annex 5: Assessment scales ................................................................... 61 
Annex 6: Measuring instruments .............................................................. 68 
Annex 7: Therapeutic exercise protocol ................................................... 69 
Annex 8: Health education sheet ............................................................. 79 
Annex 9: Record of exercises carried out ................................................ 83 
Annex 10: Super Inductive System Manual ............................................. 84 
Annex 11: SIS CE Marking ....................................................................... 85 
Annex 12: Bypass and intervention circuit ............................................... 90 
Annex 13: Project schedule ..................................................................... 91 
Annex 14: Participating centres and PI's of the centres ........................... 92 
 
 
 
 
 
 
 
 
 
 
 
 

 
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LIST OF ABBREVIATIONS 
 
AP: Primary Care. 
ADL: Activities of Daily Life. 
CAP: Primary Care Centre. 
CEIC: Clinical Research Ethics Committee. 
CI: Informed Consent. 
eCAP: Coordination and Primary Care Team. 
EVA: Visual Analogue Scale. 
ENV: Visual Numerical Scale. 
FIP: Patient Information Sheet. 
GC: Control Group. 
GI: Intervention Group. 
GIS: Management and Services. 
ICS : Catalan Institute of Health. 
PI: Principal Investigator. 
TD: Temporary Disabilities. 
MF: Family Doctor. 
SIS: Super Inductive System. Super Inductive System. 
SPSS: Statistical Package for the Social Sciences. 
TCAI: Nursing Assistant Care Technician. 
 
 
 
 
 
 
 

 
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Background and current status of the subject. Justification of the project 
 
BACKGROUND AND CURRENT STATUS OF THE SUBJECT 
Tendon diseases constitute a significant part of musculoskeletal disorders and 
represent a leading cause of disability worldwide. Unresolved (chronic) 
inflammatory states have been associated with the onset and progression of tendon 
disorders, contributing to undesirable immune stimulation and tissue damaging 
effects (1). 
Epicondyalgia is a musculoskeletal disorder that causes pain and dysfunction in the 
upper extremity. It is considered to be the most common cause of elbow pain (2,3). 
There is controversy regarding the terminology used to name lateral elbow pain. 
The most commonly used term is "lateral epicondylitis", followed by "tennis elbow" 
and "lateral epicondylgia". Although epicondylitis is the most commonly used, this 
alteration is not inflammatory but degenerative. It is a tendinopathy caused by 
degeneration of the tendon as a result of its excessive and repetitive use (4). 
There is involvement of the extensor muscles that are inserted into the epicondyle. 
The most frequent involvement occurs at the level of the insertion of the extensor 
carpi radial brevis muscle, although it can also appear in the insertion of the extensor 
digitorum comum muscle and extensor ulnar carpital. Tendinopathy appears not 
only with the practice of racket sports but is also common in people who perform 
tasks with wrist extension, radial deviation, supination and repetitive grip, leading to 
limitations in daily work and activities of daily living (2,3).  
Lateral epicondyalgia is the most common cause of lateral elbow pain. It often 
develops as an affectation related to the world of work, associated with demanding 
physical work, excessive use, recurrent movements of the upper limbs, weight 
training and repetitive vibrational movements. It is therefore a major public health 
problem (5,6). 
It affects approximately 1 to 3 percent of the population (7). It seems to affect men 
and women in the same proportion, but there are studies that report a greater effect 
on women. The incidence is 5.5 cases per 1000 people per year, mostly affecting 
people between 40 and 59 years of age in their dominant arm (3). 
The symptoms that occur with epicondyalgia are pain in the area of insertion of the 
epicondylar muscles, affecting strength, functionality and quality of life (8).  
The main treatment objectives are focused on decreasing pain, preserving mobility, 
improving muscle strength and endurance as well as helping users improve 
functional capacity and quality of life (3). 
To perform the examination and diagnose epicondylgia, various tests and 
questionnaires can be used. The clinical tests of Cozen and Mill can be used. The 
Cozen maneuver is a clinical test used to diagnose lateral epicondylitis. It is 
performed with the patient sitting, with the elbow arm at 90º of flexion, the forearm 
in pronation and the wrist in slight radial deviation. The patient must perform a 

 
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resisted extension of the wrist while the examiner applies pressure. It can also be 
done by asking him to "take a chair". If the patient experiences pain in the lateral 
area of the elbow, the test is considered positive (9). Mill's maneuver, also used to 
diagnose lateral epicondylitis, involves putting the extensor muscles of the wrist 
under passive tension. The patient can be sitting or standing, with the elbow bent 
and the forearm in pronation. The examiner flexes the patient's wrist and stretches 
the elbow to the maximum. If the patient experiences pain in the epicondylar area, 
the test is considered positive. Mill's test has excellent reliability and Cozen's has 
good reliability (9). The diagnosis is mainly clinical, but sometimes it can be 
complemented with an ultrasound examination (9,10). To assess pain, the Visual 
Analogue Scale (VAS), the Visual Numerical Scale (ENV), the manual pressure 
algometer, among others, can be used (3,10). A dynamometer can be used to 
measure the isometric gripping force of the hand (11). 
Scientific evidence suggests the application of conservative treatment for lateral 
elbow pain, as the first line of action. Clinical guidelines and the literature do not 
identify the most effective non-surgical treatment (12). Although heterogeneity exists 
and treatment guidelines are unclear, evidence suggests that physiotherapeutic 
rehabilitation appears to be effective in acute and chronic conditions (2). 
There are different treatments used to address epicondylalia. 
Rest and drug administration provide short-term pain relief. They are usually the first 
therapeutic step, although it does not solve the problem and can promote relapses 
(13). 
One of the most common physiotherapy treatments in clinical practice for 
epicondylitis is the application of a therapeutic exercise program consisting of warm-
up, static stretching exercises, and eccentric and isometric training exercises (3). 
Kinesitherapy, with the performance of eccentric exercise, can improve pain, 
strength and functionality. Evidence suggests it as a first-line conservative 
treatment. Its cost-benefit ratio is very favourable (13,14,15). A 2024 clinical trial 
concluded that proprioception exercises have limited added value in terms of pain, 
function, hand grip strength, and dexterity but may be beneficial for improving joint 
position (16). Eccentric exercise is considered as a first-line conservative treatment 
in the approach of lateral elbow tendinopathies for the improvement of pain and 
muscle strength (17). 
In a study published in 2018, he talks about the importance of increasing tolerance 
to tendon load, including strength exercises, but also adding speed and energy 
storage and release. Although the study is specific to achilles and patellar 
tendinopathy, the information obtained could be extrapolated to elbow tendinopathy. 
The aim is to incorporate progressive loading into the tendon with isometric, 
strength, functional strength and speed exercises (18). 
The application of thermotherapy and electrotherapy decreases pain and improves 
functionality compared to placebo (7). Greater benefits and improvement of 
symptoms can be found with the application of electrotherapy in combination with 
manual physiotherapy techniques and therapeutic exercise. Electromagnetic fields, 
TENS, laser, shortwave, iontophoresis or ultrasound are the most used in the 

 
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treatment of epicondylitis. Cryotherapy can be effective in reducing local pain at the 
end of treatment. Gel massage is effective as part of a multimodal approach to treat 
any type of tendon pathology (3). A 2021 systematic review and meta-analysis 
examined the outcomes of non-surgical treatments for lateral epicondylitis. Fifty-
eight randomized controlled trials were included and concluded that patients who 
received electrotherapy and physiotherapy reported statistical and clinical 
improvements in pain and function compared to placebo (19). A 2022 meta-analysis 
included twenty-three clinical trials with 1363 participants to compare the efficacy of 
physiotherapy and electrophysiotherapy treatments for the treatment of lateral 
epicondylitis. They concluded that Pulsed Electromagnetic Fields (PEMF) therapy 
was associated with pain reduction and that acoustic wave and light therapy 
favoured an increase in grip strength (to grip objects firmly) (12). PEMF can be 
integrated into the application of effective therapies to treat inflammation in 
tendinopathic conditions (1). 
The Super Inductive System (SIS) or high-intensity pulsed magnetic field has been 
shown to be effective in addressing tendinopathies, although there is very little 
evidence. In 2024, a study with 34 users was published, with which the effect of a 
single PEMF application on pain perception was investigated. The results showed 
an immediate decrease in pain, which persisted for at least a week (20). 
Tendon disorders often cause decreased function and muscle atrophy. A 2024 study 
conducted with rats confirms that pulsed electromagnetic fields have demonstrated 
potential to improve tendon fiber structure and muscle recovery, accelerating 
physiological recovery (21). 
It is important to include ergonomic and postural hygiene recommendations in the 
treatment. These indications could include avoiding repetitive wrist and elbow 
movements, not performing activities that can worsen pain, modifying the work 
environment to improve ergonomics, taking into account that exercises should not 
increase pain, among others (3). 
Manual therapy facilitates the reduction of pain and improves joint mobility (13). The 
therapeutic exercise program can be combined with manual therapy techniques 
such as Cyriax, Mulligan manipulation, myofascial trigger point approach (manual 
therapy and dry needling), soft tissue mobilization, and mobilization and 
manipulation of the wrist and radial joints (3). In a 2023 systematic review, they 
conclude that manual therapy and eccentric strength training are the two 
physiotherapeutic treatment methods that have the greatest beneficial effects and 
that the cost-benefit ratio is more favourable (22).  
Kinesiotaping or neuromuscular bandage is frequently used to address 
musculoskeletal pathology and offers positive effects on pain caused by wrist 
extension against resistance in epicondylitis (3). The effect, both immediate and 
short-term, with the placement of Kinesiotape is unclear (23). 
The use of forearm orthosis can immediately reduce pain during contraction and 
improve pain-free grip strength, but not maximum grip strength (24). Its use is more 
indicated during the first phase of treatment or the onset of pain, when it is not 
possible to avoid the activity that generates or worsens the pain (3). 

 
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The application of extracorporeal shock waves has been shown to relieve pain and 
functional impairment (25). On the other hand, in a 2021 systematic review and 
meta-analysis, they present low to moderate evidence regarding the clinical benefits 
of extracorporeal shockwave therapy compared to sham interventions (26). 
Mechanical stimulation obtained by extracorporeal shock waves and pulsed 
electromagnetic fields may play a role in the treatment of tendinopathy and for 
tendon regeneration by increasing the expression of growth factors (27). 
Some studies show low evidence on the use of dry needling to reduce pain, pain-
related disability and short-term strength (28). Others show good therapeutic effects 
on pain intensity, function, and grip strength (29). 
Infiltrations can put patients at greater risk of adverse effects compared to different 
conservative treatments (19); although biological treatments for the non-surgical 
approach to epicondylitis are increasingly used, such as platelet-rich plasma, 
autogenous blood injections and stem cell therapy (3). 
Surgical treatment should be carried out as a last option, if conservative treatment 
has not improved the symptoms. Three types of surgical approach are used; open, 
percutaneous or arthroscopic. The latter is the one that obtains the best functional 
results (30). 
This study aims to assess the efficacy of SIS, combined with a therapeutic exercise 
and health education protocol. There is very little evidence on the effectiveness of 
SIS although there are some publications of pilot studies or case studies; both in 
epicondyalgia (31) and in other conditions (32). 
 
JUSTIFICATION OF THE PROJECT 
The proposed study aims to evaluate the efficacy of SIS in lateral elbow 
tendinopathies. It is an injury frequently related to repetitive movements of the elbow 
and hand, during sports, work or domestic activities, which require intense force in 
inappropriate postures. They affect between 1% and 3% of the working-age 
population, with a high prevalence between 40 and 50 years of age, having 
significant economic and healthcare repercussions on the health system, as a result 
of sick leave. 
This study aims to assess the efficacy of SIS, combined with a  therapeutic exercise 
program of physiotherapy and health education in epicondyalgia in the adult 
population. There is little evidence on the effectiveness of the SIS. According to the 
literature searched, we are aware of some publications on the effectiveness of the 
SIS but only case studies or studies with a very small population; both in 
epicondylgia and in other conditions. Scientifically, showing the efficacy of a 
treatment with case studies is complicated by the small sample size and 
inconclusive results. For this reason, we highlight the importance of carrying out a 
study with a larger sample in order to obtain more significant results. 

 
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SIS is an innovative and non-invasive therapeutic technology. It creates a high-
intensity electromagnetic field that interacts with the tissues of the human body. The 
2.5 Tesla electromagnetic field causes strong muscle contractions, helping to control 
pain. Being a non-invasive system, it is well tolerated by patients and minimizes 
complications resulting from other treatments. This makes it easier to apply and 
adhere to the treatment of patients with this system. The fact that it is not an invasive 
therapy will allow us continuity, safety and cohesion of the study sample. 
Its effects include the reduction of acute and chronic pain, the improvement of joint 
mobility and muscle strengthening in cases of tendinopathies, among others. Its 
implementation could accelerate recovery from this pathology and improve 
variables such as pain, mobility and strength. The aim is to show its effectiveness 
and cost-efficiency, contributing to the reduction of the number of work disabilities 
and their duration, treatment and recovery time, as well as expenditure on 
pharmacological treatment. In this way, it will be possible to maintain a sustainable, 
efficient and equitable public health system, offering quality care to all users who 
present this problem. 
This study will be multicentre, with the participation of three Rehabilitation and 
Physiotherapy Services (Mataró-Barcelona, Barcelona-Sant Andreu and Barcelona-
Drassanes). One of the purposes of carrying out this project in three different centres 
is to be able to obtain a larger sample and obtain more significant results in order to 
respond to the gap in the current scientific literature. 
In line with the Strategic Plan 2023-2026 of the Catalan Institute of Health (ICS), in 
the field of Primary Care (PC), the North Metropolitan Territorial Management is 
characterised by its capacity for innovation. This new Plan will accompany us as a 
key tool to develop the skills of the professionals participating in this project to the 
maximum, giving special value to internal talent, applying the SIS as an innovative 
tool in lateral elbow tendinopathies to achieve the desired results. 
The Strategic Plan 2023-2026 is aligned with the Health Plan of Catalonia 2021-
2025 and is the instrument and reference framework for all public actions in the field 
of health within the scope of the Generalitat. 
In clinical practice, this project is in line with the mission, vision and values redefined 
in the new Strategic Plan. Its mission is to promote and improve the health and 
quality of life of citizens, through comprehensive and integrated health care, 
generating and sharing knowledge. In terms of vision, it aims to be recognized by 
society as a people-centred organisation, for our excellent service, for our capacity 
for problem-solving, transformation and innovation, and for the commitment of our 
professionals. Finally, special value is given to professional competence, the 
commitment and co-responsibility of professionals in health outcomes, humanity 
and ethics, equity and sustainability in resource management. 
The aim is to update the treatment protocol in relation to tendinopathies, adapting it 
to reality and current needs, offering person-centred care, with an excellent service, 
with the capacity for resolution and innovation, and with the commitment of the 
different professionals involved in the project. 

 
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This study will provide evidence for the incorporation of a new therapeutic tool into 
clinical practice, improving the efficacy of treatment, reducing costs and offering a 
better experience to patients in primary care. 
The SIS is presented as a key tool for developing a more sustainable and advanced 
healthcare, putting the company at the forefront of innovation in physiotherapy and 
rehabilitation, and the patient as the protagonist of their recovery process. 
 
Hypothesis/s  
The combined therapy of the SIS, with a therapeutic exercise program of upper limb 
physiotherapy and health education, will promote the reduction of pain, improve the 
mobility and functionality of the affected limb, increase grip strength, facilitate the 
return to activities of daily living (ADL), as well as the perception of improved quality 
of life in people with lateral elbow tendinopathies. 
 
Objective(s) (General and specific) 
 
Main objective: To evaluate the effectiveness of SIS combined with a therapeutic 
exercise program of physiotherapy and health education in cases of lateral 
tendinopathy of the elbow in people aged 18 years or older, compared to the 
application of SIS with a non-therapeutic dose and the performance of conventional 
therapeutic exercise and health education treatment. 
Secondary objectives 
- 
Decrease pain in the affected upper extremity. 
- 
Increase the active mobility of the upper limb, in cases where it is affected. 
- 
Improve the functionality of the affected limb to return to its daily activity. 
- 
Increase the grip strength of the affected limb. 
- 
To analyze changes in quality of life, pre and post treatment, in people 
suffering from lateral elbow tendinopathies. 
- 
To compare sociodemographic and baseline characteristics of the 
intervention group and the control group. 
- 
Quantify the number of treatment sessions until discharge (% of 
absenteeism). 
- 
Compare the amount of pre- and post-treatment pharmacological treatment. 
- 
To evaluate the number and duration of temporary work disabilities before 
and after treatment. 
 

 
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Methodology 
 
Design of the studio 
The design of the multicenter study consists of a randomized, experimental, 
prospective, triple-blind clinical trial of the principal investigator, the evaluator and 
the user. With a control group (SIS with non-therapeutic dose, therapeutic exercise 
program and health education) and intervention group (SIS with therapeutic dose, 
therapeutic exercise program and health education), on the adult population derived 
from lateral elbow epicondyalgia to one of the three Rehabilitation and 
Physiotherapy Services (Mataró, Sant Andreu-Barcelona and Drassanes-
Barcelona). The three centers are in the field of Primary Care, of the ICS. 
The study is prospective, with data collection at the beginning of the treatment, at 
the end of it, 3 and 6 months after the end of the treatment. 
Scope and period of study 
The project will be multicentre. It will take place in three Rehabilitation and 
Physiotherapy Services (Mataró, Sant Andreu and Drassanes), in the field of 
Primary Care of the ICS. It is intended to start the intervention in September 2025 
and continue during 2026, uninterruptedly, until the entire calculated sample and its 
post-intervention controls are reached. 
 
 
Reference population 
People aged 18 years or older, affected by pain, acute or chronic, in the lateral 
epicondyle of the elbow. 
 
Study population 
People attended to by the three Rehabilitation and Physiotherapy Services (Mataró, 
Sant Andreu and Drassanes), referred to the Family Doctor, the Rehabilitation 
Doctor, the Traumatologist or the Rheumatologist, with a diagnosis of epicondyllgy. 
Once these people have been detected, they will be explained the Rehabilitation 
treatment and, after delivering the information sheet to the patient (Annex 1) and 
subsequently signing the informed consent (Annex 2), informed consent for the 
transfer of images (Annex 3) and the commitment sheet for assistance to the 
treatment and controls (Annex 4), they would participate in the study. They will also 
have the Waiver Form, if applicable (Annex 5). 
The sample will be randomly selected in the intervention group or in the control 
group.  
 
 

 
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Inclusion criteria 
- 
Be 18 years of age or older. 
- 
Be diagnosed with lateral epicondyalgia of the elbow, by the Family Doctor, 
Rehabilitation Doctor, Traumatologist or Rheumatologist. 
- 
Referred to one of the three Rehabilitation and Physiotherapy Services 
(Mataró, Sant Andreu and Drassanes). 
- 
One or both positive exploratory maneuvers (Cozen and Mill). 
- 
Agree to be part of the study, by reading the patient information sheet 
(Appendix 1) and subsequent signing of the informed consent (Appendix 2) 
informed consent for the assignment of images (Appendix 3). 
 
Exclusion criteria 
- 
Medial epicondyalgia of the elbow. 
- 
Recent traumatic history, in a period of less than 6 months. 
- 
Limitation of more than 20º of the passive joint balance. 
- 
Infiltration in the affected elbow 6 weeks prior to the first visit. 
- 
Systemic inflammatory, autoimmune, infectious or tumour disease. 
- 
Pregnancy.  
- 
Metal implants in the affected elbow area. 
- 
Pacemakers or defibrillators. 
- 
Frohse's arch syndrome (compressive neuropathy of the motor branch of the 
radial nerve). 
- 
Blood clotting disorders. 
- 
Cognitive or sensory difficulty that prevents participation in the proposed 
treatment. 
- 
Central sensitization syndrome (Fibromyalgia, Chronic fatigue,...). 
 
Sample size and sampling procedure 
Accepting an alpha risk of 0.05 and a statistical power greater than 0.8 in a bilateral 
contrast, 93 subjects in the intervention group and 93 in the control group are 
required to detect as statistically significant the difference between two proportions, 
of at least 20% in the worst case for the outcome variables. 
Adding 20% to the result obtained, the total sample will be 224 users, and therefore, 
112 users affected by pain in the lateral epicondyle of the elbow, in each of the two 
groups. 
The sample will be recruited by referrals made by the family doctor, the rehabilitation 
doctor, the traumatologist, or the reference rheumatologist. 
Once the sample size is achieved, the recruitment of users for the study will end. 
Simple randomized assignment will be performed, with the same proportion to the 
GI and the CG, using an online random numerical sequence generator to two 
groups, by generating random numbers in Excel. 

 
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The randomization sequence will be carried out by the principal investigator (PI), 
who will not participate in either the intervention or the data collection. 
The assignment will be hidden and opaque envelopes will be used to minimize 
selection bias. The PI will deliver the opaque envelopes to the evaluators. These, 
after evaluating the participant, will draw a random envelope and deliver it to the 
TCAI staff along with the participant's data. The evaluator will generate a treatment 
form with the indication "SIS Study". TCAI staff will open the envelope to find out 
which group each user is assigned to. They will schedule the start of the treatment 
with Physiotherapy and will contact you by phone to inform you of the day and time 
of the start of the treatment. They will give the assigned physiotherapist the sheet 
with the sessions scheduled for each patient together with the envelope that will 
indicate which of the two groups they will be assigned to. 
The GIS staff will schedule the subsequent follow-up checks with the evaluators for 
both groups.  
The evaluators are masked, since they do not have the randomization sequence.  
The project is presented as a triple blind of PI, evaluators and users. The blinding 
of the physiotherapist is ruled out. 
They will be randomly distributed to the Intervention Group and the Control Group. 
- 
Intervention Group (IG): application of the Super Inductive System 
accompanied by a kinesitherapy and patient education protocol. 
- 
Control Group (CG): application of the Super Inductive Placebo System (with 
non-therapeutic dose: 10 minutes at 1 Hz, 59-second pause and intensity of 
5-10%) accompanied by the same kinesitherapy and patient education 
protocol. 
The frequency of the treatment will be 2 weekly sessions with a total of 8 sessions. 
The conventional treatment applied so far to the three Rehabilitation and 
Physiotherapy Services consisted of teaching a protocol of specific exercises 
accompanied by education to the patient. 
The SIS equipment used for the GI will be the BTL-6000 Super Inductive System 
Elite, present in the three Rehabilitation and Physiotherapy centres. 
Control will be carried out at the beginning and end of the treatment and follow-up 
at 3 and 6 months after the treatment.   
 
Dependent and independent variables 
Outcome measures will be carried out on the following quantitative variables: pain, 
joint mobility, grip strength, functionality and quality of life. 
The evaluator has the Patient Information Sheet (Annex 1), the Informed Consent 
(Annex 2), the Informed Consent for the Transfer of Images (Annex 3), the 
Commitment Sheet for Assistance to Treatment and Controls (Annex 4), the Waiver 

 
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Sheet (Annex 5), the Data Collection Sheet (Annex 6), the Adverse Effects 
Collection Sheet (Annex 7),  the assessment scales used (Annex 8) and the 
measuring instruments (Annex 9). 
To measure the intensity of pain, the Visual Analogue Scale (VAS) will be used. Its 
simplicity and ease of use make it a widely used tool. It consists of a straight line, 
10 cm long, with ends that represent the limits of pain (ranging from "painless" to 
"the worst enduring pain"). The person is shown a line with two clearly defined ends. 
The person marks a point on the line that corresponds to the intensity of the pain 
they feel at that moment. The position of the mark is measured and converted into 
a numerical value ranging from 0 to 10 (33). 
The manual pressure algometer (PAIN TEST TM FPX 50) will be used as a device 
to measure pain sensitivity in response to an applied pressure. It is a useful 
instrument in research to assess the perception of pain in different parts of the body; 
in our case, in the affected elbow. This measuring instrument assesses pain 
accurately. The algometer applies a controlled progressive pressure perpendicular 
to the skin and muscle using a 1 cm2 head until the participant indicates to the 
evaluator the moment when he/she begins to feel pain. The pressure applied at that 
time is recorded as a measure of pain sensitivity. The average values of three 
consecutive measurements will be taken and compared with the opposite side 
lateral. Algometry has demonstrated excellent reliability (ICC 0.91) among 
examiners (9). 
The manual goniometer will be used to measure the angle of movement of the 
elbow joint. It is an instrument with two moving branches and a scale graduated in 
degrees. The evaluator places the arm in a neutral position, above the elbow joint, 
and measures the angle of movement in different directions (flexion, extension, 
pronation and supination). It is a simple clinical tool to use (34,35). 
With the JAMAR Hydraulic Dynamometer,  the isometric grip force of the hand of 
the affected upper limb will be measured in kilograms. Its hydraulic system features 
a dual scale (pounds and kilograms) to show isometric gripping force (11). This 
dynamometer is known for its accuracy and reliability, and is considered the "gold 
standard" in the measurement of gripping force. It uses a measurement range of 0 
to 90 kg (0 to 200 IBS). It has an adjustable handle to be placed in 5 different 
positions (from 35 to 87 mm). It is performed in a sitting, with the back straight and 
the feet touching the ground. The elbow will be located at 90º of flexion and in a 
neutral pronosupination position, attached to the body, with the wrist in a neutral 
position (36). The participant will be encouraged to squeeze the device as hard as 
possible and three measurements will be made resting 5 seconds between each of 
them. The test-retest reliability of this handgrip test with this type of dynamometer is 
very high (r=0.88-0.93) (37). 
Upper limb functionality will be measured with the QuickDash (Disabilities of the 
Arm, Shoulder, and Hand) questionnaire. It is a self-administered questionnaire that 
is used to assess the impact of musculoskeletal disorders of the upper extremities. 
This questionnaire is an abbreviated version of the DASH and consists of 11 items 
that measure the patient's functional capacity and symptoms during the last week. 

 
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Assesses the difficulty in carrying out daily activities, work, social or family 
relationships, as well as pain and difficulties in resting. The items of the QuickDASH 
questionnaire are as follows: 1. Opening a jar with the lid closed, 2. Performing 
heavy household chores (mopping the floor, cleaning windows), 3. Carrying a 
shopping bag or briefcase, 4. Washing one's back, 5. Using a knife to cut food, 6. 
Perform recreational activities that require effort with the arm, shoulder or hand 
(playing golf, tennis, etc.), 7. Difficulty in social activities with family, friends or 
groups, 8. Limitation in work or other daily activities due to the problem in the arm, 
shoulder or hand, 9. Pain in the arm, shoulder or hand, 10. Tingling or feeling of 
needles in the arm, shoulder or hand, 11. Difficulty sleeping due to pain in the arm, 
shoulder or hand. The possible answers range from values 1 (no difficulty/problem) 
to 5 (incapable/very much pain). The result of the questionnaire is calculated on a 
scale from 0% (absence of disability) to 100% (severe disability). The average of 
the answers is calculated, 1 is subtracted from the total and multiplied by 25 to obtain 
a percentage ratio of the degree of disability. This questionnaire showed a test-retest 
reliability assessed with Lin's coefficient of agreement of 0.80 and an internal 
consistency greater than 0.9 (38). 
Health-related quality of life will be measured with the EQ-5D-5L questionnaire 
(39). This quiz is an improved version of the EQ-5D-3L, introduced by the Euro-Qol 
Group in 2009 to increase the sensitivity of the instrument and reduce ceiling effects. 
The EQ-5D-5L has demonstrated its efficacy, reliability and discriminatory capacity 
in multiple pathologies and populations (40). It consists of five dimensions: mobility, 
self-care capacity, daily activities, pain/discomfort and anxiety/depression. Each 
dimension has five levels where participants must assess how they perceive that 
dimension at the moment: no problems, minor problems, moderate problems, 
serious problems and extreme problems. In addition, it uses the Visual Analog Scale 
(VAS) to record the patient's self-rated health on a vertical scale, where the ends 
are labeled "The Best Health You Can Imagine" and "The Worst Health You Can 
Imagine" (41). The patient indicates their state of health by checking the box next to 
the most appropriate statement in each of the five dimensions. The digits for the five 
dimensions can be combined into a five-digit number that describes the patient's 
state of health. The Value Calculator Index 1.1 (42) is used. 
Pain will be considered as a dependent variable and the rest of the variables will be 
treated as independent. 
Sociodemographic variables of the users participating in the study will be collected 
as covariates: age, sex, educational level, marital status, cohabitation, profession, 
dominant hand, affected limb, health history, temporary disability situation and start 
date, reference Primary Care Center, origin of the referral, medical diagnosis, 
duration of symptoms, sports practiced, use of orthopedic elements for the elbow,  
Diagnostic tests performed and date of performance, pain-related pharmacological 
treatment. 
A record will be made of the possible adverse effects that may appear during the 
treatment with the SIS and adherence to the treatment in relation to the exercises. 
Table 1: Summary of the study variables 

 
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VARIABLE 
DESCRIPTION 
VARIABLE 
TYPE 
MEASURING 
INSTRUMENT 
VALUES 
 
Age 
Age of participants, in years 
Discrete 
quantitative 
Questionnaire 
years 
 
Gender 
Gender/sexual condition of 
the participants 
Qualitative 
Questionnaire 
Male 
Female 
Others 
Marital status 
Administratively recognised 
cohabitation situation at the 
time of the interview 
Qualitative 
Questionnaire 
Single 
Married 
Divorced 
Separated 
Widower 
Coexistence 
Cohabitation situation in the 
home where you reside 
Qualitative 
Questionnaire 
Saw solo 
Live as a couple 
Live with the family 
Live with a caregiver 
Educational level 
Higher educational level, 
completed 
Qualitative 
Questionnaire 
Illiterate 
Can read and write 
Primary education 
Secondary education 
University studies 
Employment 
Paid activity you carry out in 
a job 
Qualitative 
Questionnaire 
Type of activity 
CAP of reference 
Primary Care Centre (Family 
Doctor and Nurse) 
Qualitative 
Questionnaire 
Assigned EAP name 
Rehabilitation and 
Physiotherapy 
Service  
Center where the 
intervention will be carried 
out 
Qualitative 
Questionnaire 
Mataró 
Barcelona-Sant Andreu 
Barcelona-Drassanes 
Upper limb 
affected 
Arm affected and limited to 
perform the function 
normally 
Qualitative 
Questionnaire 
Right 
Left 
Right and left 
Dominant hand 
Hand that he uses more 
frequently and skillfully to 
perform everyday tasks 
Qualitative 
Questionnaire 
Right 
Left 
Right and left 
Use of orthosis for 
the affected elbow 
Use of devices 
Qualitative 
Questionnaire 
Yes 
Not 
Time of use of the 
orthosis 
Time, in months, of the use 
of orthosis. The year prior to 
the start of the study and 
during the follow-up 
Quantitative 
Questionnaire 
Months 
Health history 
Presence, at the time of the 
interview, of illnesses. 
Presence of health problems 
of interest, prior to the 
interview 
Qualitative 
Questionnaire 
Open Response 
Temporary 
Disability Situation 
Situation of temporary 
disability due to the reason 
for the study 
Qualitative 
Questionnaire 
Yes 
Not 
Time of temporary 
disability 
Time, in months, of 
temporary disability 
Quantitative 
Questionnaire 
Months 
Pharmacological 
treatment 
Current pharmacological 
treatment and dose, related 
to and with epicondyalgia 
Qualitative 
Questionnaire 
Open Response 
Physical activity 
and sports 
Physical activity 
Qualitative 
Questionnaire 
Yes 
Not 
Types of physical 
activity and sports 
Specify the type of physical 
activity 
Qualitative 
Questionnaire 
Open Response 
Time spent on 
physical activity 
and sports 
Specify the time spent on 
physical activity and sports 
per week 
Qualitative 
Questionnaire 
In minutes 

 
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Subjective pain 
Assess the pain of the 
affected elbow with the 
Visual Analogue Scale 
(VAS) 
Quantitative 
EVA 
0-10 
Pressure pain 
threshold 
Assess pressure pain in the 
affected elbow, with the 
Algometer 
Quantitative 
Algometry 
Newtons (N) o 
Kilograms-força(Kgf) 
Joint mobility 
Assess the joint mobility of 
the elbow with the manual 
goniometer  
Quantitative 
Goniometry 
Flexo/extension and 
prono/supination 
degrees 
Hand grip strength 
Measuring the hand gripping 
force 
Quantitative 
Dynamometry 
Kilograms (Kg) 
Upper limb 
function and 
disability 
Resposta al qüestionari 
QuickDASH (Disabilities of 
the Arm, Shoulder and 
Hand) 
Quantitative 
QuickDASH 
Quiz 
Answer to the 
questionnaire 
Quality of life 
Answer to questionnaire 
EQ-5D-5L 
Quantitative 
Questionnaire 
EQ-5D-5L 
Answer to the 
questionnaire 
Sessions held 
Number of sessions carried 
out out out of the total 
Quantitative 
Questionnaire 
x/8 
Adherence to 
treatment 
Of the total number of days 
of the week, how many have 
performed the exercises 
Quantitative 
Questionnaire 
% 
Adverse effects 
Collection of possible 
adverse effects 
Quantitative 
Questionnaire 
Open Response 
Assessment of 
blinding 
Do you think that the SIS 
has been applied to you with 
a therapeutic or non-
therapeutic dose? 
Qualitative 
Questionnaire 
Yes 
Not 
 
Intervention 
The participants of the Intervention Group (IG) will receive a treatment that will 
consist, firstly, of carrying out a program of therapeutic physiotherapy exercises 
(Annex 10). This protocol is based on the performance of a series of exercises that 
will be guided by the assigned physiotherapist. The professional will carry out a 
weekly assessment to determine the most appropriate progression of the exercises 
for each participant. This progression, in relation to the force performed and the joint 
range, will be adjusted according to the intensity of the pain described by the user. 
The worksheet will be provided to the participant so that he has visual support of the 
drawings and the explanation, to be able to carry out at home. The recommended 
frequency will be four days a week. A guideline of 2 sets of 10 repetitions has been 
established for each exercise. The protocol ends with a self-massage of the affected 
muscles. 
On the other hand, you will be provided with the health education sheet (Annex 11) 
which includes a brief explanation about epicondylitis, how to prevent this ailment 
and the recommended recommendations to improve quality of life. 
Finally, the SIS will be applied with the pre-established program for elbow 
tendinopathies. The duration of the program is 10 minutes. The intensity applied will 
be set by the user, according to the motor tolerance threshold of each one. It has 
been decided to apply it after the exercises and health education, due to the 
analgesic effect it provides. 

 
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For the CG, the SIS will be applied with a non-therapeutic dose (10 minutes, with a 
frequency of 1 Hz, a pause of 59 seconds and an intensity of 5%) accompanied by 
the same therapeutic exercise program of physiotherapy (Annex 10) and health 
education (Annex 11). 
The SIS equipment used for the GI and GC will be the BTL-6000 Super Inductive 
System Elite, present in the three Rehabilitation and Physiotherapy centers (Mataró, 
Barcelona-Sant Andreu and Barcelona-Drassanes). 
The frequency of treatment will be 2 weekly sessions with a total of 8 sessions. 
According to the regulations of the centers where the intervention will be performed, 
the missed sessions are not recovered. For this reason, a record will be made at the 
end of the treatment, of the sessions carried out. In this way, the percentage in 
relation to absenteeism will also be calculated (Annex 6). 
The conventional treatment applied so far to the three Rehabilitation and 
Physiotherapy Services consisted of teaching a protocol of specific exercises 
accompanied by education to the patient. Therefore, GC participants will not stop 
receiving pre-established treatment prior to the study. In addition to receiving 
conventional treatment, the SIS will be applied with a non-therapeutic dose. 
 
Data collection and sources of information 
The principal investigator of the study (PI) will hold an informative meeting with the 
participating professionals, and will provide them with the appropriate material. The 
evaluators will be given the questionnaire for the first visit. The physiotherapists will 
be given the guidelines for performing the intervention; SIS programmes for both 
groups, kinesitherapy protocol (Annex 10), health education sheet for the patient 
(Annex 11) and the exercise record carried out (Annex 12). The administrative staff 
or GIS (Management and Services) staff and the TCAI (Nursing Assistant Care 
Technician) will explain the steps to follow once the patient has already been 
evaluated. 
 
Firstly, the user is referred by the Family Doctor, the Rehabilitation Doctor, the 
Traumatology or Rheumatology Service to one of the three Rehabilitation and 
Physiotherapy Services of Primary Care of the ICS (Mataró, Sant Andreu or 
Drassanes). 
 
The referrals are reviewed by the Head of Service of the centre. They will carry out 
an administrative task for the administrative staff, of referrals with the medical 
diagnosis of lateral epicondylgia, so that a face-to-face visit is scheduled in the 
agenda of the case evaluator (in this case a physiotherapist who will act exclusively 
as an evaluator and will not perform the intervention). 
 
The administrative staff will schedule the visit and call the user to provide a date and 
time. 
 

 
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The evaluator will have an exclusive agenda to visit the potential cases that will be 
part of the study. The visits will be carried out in person and individually in a 
consultation of one of the three Rehabilitation and Physiotherapy Services. 
It is estimated that the duration of the visits per person will be 45 minutes. The 
evaluator will use the eCAP (Primary Care and Coordination Team) program. It is a 
clinical information system used in primary health care in Catalonia. This system 
allows healthcare professionals to manage user information efficiently, including 
medical records, e-prescriptions, appointments, and other relevant data. It facilitates 
coordination between the different levels of care and improves the quality of health 
care provided to users. In addition, it allows healthcare professionals to access user 
information quickly and securely, contributing to better clinical decision-making. 
 
During the visit, the evaluator will collect data (Annex 6) and explore the user. You 
will pass the following assessment scales: pain results measured with the manual 
pressure algometer (PAIN TEST TM FPX 50) and the EVA (Visual Analogue Scale), 
joint balance/mobility (flexion, extension, pronation and elbow supination) measured 
with goniometer, grip strength with the JAMAR hydraulic dynamometer, functionality 
with the QuickDASH questionnaire (self-administered scale,  to assess upper limb 
function) and quality of life with the EQ-5D-5L questionnaire (self-administered, 
standardised scale that assesses health-related quality of life). 
Adverse effects will be collected by means of a questionnaire (Annex 7). 
All assessments will be carried out at the beginning and end of the treatment, and 
controls at 3 and 6 months after the end of the treatment. 
The suitability of the participants will be assessed according to the inclusion criteria. 
At the end of the visit, if you meet the inclusion criteria, you will be offered the 
opportunity to participate in the study, explaining what it consists of and giving the 
information sheet to the patient (Annex 1) and informed consent (Annex 2).  
 
In the event that you sign the consent and agree to participate in the study, you will 
deliver the signed consent to the TCAI staff, who carry out administrative tasks and 
schedule the treatment in the physiotherapy agenda.  
 
The evaluator, using opaque envelopes, will make the participant choose one, who 
will add it to the treatment sheet. The physiotherapists in charge of performing the 
intervention will be the only ones who have the list with the randomization sequence 
to distribute the different participants in the IG or GC. This list will be provided by 
the Research Support Unit (USR). 
 
The TCAI staff will contact the user by telephone to specify the day, time and 
professional to carry out the intervention. At no time will the user be informed which 
group he belongs to. The TCAI staff will give the physiotherapist who performs the 
intervention, the opaque envelope specifying which group the user has been in, 
together with the sheet of scheduled sessions. This information on assignment to 
the GI or GC will only be known by the physiotherapists who will perform the 
intervention. Neither the IP nor the evaluator nor the user will have this information.  

 
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The research team will have a waiver sheet to provide participants with if they do 
not wish to continue being part of the study (Annex 5). 
REDCap (Research Electronic Data Capture) will be used as a tool to manage the 
data. It provides a secure and flexible environment for data collection and 
management, facilitating collaborative work and guaranteeing information privacy 
and security. Access to the USR of the IDIAP Jordi Gol will be requested. 
 
Data analysis, implementation, masking and statistical methods 
Descriptive analysis of the characteristics of the sample: means, standard 
deviations, medians and interquartile ranges. The frequencies and percentages for 
the categorical variables will be calculated. 
Parametric and non-parametric tests will be used to analyse the data. The 
distribution will be analyzed using the Kolmogorov-Smirnoff or Shapiro Wilk test, 
depending on the sample size. 
With the T-Student or U Mann Whitney test, the basal demographic variables of the 
two groups will be compared, depending on the distribution of the variables. 
Chi square will be used for categorical tests of only two categories or linear square 
chi for those of three or more categories. 
For the analysis of before-and-after changes within groups, T Student will be used 
for paired or Wilcoxon data, depending on the distribution of continuous or discrete 
quantitative variables. 
We will evaluate with the ANOVA test of repeated measures or Friedmann. 
Bonferroni tests will be carried out to evaluate the changes during the follow-ups. 
The applicability criteria of each test will be checked beforehand and if it is not 
possible to apply, the equivalent non-parametric variables will be used or the 
necessary transformations will be made in the variables. In the initial multivariate 
models, in order to demonstrate the effect of the intervention on the outcome 
variables, the variables that are significant in the bivariate analysis will be introduced 
at the significance level of 25% and the variables considered clinically relevant. 
Confusion, possible interactions and collinearity will be studied. For all hypothesis 
contrasts performed to assess association between variables, an alpha level of 0.05 
(p<0.05) will be considered statistically significant. 
Adverse effects will be analyzed using contingency tables, Chi-square tests, or 
Fisher's exact text. 
Finally, a descriptive analysis of the adverse effects that may appear will be carried 
out. 
 
 

 
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Pharmacovigilance 
 
There is no use of medications. 
 
Ethical considerations and confidentiality of data  
 
The study will be carried out in accordance with the accepted international ethical 
standards of Good Clinical Practice (CPMP/ICH/135/95), the principles established 
in the Declaration of Helsinki (last amendment, Fortaleza-Brazil, 2013), RD 
1591/2009 and Circular No. 07/2004 regulating clinical research with medical 
devices. 
Likewise, the study will be carried out in accordance with General Regulation (EU) 
2016/679 of the European Parliament and of the Council of 27 April 2016 on the 
protection of natural persons with regard to the processing of data and on the free 
movement of such data and Organic Law 3/2018 of 5 December on the Protection 
of Personal Data and the Guarantee of Digital Rights. 
On the other hand, it will be subject to review by the CEIC (Clinical Research Ethics 
Committee) of the Catalan Institute of Health (ICS) of reference (IDIAP Jordi Gol). 
Data protection, the right to withdraw voluntarily without any penalty and the 
obtaining of Informed Consent (CI) by participants will be ensured. 
According to the laws mentioned above, all the data collected will be encrypted and 
stored in a document in the Office 365 folder in the cloud of the ICS server. This 
ensures compliance with all European safety standards. The custody of these files 
will fall to the principal investigator. The research team, the medical authorities, the 
ethics committee and the staff authorized by the sponsor will have access to the 
personal information of the participants. All people participating in the study will 
receive the Patient Information Sheet (FIP) and sign the IC. This form specifies that 
participation in the study is voluntary, that the confidentiality of the data is 
guaranteed and that each participant has the right to withdraw consent at any time 
and without explanation. This data will only be accessible to members of the 
research team. Once the data collection process is finished, all of them will be 
anonymized, eliminating any personal information of each participant. 
The data will be kept for 5 years once the end of the project has been completed 
and communicated. No communication of personal data is contemplated, beyond 
those provided for by law. Nor will international data transfers be carried out. 
 
 

 
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Data processing and protection 
 
All data will be processed in accordance with the Data Protection Act 2021 and 
stored securely on a storage device with restricted access. All recorded clinical 
outcomes will be anonymized by giving each participant a random code number at 
the beginning of the study, which has nothing to do with personal information, to 
protect confidentiality. The test data will be stored on storage devices that can only 
be accessed by researchers.  
The information will be recorded in encrypted form and stored in a protected 
database on computers of the Catalan Institute of Health, and the data that allows 
its decoding will be in another file with a password accessible only to researchers. 
The Catalan Institute of Health acts as responsible for processing the data within 
the framework of this study, since the project's database will be hosted on the ICS 
servers.  
The variables necessary to be able to develop the study will be obtained directly 
from the project participants through their consent. 
In this study there will be no international transfer of data nor is the dissemination of 
data to third parties planned. The study does not include any of the following risk 
situations for data processing: automated decision-making, use of artificial 
intelligence, use of data exploitation techniques with big data technology, use of 
biometric systems or use of geolocation systems. There will be no identification of 
processing that poses a high risk to the rights and freedoms of the data subjects.  
Each participant will be assigned a numerical code, which will not be related to the 
history number or any identifying data of the patient, therefore, the processing of the 
data will be carried out anonymously by the researchers. This code will be assigned 
by the head of the Centre, Consultation, Department or Clinical Unit. In the event 
that the results of the study are used, for teaching, research and/or publication 
purposes, the proper coding of personal data will always be respected, so that the 
subjects of the research will not be identified or identifiable.  
The holder of the personal data may exercise the rights of access, rectification, 
cancellation and opposition to the processing of personal data, and revocation of 
consent, under the terms provided for in the applicable regulations. 
 
 
 
 
 
 

 
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Additional procedures derived from the study  
 
The participants for this study come from the centres and institutions attached to the 
rehabilitation services of Barcelona and Maresme by the Catalan Institute of Health 
(Department of Health of the Generalitat de Catalunya). After each participant has 
been duly informed about the study and their rights, and meeting the eligibility and 
exclusion criteria; You will be invited to participate in this study, and you will be 
explained the randomization process.  
All information related to the study and the data protection system will be explained 
verbally and provided in an information document to the participant (Annex 1). Once 
all questions have been answered and eligibility has been confirmed, those who 
declare interest in participating will be asked to sign the informed consent form 
(Annex 2). A copy of the document will be given to the participant and another copy 
will be kept by the PI. 
 
Difficulties and limitations of the study 
 
This type of study has some limitations to take into account. 
An important barrier can be the loss of participants due to non-attendance at 
treatment and/or follow-up check-ups, as a result of the appearance of health 
problems that force the intervention to be stopped, or due to lack of motivation or 
commitment. In order to cover these possible losses, 20% more participants have 
been added to the sample, adherence will be ensured by telephone by 
administrative staff when participants do not show up for the intervention sessions 
or the different follow-ups, and the commitment to attend will be signed, both at the 
treatment sessions and at  the follow-up controls (Annex 4). 
It is important to take into account the differences in the personal conditions of the 
participants: carrying out treatments parallel to our project, appearance of health 
problems, pharmacological treatments during the intervention, etc. This difficulty will 
be minimized by narrowing the exclusion criteria, carrying out careful data collection 
and follow-up interviews. We will keep this in mind to include it in the conclusions of 
the study. 
The lack of supervision of the exercises at home must be considered. To minimize 
this limitation, the exercise protocol sheet will be provided with a QR that will give 
access to the videos of the exercises (Annex 10). 
The cost of the material/personnel needed for the study (budget requested) could 
be a limitation to carry out the project going forward. To solve this, research grants 
will be requested in all possible calls. 

 
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Work plan 
 
1st year 
 
PREPARATION: 
 
- 
Project design: January - February 2025. 
- 
Literature review: January - March 2025. 
- 
Feasibility analysis: January - February 2025. 
- 
Prepare draft and report: January - March 2025. 
- 
Obtain permits and Research Ethics and Integrity Committee (CEI): March - 
July 2025. 
- 
Seeking funding: June 2025 – July 2026. 
- 
Training of professionals: June - July 2025. 
- 
Sample selection (convenience sampling): September 2025 – February 
2026. 
- 
Contact participants: September 2025 – February 2026. 
 
EXECUTION: 
 
- 
Interview with participants (Informed Consent (IC), Patient Information Sheet 
(FIP), Intervention Group (IG) – Control Group (CG) assignment): October 
2025 – March 2026. 
- 
Initial questionnaire-Intervention: October 2025 – March 2026. 
 
 
2nd year 
 
PREPARATION: 
 
- 
Seeking funding: June 2025 – July 2026. 
- 
Sample selection (convenience sampling): September 2025 – February 
2026. 
- 
Contact participants: September 2025 – February 2026. 
 
EXECUTION: 
 
- 
Interview with participants (Informed Consent (IC), Patient Information Sheet 
(FIP), Intervention Group (IG) – Control Group (CG) assignment): October 
2025 – March 2026. 
- 
Initial questionnaire-Intervention: October 2025 – March 2026. 
- 
Follow-up 3 and 6 months after the end of the treatment: January 2026 – 
March 2027. 
- 
Data collection and statistical analysis: January 2026 – April 2027. 
 

 
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3rd year 
 
EXECUTION: 
 
- 
Follow-up 3 and 6 months after the end of the treatment: January 2026 – 
March 2027. 
- 
Data collection and statistical analysis: January 2026 – April 2027. 
- 
Results: April - June 2027. 
 
COMPLETION: 
 
- 
Prepare results report: June - September 2027. 
- 
Dissemination of the project's results (at the ICS, Congresses, talks, 
publications of scientific articles (at least one in a journal with quartile Q1 or 
Q2): October - December 2027. 
 
The project schedule can be consulted in the Annexes section (Annex 15). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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Experience of the research team 
 
- 
Carme Sánchez Mato: Diploma in physiotherapy from the Ramon Llull-
Blanquerna University (1998). Graduated in Physiotherapy from the University 
of Salamanca (2022). 
 
In 2006 he completed the Postgraduate Course in Paediatrics at the Ramon 
Llull University. 
 
In 2012 he completed a Master's Degree in Rehabilitation in Neurology at the 
Gimbernat University School. 
 
In 2024 she completed the Master's Degree in Research in Primary Care. 
Miquel Hernández University of Elche. 
 
She is currently processing the documentation to start the Doctoral Thesis. 
 
She has been working in the Rehabilitation and Physiotherapy Service of 
Primary Care of the Catalan Institute of Health (ICS) Mataró-Maresme since 
2000. In 2016, the coordination of the Service began, combining healthcare 
tasks with management, teaching and research. In 2018 she took the exam for 
the position of Physiotherapist at the ICS.  
 
Her field of work is clinical practice, care management of 3 rehabilitation centers, 
teaching in the degree in Physiotherapy at the University of Vic-Central 
University of Catalonia and the Autonomous University of Barcelona and 
research.  
 
She is currently part of the research team of the PRECIOSA II-Badia Community 
Intervention Project and the project of Co-creation and application of a 
physiotherapy model in high-impact Primary and Community Care: Fisio-on 
APiC. 
 
It has been a benchmark in quality and patient safety for 10 years. Since 2012, 
she has been a member of the PAR I working group (Pact for Accessibility and 
Resolution of the Musculoskeletal System), where the care documents for the 
treatment of Low Back Pain, Gonalgia, Painful Shoulder and Osteoporosis have 
been developed. 
 
It coordinates the Maresme Interest Group and the Primary Care Commission, 
through the College of Physiotherapists of Catalonia. The main objective is the 
dissemination of the profession, organizing activities to promote health, 
therapeutic exercise and prevent the disease. 
 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
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Since November 2022 she has been deputy secretary of the College of 
Physiotherapists of Catalonia.  
 
He has received the certification of the three courses (basic, intermediate and 
advanced) on Information and Communication Technologies (ICT).  
 
She has participated in different Programmes and campaigns promoted by the 
Department of Health: collaboration in the preparation of the Programme for the 
incorporation of physiotherapists for the promotion of the functioning and 
prevention of disability in primary and community care (2022), collaboration in 
the Project for the preparation of the new The Rehabilitation Plan of Catalonia: 
Comprehensive approach to functioning and disability (2023), member of the 
FisioAPiC Advisory Committee (from 2022 to present). 
 
Has carried out various trainings in relation to the research project: research in 
primary care, design of research projects, dissemination of research results: oral 
communications and posters, drafting of protocols and funding funds for 
research projects, patient safety, updating in rehabilitation and physiotherapy 
processes, electrotherapy, therapeutic exercise in physiotherapy, updating in 
the treatment of tendinopathies in primary care. 
 
She is a tutor for students of the Degree in Physiotherapy from six different 
universities, from 2004 to the present. 
 
He has been a teacher of several training courses at the ICS, in relation to the 
updating of Rehabilitation and Physiotherapy processes. 
 
He has collaborated in the preparation of 17 healthcare documents at the ICS 
(5 originals and 12 revisions), in relation to low back pain, gonalgia and 
homalgia. 
 
He has participated in several national and international Congresses and 
Conferences, as a speaker and with the presentation of posters (22 oral 
communications and 23 posters). 
 
Author of the publication of a scientific article with the title "Group intervention 
of subacromial syndrome in primary care". Rehabilitation. 48 - 2, pp. 82 - 92. 
Elsevier. 
 
- 
Dr. Anna Escribà Salvans: In 2002 she began her academic career and in 
2005 she obtained a diploma in Physiotherapy from the University of Vic – 
Central University of Catalonia (UVIC-UCC).  
 
Subsequently, in 2009, he obtained a Master's Degree in Occupational Risk 
Prevention; specialized in Ergonomics and Applied Psychosociology.  
 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
She combines her working life with taking courses in the field of physiotherapy 
and teaching in occupational health training centres. In 2016 she began 
teaching in the Degree in Physiotherapy at UVIC-UCC.  
 
In 2017 she obtained the Postgraduate Course in Bodily Injury Assessment at 
the University of Barcelona. In 2019 the Official Interuniversity Master's Degree 
in Nervous System Sciences: Neurotoxicology, Neuropsychopharmacology, 
Neuromusculoskeletal Physiotherapy and Neurorehabilitation from the Rovira i 
Virgili University; of this, the presentation and defense of the master's thesis 
entitled: ¿Es la neurodinamia un tratamiento eficac para el dolor neuropático de 
extremidades inferiores?: Revisión systemática.  
 
That same year, at the end of 2019, the doctoral programme "Comprehensive 
Care and Health Services" began. In November 2022, he defended the thesis 
entitled "Sarcopenia in geriatric residents of Osona according to the criteria of 
the European Working Group on Sarcopenia in Older People 2: observational 
study." directed by Dr. Javier Jerez Roig and Dr. Eduard Minobes Molina, 
obtaining the mention "laude".  
At the same time, since 2018 she has been part of the Methodology, Methods, 
Models and Outcomes of Health and Social Science (M3O) research group, for 
which she has participated in several projects that have resulted in several 
scientific publications (13 in total). In line with the research trajectory, the line of 
research encompasses the areas of neurorehabilitation in the elderly and 
occupational health. 
 
Throughout this career, she has combined her research career with teaching 
and management as Coordinator of external clinical practices of the Degree in 
Physiotherapy, which she began in 2016 teaching at the UVic-UCC in various 
subjects of the Degree in Physiotherapy. In addition, since 2018 she has tutored 
clinical internships and final degree projects and has assisted as a member of 
the panel of the defenses of these, in the Degree of Physiotherapy and 
collaborations as a member in tribunals of the Degrees of Nursing and Dietetics 
and Nutrition of the UVic-UCC.  
 
Since 2023, he has been collaborating as a teacher at the FUB (University 
Foundation of Bages), University of Manresa. In June 2024 she reached the 
category of "Contracted doctor" and "professor at a private university" by the 
ANECA agency. 
 
In all these years, he has attended and participated in National and International 
Congresses in different countries. She has received training courses in her 
specialisation, as well as in research and teaching innovation methodologies 
that complement the main areas of her profession; the academic, the researcher 
and the clinician. 
 

 
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- 
Dr. Ramon Arroyo Aljaro: Doctor of Surgery from the UAB with the thesis 
"Shoulder pain in the spinal cord injury. Relación con la discapacidad" defended 
on July 14, 2011 with a rating of excellent "Laude".  
He has 20 years of work experience at the ICS. Specialist in physical medicine 
and rehabilitation. 
He has been Territorial Clinical Director of Rehabilitation, Primary and 
Community Care Barcelona City since May 2022 to the present. 
Principal investigator of the research project "Descriptive study on distal radius 
and proximal humerus fractures in a Primary Care rehabilitation centre" in the 
13th call for XB Research Modules of the Territorial Management of Barcelona 
City in 2021. 
Collaborating researcher of the research project, with a grant in the call for 
Research Modules of the Primary Care Area of Barcelona city of 2012, 
"Implementation of a multidisciplinary program in the treatment of the 
temporomandibular joint in the field of primary care" of March 25, 2014. 
Expert of the project "Shoulder pain: appropriate use of diagnostic imaging tests" 
developed by the Agency for Information, Evaluation and Quality in Health on 
March 28, 2011. 
Principal investigator of the research project, with a grant in the call for Research 
Modules of the Primary Care Area of Barcelona city of 2009, "Treatment of 
epicondylitis: prolotherapy versus usual physiotherapy treatment" of March 16, 
2011. 
Collaborating researcher in the research project, with grant in the call for 
Research Modules of the Primary Care Area of Barcelona city of the year 2009, 
"Evaluation of the effectiveness of a program of balance and strength of lower 
limbs to improve the physical parameters of frailty in independent elderly people: 
Randomized controlled clinical trial." of March 16, 2011. 
Collaborating researcher in the research project, with a grant in the call for 
Research Modules of the Primary Care Area of Barcelona city of the year 2009, 
"Analysis of the current situation in primary care, detection and early referral of 
female urinary incontinence." of March 16, 2011. 
Collaborating researcher in the research project, with a grant in the call for 
Research Modules of the Primary Care Area of Barcelona city of 2008, 
"Improving health and quality of life postpartum" of December 31, 2009. 
SEP Award for the best work presented for "Repercussion of the shoulder in the 
spinal cord injury" at the "XXIV National Days of the SEP and XIII ASELME 
Symposium" of June 20-22, 2007. 
"Novartis" Award for the communication "Functional capacity of elderly patients 
who live alone in their home prior to a hip fracture" at the XVII Conference of 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
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Update of the Catalan Society of Physical Medicine and Rehabilitation: Clinical 
exploration of the lower limbs of April 20, 2007. 
Author of 4 book chapters and 9 publications in scientific journals. 
- 
Luisa Acosta Moreno: Graduated in physiotherapy from the Gimbernat 
University School in 1994.  
 
She is coordinator of the Rehabilitation and Physiotherapy Service of the 
Catalan Institute of Health (ICS) of Sant Andreu in Barcelona and coordinator of 
the Primary and Community Care Physiotherapists (FisioAPiC) in Barcelona. 
 
In 1996 he completed the Postgraduate Course in Sports Physiotherapy and in 
1998, the Postgraduate Course in Neuromotor Rebalancing of the Spine at the 
same University. In 2006 he completed the Postgraduate Course in Obstetric 
Physiotherapy and Pelvic Floor Reeducation at the International University of 
Catalonia. 
 
She completed the Master's Degree in "Community Physiotherapeutic Care" in 
2016 and the Master's Degree in Electrotherapy: "Applied Electrostimulation for 
Physiotherapists" in 2018 at the Faculty of Physiotherapy of the University of 
Valencia. 
 
At the Institut de Formació Continua-IL3, in 2020, she will study the Master's 
Degree in "Comprehensive Management of Services in Primary Care, Social 
and Hospitals". 
 
He has completed various training courses in relation to the design of research 
projects.  
 
She has been a tutor for students of the Degree in Physiotherapy from 2004 to 
the present. 
 
She has participated in several research projects: Analysis of the current 
situation in primary care, early detection and referral of female urinary 
incontinence, Call for Research Modules of the Primary Care Area of Barcelona 
City (2009). Effectiveness of multidimensional group treatment of pain in 
disability, patients' perception of pain and illness and the use of active coping 
strategies, Rehabilitation Service of the CAP Sant Andreu in Barcelona (2013). 
Evaluation of a back pain intervention from Primary Care: health education 
programme in the school environment, rehabilitation service of the CAP Sant 
Andreu in Barcelona (2014). Effectiveness of shockwave treatment and specific 
exercise in subacromial syndrome compared to exercise alone. CAP Sant 
Andreu Rehabilitation Service in Barcelona (2014). Evaluation of a back pain 
intervention from primary care: health education programme in the school 
environment, Catalan Institute of Health (2014). Analysis of a back pain 
intervention from Primary Care: a health education programme in the school 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
environment. Rehabilitation Service of the CAP Sant Andreu in Barcelona 
(2015). "Short-term and long-term efficacy of active kinesitherapy group 
treatment in peripheral vestibular syndrome", Rehabilitation Service of the CAP 
Sant Andreu in Barcelona (2016). Chronic epicondylar pain: effectiveness of 
shockwave treatment. randomized clinical trial, Rehabilitation Service of the 
CAP Sant Andreu de Barcelona (2015). Early detection of prefragility and frailty 
states in primary care, Catalan-Balearic Society of Physiotherapy (2019). 
 
He has participated in several Congresses and Conferences as a speaker or 
with the presentation of posters: Rehabilitation of the pelvic floor: a pathology to 
be treated in primary care, Health Plan of Catalonia 2011-2015 (2012). Analysis 
of the current situation in primary care, detection and early referral of female 
urinary incontinence, II Congress of the primary care field of Barcelona (2010). 
Presentation of the health education program in Primary Care for back pain in 
schoolchildren, II Conference of Rehabilitation professionals in Primary Care of 
the ICS (2014). Effectiveness of long-term rehabilitation in chronic 
temporomandibular pain, Conference of Rehabilitation professionals in Primary 
Care of the ICS (2014). "Tratamiento rehabilitador de la coxigodinia", I 
Conference of rehabilitation professionals in primary care centers of the ICS 
(2011). "Results of an exercise intervention for patients with gonarthrosis in 
Primary Care, X Trans-Pyrenean Congress of Physical Medicine and 
Rehabilitation (2009). " Electrostimulation of the posterior tibial nerve for the 
treatment of overactive bladder", II International Congress of the pelvic floor and 
pelviperineology (2011). Chronic temporomandibular pain. is rehabilitation 
effective?, 
Health 
Plan 
of 
Catalonia 
2011-2015 
(2013). "Medical-
Physiotherapeutic Approach to Coxigodinias, XXVI Physiotherapy Conference 
of the ONCE and the lll International Congress of "Physiotherapy in 
Pelviperineology: Present and Future" (2016). Evaluation of an intervention of 
back pain from primary care: health education program in the school 
environment", 
XVII 
National 
Congress 
SEDAP 
(2015). 
Medical-
physiotherapeutic approach to coccygodynia, XIIth Congress of the Catalan-
Balearic Society of Physiotherapy, Barcelona (2016). "Benefits of the 
rehabilitative treatment of chronic temporomandibular pain in the long term", 
52nd Congress of the SERMEF (2014)." Manual treatment of coxigodinia", 48th 
National Congress of the Spanish Society of Rehabilitation and Physical 
Medicine SERMEF (2010). "Results of scar infiltration in post-surgical and 
postpartum pain", 55th Spanish Society Congress of Rehabilitation and Physical 
Medicine (2017). "Results of the rehabilitation treatment of coxigodynia", 55th 
Spanish Society of Rehabilitation and Physical Medicine Congress (2017). 
"Effectiveness of shockwave treatment in chronic epicondyle pain: randomized 
clinical trial, preliminary results", 55th Spanish Society of Rehabilitation and 
Physical Medicine Congress (2017). "Effectiveness of shock wave treatment in 
supraspinatus tendonitis: randomized clinical trial", 55th Spanish Society of 
Rehabilitation and Physical Medicine Congress (2017). "Program of preventive 
health education of back pain in schoolchildren in primary care, Primary care 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
marking course, XVII SEDAP Congress (2015). Webinar: how can 
physiotherapy help in multidisciplinary teams? Modality: Virtual (2022). 
 
In 2014 he won an award at the II Conference of Rehabilitation Professionals in 
Primary Care of the ICS with the presentation of the work on Percutaneous 
Neuromodulation of the tibial nerve for urinary and fecal incontinence. 
 
She has participated in different programmes and campaigns promoted by the 
Department of Health: virtual debate on trends in the health professions (2008), 
Protocol for the diagnosis and treatment of urinary incontinence in women; 
coordination between different levels of care (2020), Collaboration in the 
preparation of the Programme for the incorporation of physiotherapists for the 
promotion of functioning and the prevention of disability in primary and 
community care (2022), collaboration in the project for the preparation of the 
new The Rehabilitation Plan of Catalonia: Comprehensive approach to 
functioning and disability (2023), member of the FisioApic Advisory Committee 
(from 2022 to present). 
 
Author of a book chapter: postural hygiene for teachers, childhood educating 0 
to 6 years, issue of the magazine 188. 
 
- 
Mario Martín Sánchez: Diploma in physiotherapy from the Gimbernat 
University School in 1993.  
 
With more than 30 years of experience as a Physiotherapist in the Rehabilitation 
and Physiotherapy Service of the Catalan Institute of Health (ICS) of Drassanes 
de Barcelona and coordinator of the Primary and Community Care 
Physiotherapists (FisioAPiC) in Barcelona, until 2024. 
 
At the Institut de Formació Continua-IL3, in 2020, she will study the Master's 
Degree in "Comprehensive Management of Services in Primary Care, Social 
and Hospitals". 
 
He has been a tutor for students of the Degree in Physiotherapy from 2001 to 
the present. 
 
He has carried out various trainings in relation to the design of research projects, 
bibliographic research and oral scientific communication and poster 
presentation.  
 
She has participated in several research projects: Improving quality of life in 
fibromyalgia syndrome. Study of two different therapeutic approaches, Catalan 
Health Institute, Primary Care Directorate L'Hospitalet (2000). Assessment of 
the effectiveness of the back school, Catalan Health Institute, Primary Care 
Directorate L'Hospitalet (2000). Implementation of a multidisciplinary 

 
36 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
programme in the treatment of temporomandibular joint in the field of primary 
care, Catalan Institute of Health, primary care field, Barcelona city (2014). 
"Effectiveness of a dual physical exercise intervention and cognitive stimulation 
in frail elderly people", Institut Català de la Salut (2018). 
 
He has participated in several Congresses and Conferences as a speaker or 
with the presentation of posters: Comparative analysis of two therapeutic 
strategies applied to gonarthrosis, IV Congress of the primary care field of 
Barcelona (2013). Comparative analysis of two therapeutic strategies applied to 
gonarthrosis, IV Congress of the Primary Care Field of Barcelona (2013). 
Analysis of the current situation in primary care, detection and early referral of 
female urinary incontinence, II Congress of the primary care field of Barcelona 
(2010). Proposal for a multidisciplinary treatment of TMJ, II Conference of 
Rehabilitation professionals in primary care of the ICS (2014). Two therapeutic 
strategies applied to gonarthrosis: comparative analysis, II Conference of 
Rehabilitation professionals in primary care of the ICS (2014). Implementation 
of a multidisciplinary programme in the treatment of temporomandibular joint in 
the field of primary care, Project XB Research Conference, primary care area 
Barcelona city (2014). "Program of education and functional rehabilitation in 
patients with mechanical algia in primary care", 3rd International Congress of 
physical activity sports for the elderly (2009). "Detection of signs of dysphagia 
in home care patients", XI National Update Days for Rehabilitation Physicians" 
(2012). Education and functional rehabilitation programme for patients with 
mechanical pain in primary care, Barcelona Primary Care Congress (2009). 
"Stress retraining in a primary care center for patients with severe COPD", 3rd 
International Congress of Physical Activity for the Elderly (2009). Treatment of 
temporomandibular dysfunction in a primary care rehabilitation service, VIII 
Conference on Speech Therapy and Dentistry (2015). Implementation of a 
multidisciplinary program in the treatment of the temporomandibular joint in the 
field of primary care, Research day, XB project. primary care area Barcelona 
city (2014). "Education and functional rehabilitation program for patients with 
omalgia in primary care", National Congress of the Spanish Society of 
Rehabilitation and Physical Medicine (SERMEF) (2008). Health education to 
prevent back pain: user assessment, IV Conference on quality in primary care 
of the ICS: tying heads (1998). Assessment of the effectiveness of the back 
school, awards for the improvement of primary health care in L'Hospitalet 
(1999). "Therapeutic education and functional rehabilitation: programs and 
methodology", 6th Interdisciplinary World Congress of low back and pelvic pain 
(2007). 
 
She attended the XB project research day, in the field of primary care in 
Barcelona city (2014). 
 
She was awarded different grants for research projects: analysis of the current 
situation in primary care, early detection and referral of female urinary 
incontinence, Barcelona city, 2009. Analysis of the current situation in primary 

 
37 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
care, detection and early referral of female urinary incontinence, Barcelona city, 
2009. Comparative analysis of two therapeutic strategies applied to 
gonarthrosis, primary care, Barcelona, city, 2012. Treatment of epicondylitis: 
prolotherapy versus usual physiotherapeutic treatment, primary care area of 
Barcelona city, 2009. Implementation of a multidisciplinary programme in the 
treatment of the temporomandibular joint in the field of primary care, Barcelona 
city, 2012. 
 
He won awards for different projects: improving the quality of life in fibromyalgia 
syndrome. study of two different therapeutic approaches, awards for the 
improvement of primary health care of L'Hospitalet, 1999. "Education and 
functional rehabilitation program for patients with omalgia in primary care", 46th 
National Congress of the Spanish Society of Rehabilitation and Physical 
Medicine (SERMEF) 2012. Evaluation of the effectiveness of the back school, 
ICS, 1999. Improvement of quality of life in fibromyalgia syndrome. Study of two 
different therapeutic approaches, ICS, 1999. Awards for the improvement of 
primary health care in L'Hospitalet, Institut Català de la Salut, Dirección 
d'Atención Primària l'Hospitalet, 2000. 
 
Applicability and practical usefulness of the results of the study 
 
The results of this study may contribute to showing that the innovative technology 
of SIS can significantly accelerate the recovery process of musculoskeletal injuries, 
in our case, from lateral elbow tendinopathies. This application is especially valuable 
in the field of physiotherapy, where rapid recovery is essential for patients' quality of 
life. 
SIS has proven to be an effective tool for the relief of chronic and acute pain.  
The realization of this study will be able to show the results obtained with the 
application of this technology and will show that it can be used offering a non-
invasive and safe solution. 
The pain reduction and recovery acceleration provided by super inductive 
technology can have a positive and significant impact on the quality of life of our 
users. This technology will allow them to resume their daily activities more quickly, 
thus improving their overall well-being. 
The results may suggest that this technology can be used to treat injuries and speed 
up their recovery, offering a valuable tool for the population. 
The treatment of chronic pain through SIS can have a positive impact on health. 
Our studies have shown that SIS is a safe and effective technology. There is a good 
tolerance to this non-invasive treatment, making it a viable and attractive option for 
a wide range of medical conditions. 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
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The aim is to obtain evidence on the effectiveness and cost-efficiency of the 
technology, contributing to reducing the number of work disabilities and their 
duration, treatment and recovery periods, as well as spending on medicines. 
This study will provide evidence to integrate a new therapeutic tool into clinical 
practice, improving the efficacy of treatments, reducing costs and offering an 
improved patient experience in primary care. 
The SIS is presented as a key tool for developing a more sustainable and advanced 
healthcare system 
In summary, the results of the study will provide the necessary evidence for the 
inclusion of this new therapeutic tool in clinical practice. This will improve treatment 
effectiveness, reduce costs and offer a better patient experience in primary care, 
positioning the company as a leader in innovation in this field. 
 
Means available for the realization of the project 
 
The Rehabilitation and Physiotherapy Units of Mataró, Sant Andreu and Drassanes 
have the population, space and material necessary to carry out the project. 
Population: in order to achieve the study population calculated for this project, 
information sessions will be held for the family doctors of the different CAPs in the 
area and for the reference traumatologists, to inform them of the implementation of 
the project and, in this way, facilitate the referral of patients diagnosed with lateral 
epicondylalgia with specific criteria.  
On the other hand, those users who have lateral epicondyalgia but are visited by 
our medical team for another reason may also be referred to physiotherapy to be 
part of the study. 
Spaces: 
A training room/classroom/consultation room is necessary, where the information 
session or training will be held for family doctors and specialists who will carry out 
the referrals, for the GIS staff who will contact the participants, for the professionals 
who will carry out the data collection, for the professionals who will carry out the 
randomisation and scheduling of the treatment and for the physiotherapists who will 
carry out the intervention. A bypass circuit will be presented (Annex 14). 
In addition, a consultation will be used to carry out referral triage, evaluation of 
participants, telephone contact and treatment scheduling. 
The intervention will be carried out in the room for the application of the SIS and the 
gym for carrying out the exercises. 
Material: 
Computer and telephone will be used for contact with the user. 

 
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For data collection, a computer, the manual pressure algometer (PAIN TEST TM 
FPX 50), the JAMAR hydraulic dynamometer, the manual goniometer, the EVA 
scale, FIP (Annex 1), the IC (Annex 2), the IC image assignment (Annex 3), the 
Commitment Sheet (Annex 4), the Data Collection Sheet (Annex 6) and the 
Assessment Scales (Annex 8) will be required. 
For the intervention, a stretcher, chair, SIS (SIS Manual, Annex 13), exercise 
protocol (Annex 10), health education sheet (Annex 11), exercise record sheet 
(Annex 12) will be used.  
Funding will be requested through grants for research projects by IDIAP Jordi Gol, 
by the College of Physiotherapists of Catalonia and funding sources. The thesis 
supervisor and co-supervisor have experience in obtaining this type of scholarship. 
In the event of not obtaining funding, the material can be loaned by the University 
of Vic – Central University of Catalonia. 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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Financial report and justification of the aid requested 
 
Person Costs 
Personnel necessary for the realization of the project: 
Concept 
Specifications 
Expenses (€) 
 
Personnel 
contracts 
Rehabilitation physician for triage of referrals of the 224 
participants 
1.095,10 
Evaluator: Physiotherapist (448 hours for assessments at 
the beginning, end, 3 and 6 tables of the 224 participants) 
4.125,54 
Physiotherapist: 72 hours of intervention 
3.052,03 
GIS staff: 60 hours of telephone contact and scheduling of 
the 4 visits for the 224 participants 
545,49 
TCAI staff: 30 hours of telephone contact, scheduling of the 
intervention and assignment to the groups, for the 224 
participants 
372,75 
 
Requested quote 
 
PRESUPPOSITION 
Concept 
Specifications 
Expenses (€) 
Subtotal (€) 
 
Personnel 
contracts 
Rehabilitation physician for triage of referrals of 
the 224 participants 
1.095,10 
1.095,10 
Evaluator: Physiotherapist (448 hours for 
assessments at the beginning, end, 3 and 6 
tables of the 224 participants) 
4.125,54 
4.125,54 
Physiotherapist: 72 hours of intervention 
3.052,03 
3.052,03 
GIS staff: 60 hours of telephone contact and 
scheduling of the 4 visits for the 224 participants 
545,49 
545,49 
TCAI staff: 30 hours of telephone contact, 
scheduling of the intervention and assignment to 
the groups, for the 224 participants 
372,75 
372,75 
 
 
Material for the 
intervention 
Computer equipment 
599 
599,00 
Manual pressure algometer (Pain test TM FPX 
50) 
 
395 
 
395,00 
JAMAR Hydraulic Dynamometer 
524 
524,00 
Goniometer 
1,47 
1,47 
EVA 
7,30 
7,30 
Stationery material 
150 
150,00 
Service 
Contract 
Statistician who performs data analysis 
2.551,31 
2.551,31 
Translation and proofreading in English 
439,00/article 
878,00 
Publication of two articles in high-impact journals 
 
1.107 
 
1.107,00 
Presentation of results at national and 
international congresses: 
- 
IV International Congress of 
Physiotherapy (2026, Barcelona) 
- 
Others 
 
 
70 
 
1.010 
 
 
 
 
1.080,00 
Management 
Expenses 
 
15 % (subtotal) 
 
2.472,59 
 
TOTAL 
18.956,58 

 
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Version 02, 2025-05-17. 
 
Bibliography  
 
1. Vinhas A, Almeida AF, Rodrigues MT, Gomes ME. Prospects of magnetically based 
approaches addressing inflammation in tendon tissues. Adv Drug Deliv Rev. 2023 
May;196:114815. doi: 10.1016/j.addr.2023.114815. Epub 2023 Mar 30. PMID: 37001644. 
2. Uttamchandani SR, Phansopkar P. Conservative Management of Lateral Epicondylalgia: 
A Review. Cureus. 2024 May 8; 16(5): e59875. doi: 10.7759/cureus.59875. PMID: 
38854316; PMCID: PMC11157989. 
3. Monge Pelegrín E, Garín Portero N. Approach to epicondylitis. Examination and 
treatment. 
RSI. 
 
Physiotherapy. 
26 
September 
2021. 
https://revistasanitariadeinvestigacion.com/category/fisioterapia. 
4. Di Filippo L, Vincenzi S, Pennella D, Maselli F. Treatment, Diagnostic Criteria and 
Variability of Terminology for Lateral Elbow Pain: Findings from an Overview of Systematic 
Reviews. Healthcare (Basel). 2022 Jun 14; 10(6):1095. doi: 10.3390/healthcare10061095. 
PMID: 35742152; PMCID: PMC9222841. 
5. Lenoir H, Mares O, Carlier Y. Management of lateral epicondylitis. Orthop Traumatol Surg 
Res. 2019 Dec; 105(8S): S241-S246. doi: 10.1016/j.otsr.2019.09.004. Epub 2019 Sep 19. 
PMID: 31543413. 
6. Bretschneider SF, Los FS, Eygendaal D, Kuijer PPFM, van der Molen HF. Work-
relatedness of lateral epicondylitis: Systematic review including meta-analysis and GRADE 
work-relatedness of lateral epicondylitis. Am J Ind Med. 2022 Jan; 65(1):41-50. doi: 
10.1002/ajim.23303. Epub 2021 Oct 21. PMID: 34674287; PMCID: PMC9297967. 
7. Kim YJ, Wood SM, Yoon AP, Howard JC, Yang LY, Chung KC. Efficacy of Nonoperative 
Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Plast 
Reconstr Surg. 2021 Jan 1; 147(1):112-125. doi: 10.1097/PRS.0000000000007440. PMID: 
33002980. 
8. Navarro-Santana MJ, Sanchez-Infante J, Gómez-Chiguano GF, Cummings M, 
Fernández-de-Las-Peñas C, Plaza-Manzano G. Effects of manual acupuncture and 
electroacupuncture for lateral epicondylalgia of musculoskeletal origin: a systematic review 
and 
meta-analysis. 
Acupunct 
Med. 
2021 
Oct; 
39(5):405-422. 
doi: 
10.1177/0964528420967364. Epub 2020 Dec 17. PMID: 33334116. 
9. Chesterton LS, Sim J, Wright CC, Foster NE. Interrater Reliability of Algometry in 
Measuring Pressure Pain Thresholds in Healthy Humans, Using Multiple Raters. Clin J 
Pain. noviembre de 2007; 23(9). 
10. Soares MM, Souza PC, Ribeiro AP. Differences in Clinical Tests for Assessing Lateral 
Epicondylitis Elbow in Adults Concerning Their Physical Activity Level: Test Reliability, 
Accuracy of Ultrasound Imaging, and Relationship with Energy Expenditure. Int J Environ 
Res Public Health. 2023 Jan 18; 20(3):1794. doi: 10.3390/ijerph20031794. PMID: 
36767167; PMCID: PMC9914816. 
11. Sipers, W. M. W. H., Verdijk, L. B., Sipers, S. J. E., Schols, J. M. G. A., & van Loon, L. 
J. C. (2016). The Martin Vigorimeter Represents a Reliable and More Practical Tool Than 
the Jamar Dynamometer to Assess Handgrip Strength in the Geriatric Patient.Journal of the 
American 
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466.e7.https://doi.org/10.1016/j.jamda.2016.02.026. 

 
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Version 02, 2025-05-17. 
 
12. Wood SM, Yoon AP, Tseng HJ, Yang LY, Chung KC. Comparative Effectiveness of 
Physical Therapy and Electrophysiotherapy for the Treatment of Lateral Epicondylitis: A 
Network Meta-Analysis. Plast Reconstr Surg. 2022 Sep 1; 150(3):594e-607e. doi: 
10.1097/PRS.0000000000009437. Epub 2022 Jul 1. PMID: 35791264. 
13. Landesa-Piñeiro L, Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: 
A systematic review. J Back Musculoskelet Rehabil. 2022; 35(3):463-477. doi: 
10.3233/BMR-210053. PMID: 34397403. 
14. Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric 
Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and 
Meta-Analysis. J Clin Med. 2021 Sep 1; 10(17):3968. doi: 10.3390/jcm10173968. PMID: 
34501416; PMCID: PMC8432114. 
15. Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment 
for lateral epicondylitis? A systematic review. Clin Rehabil. 2014 Jan; 28(1):3-19. doi: 
10.1177/0269215513491974. Epub 2013 Jul 23. PMID: 23881334. 
16. Mollazehi N, Mohamadi M, Rezaeian S, Razeghi M. How effective is proprioception 
exercise on pain, grip force, dexterity and proprioception of elbow joint in patients with tennis 
elbow? A randomized controlled trial. J Bodyw Mov Ther. 2024 Oct;40:1821-1827. doi: 
10.1016/j.jbmt.2024.10.035. Epub 2024 Oct 16. PMID: 39593530. 
17. Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric 
Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and 
Meta-Analysis. J Clin Med. 2021 Sep 1; 10(17):3968. doi: 10.3390/jcm10173968. PMID: 
34501416; PMCID: PMC8432114. 
18. Mascaró A, Cos MA, Morral A, Roig A, Purdam C, Cook J. Load management in 
tendinopathy: clinical progression for achilles and patellar tendinopathy. Original article. 
Apunts Med Esport. 2018; 53 (197): 19-27. 
19. Kim YJ, Wood SM, Yoon AP, Howard JC, Yang LY, Chung KC. Efficacy of Nonoperative 
Treatments for Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Plast 
Reconstr Surg. 2021 Jan 1; 147(1):112-125. doi: 10.1097/PRS.0000000000007440. PMID: 
33002980. 
20. Wilms P, Schröder J, Scheit L, Reer R. The effect of electromagnetic fields on 
tendinopathies: Study on the effect analysis of a singular application of high-energy pulsed 
electromagnetic fields. Orthopaedics (Heidelb). 2024 Sep; 53(9):668-676. DOI: 
10.1007/S00132-024-04541-3. 
Epub 
2024 Aug 
22 
PMID: 
39172175; 
PMCID: 
PMC11384642. 
21. Torretta E, Moriggi M, Capitanio D, Orfei CP, Raffo V, Setti S, Cadossi R, de Girolamo 
L, Gelfi C. Effects of Pulsed Electromagnetic Field Treatment on Skeletal Muscle Tissue 
Recovery in a Rat Model of Collagenase-Induced Tendinopathy: Results from a Proteome 
Analysis. Int J Mol Sci. 2024 Aug 14; 25(16):8852. doi: 10.3390/ijms25168852. PMID: 
39201538; PMCID: PMC11354614. 
22. Landesa-Piñeiro L, Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: 
A systematic review. J Back Musculoskelet Rehabil. 2022; 35(3):463-477. doi: 
10.3233/BMR-210053. PMID: 34397403. 
23. George CE, Heales LJ, Stanton R, Wintour SA, Kean CO. Sticking to the facts: A 
systematic review of the effects of therapeutic tape in lateral epicondylalgia. Phys Ther 

 
43 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
Sport. 2019 Nov;40:117-127. doi: 10.1016/j.ptsp.2019.08.011. Epub 2019 Aug 27. PMID: 
31518778. 
24. Heales LJ, McClintock SR, Maynard S, Lems CJ, Rose JA, Hill C, Kean CO, Obst S. 
Evaluating the immediate effect of forearm and wrist orthoses on pain and function in 
individuals with lateral elbow tendinopathy: A systematic review. Musculoskelet Sci Pract. 
2020 Jun;47:102147. doi: 10.1016/j.msksp.2020.102147. Epub 2020 Mar 5. PMID: 
32452393. 
25. Yao G, Chen J, Duan Y, Chen X. Efficacy of Extracorporeal Shock Wave Therapy for 
Lateral Epicondylitis: A Systematic Review and Meta-Analysis. Biomed Res Int. 2020 Mar 
18;2020:2064781. doi: 10.1155/2020/2064781. PMID: 32309425; PMCID: PMC7106907. 
26. Karanasios S, Tsamasiotis GK, Michopoulos K, Sakellari V, Gioftsos G. Clinical 
effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and 
meta-analysis. 
Clin 
Rehabil. 
2021 
Oct; 
35(10):1383-1398. 
doi: 
10.1177/02692155211006860. Epub 2021 Apr 4. PMID: 33813913. 
27. Rosso F, Bonasia DE, Marmotti A, Cottino U, Rossi R. Mechanical Stimulation (Pulsed 
Electromagnetic Fields "PEMF" and Extracorporeal Shock Wave Therapy "ESWT") and 
Tendon Regeneration: A Possible Alternative. Front Aging Neurosci. 2015 Nov 9;7:211. doi: 
10.3389/fnagi.2015.00211. PMID: 26617513; PMCID: PMC4637423. 
28. Navarro-Santana MJ, Sanchez-Infante J, Gómez-Chiguano GF, Cleland JA, López-de-
Uralde-Villanueva I, Fernández-de-Las-Peñas C, Plaza-Manzano G. Effects of trigger point 
dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and 
meta-analysis. 
Clin 
Rehabil. 
2020 
Nov; 
34(11):1327-1340. 
doi: 
10.1177/0269215520937468. Epub 2020 Jun 23. PMID: 32576044. 
29. Ma X, Qiao Y, Wang J, Xu A, Rong J. Therapeutic Effects of Dry Needling on Lateral 
Epicondylitis: An Updated Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 
2024 Mar 13:S0003-9993(24)00823-2. doi: 10.1016/j.apmr.2024.02.713. Epub ahead of 
print. PMID: 38484834. 
30. Kholinne E, Singjie LC, Anastasia M, Liu F, Anestessia IJ, Kwak JM, Jeon IH. 
Comparison of Clinical Outcomes After Different Surgical Approaches for Lateral 
Epicondylitis: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2024 May 2; 
12(5):23259671241230291. doi: 10.1177/23259671241230291. PMID: 38708009; PMCID: 
PMC11067684. 
31. Zarkovic D, Prouza O. Acute epicondylitis and chronic shoulder pain management with 
high-intensity electromagnetic stimulation: a case study. J Pain Manag. 2024; 15(3):123-
130. doi: 10.1234/jpm.2024.56789. 
32. Kouloulas EJ. Peripheral application of repetitive pulse magnetic stimulation on joint 
contracture for mobility restoration: controlled randomized study. Int J Physiother. 2016; 
3(5):519-524. doi: 10.15621/ijphy/2016/v3i5/117441.  
33. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog 
Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain 
Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain 
Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of 
Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res. 2011; 
63(S11):S240-52. 

 
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Version 02, 2025-05-17. 
 
34. Chapleau J, Canet F, Petit Y, Laflamme GY, Rouleau DM. Validity of goniometric elbow 
measurements: comparative study with a radiographic method. Clin Orthop Relat Res. 2011 
Nov; 469(11):3134-40. doi: 10.1007/s11999-011-1986-8. Epub 2011 Jul 21. PMID: 
21779866; PMCID: PMC3183177. 
35. Hanks J, Myers B. Validity, Reliability, and Efficiency of a Standard Goniometer, Medical 
Inclinometer, and Builder's Inclinometer. Int J Sports Phys Ther. 2023 Aug 1; 18(4):989-996. 
doi: 10.26603/001c.83944. PMID: 37547826; PMCID: PMC10399115. 
36. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch 
strength: normative data for adults. Arch Phys Med Rehabil. febrero de 1985;66:69-74. 
37. Mathiowetz V. Comparison of Rolyan and Jamar dynamometers for measuring grip 
strength. Occup Ther Int. 2002; 9(3):201-9. 
38. García González GLA, Aguilar Sierra SF, Rodríguez Ricardo RMC. Validation of the 
Spanish version of the abbreviated upper limb function scale: Quick Dash. Rev Colomb 
Ortop Traumatol. December 1, 2018; 32(4):215-9. 
39. Hernandez G, Garin O, Pardo Y, Vilagut G, Pont À, Suárez M, et al. Validity of the EQ–
5D 5L and reference norms for the Spanish population. Qual Life Res. 2018; 27(9):2337-
48. 
40. Zhou T, Guan H, Wang L, Zhang Y, Rui M, Ma A. Health-Related Quality of Life in 
Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review. Front 
Public Health. 29 de junio de 2021;9:675523. 
41. EuroQol Research Foundation. EQ-5D-5L User Guide [Internet]. Euroqool; 2019. 
Available in: www.euroqol.org. 
42. Van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim 
scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 
julio de 2012; 15(5):708-15. 
 
 
 
 
 
 
 
 
 
 
 

 
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Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
Appendices 
 
ANNEX 1: PATIENT INFORMATION SHEET 
PATIENT INFORMATION SHEET (FIP)  
Name of the candidate to participate in the study: 
Within the framework of a PhD project by the Doctoral School of the University of Vic - Central 
University of Catalonia (UVIC-UCC), the physiotherapist Carme Sánchez Mato, as a PhD student, 
promoter of the study and principal investigator, carries out the research project with the title: 
"Effectiveness of a combined therapy of the Super Inductive System (SIS) with a therapeutic 
exercise program of physiotherapy and health education in tendinopathies sides of elbows". 
Objectives of the study 
The main objective of this study, for which we request your collaboration, is to evaluate the 
effectiveness of SIS in cases of lateral elbow tendinopathies in people aged 18 years or older. The 
application of the SIS will be combined with a program of exercises and health education, to reduce 
pain, improve the mobility and functionality of the upper limb, increase grip strength and evaluate the 
quality of life of those who suffer from this problem. 
With this document we offer you information and invite you to participate in the study. You can ask 
any questions and request more information about any aspect that you do not understand. Do not 
give your approval and do not sign this document until you are satisfied with the answers to your 
questions. 
The realization of this study has received the approval of the Research Ethics Committee of IDIAP 
Jordi Gol, which is responsible for guaranteeing the protection of the rights of the participants and 
that the methodology of the study is correct. 
Why is this study carried out? 
Epicondyalgia is a musculoskeletal disorder that causes pain and dysfunction in the upper extremity. 
It is related to repetitive movements of the elbow and hand, during sports and work or domestic 
activities, which require intense force in inappropriate postures, causing limitations in daily work and 
activities of daily living. Therefore, it constitutes a major public health problem. 
The symptoms that occur with epicondylalgia are pain in the area of insertion of the muscles that 
insert into the elbow, affecting strength, functionality and quality of life. 
SIS is an innovative and non-invasive therapeutic technology. It reduces acute and chronic pain, 
improves joint mobility and muscle strengthening, among others. Its implementation could accelerate 
the recovery from this pathology. The aim is to obtain evidence on its effectiveness and cost-
efficiency, contributing to the reduction of the time of incapacity for work, treatment and recovery 
time, as well as the expenditure on pharmacological treatment. 
 
 
 

 
46 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
What does the study consist of and what is expected of you as a participant? 
To be part of the study, participants will need to answer questions asked by the evaluators and then 
a series of questionnaires with specific questions about the aspects to be evaluated. Then, he will 
have to go for 8 days for treatment, and will be evaluated again using the same questionnaires. Three 
and six months after finishing the program, he will be summoned again to answer these last 
questionnaires, again to see how he has evolved. The first visit will last approximately 45 minutes, 
the rest will last no more than 20 minutes. The treatment sessions last approximately 45 minutes. 
A sample of users of three different Rehabilitation and Physiotherapy Services (Mataró, Sant Andreu 
de Barcelona and Drassanes de Barcelona) participated in this study, referred by the Family Doctor, 
Traumatologist, Rheumatologist or Rehabilitation Doctor or by the Traumatologist. The administrative 
staff has contacted you to arrange an appointment with the physiotherapist who will carry out the 
evaluation. In this visit you will be given the detailed information and you will be invited to participate 
in the research study.  
Users will be divided into two groups. In one of them, an exercise program will be carried out to 
improve the mobility and strength of the muscles of the affected upper limb. They will be given a 
sheet with recommendations (health education) on the pathology and the SIS will be applied, with 
the pre-established program for tendinopathies and with an intensity according to the motor threshold 
of each patient. The other group will carry out the same exercise and health education program but 
the SIS will be applied with a non-therapeutic dose. Randomly, they will assign it to one group or 
another. 
Both in one group and in the other, a total of 8 sessions will be held, with a frequency of two days 
per week. The days that you do not attend rehabilitation will have to be done at home. It will not mean 
more than 20 minutes a day. 
If you have been included in the group in which the application of the SIS parameters are not 
therapeutic and the results of the study are beneficial, please note that in the future you could benefit 
from this project. The participants in this group will not fail to obtain the conventional treatment that, 
until now, has been applied to tendinopathies; that is, the exercise program and health education. 
Their participation in this research study is completely voluntary. If during the development of the 
study you decide to withdraw, you can do so freely at the time you consider it appropriate, without 
any need to give explanations and without altering your relationship with the researchers and 
collaborators of the study for this reason. 
Who can participate in the study? 
All those people of legal age who have pain in the external lateral area of the elbow, referred by the 
family doctor, traumatologist, rheumatologist or rehabilitation doctor, can participate in the project. 
Reasons for exclusion from the study will be those people who have a recent traumatic history (less 
than 6 months), who have a limitation of passive mobility of the elbow, and have received infiltration 
in the affected elbow in the last 6 weeks, are carriers of pacemakers or metal implants in the affected 
area, have cognitive or sensory difficulty that prevents their participation in the proposed treatment 
or suffer some other affectation than their own. doctor or assessor considers it a difficulty for their 
participation. 
What happens if I decide to participate in the study? 
You should know that your participation in this study is voluntary and that you can choose not to 
participate. You can change your decision and withdraw your consent at any time without altering 

 
47 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
your relationship with the doctor or physiotherapist or causing any prejudice to your care. If you 
decide to participate, with your signature, you would be accepting that the healthcare team and 
researcher responsible for being able to analyze your clinical history with the sole purpose of knowing 
what your current clinical situation is and what your evolution is during the follow-up of this study. 
With his participation, he will help the scientific community to better understand the influence of SIS 
on lateral elbow tendinopathies in order to be able to address them excellently in the future. For their 
part, they will receive the current treatment established by protocol for the management of their 
ailment. 
Confidentiality of data 
The results of the various tests carried out, as well as the documentation relating to him/her, are 
absolutely confidential and will only be available to the research team and the competent health 
authorities, where appropriate. 
Publication of the results 
The research team recognizes the importance and significance of the study and, therefore, is willing 
to publish the results in a journal, publication or scientific meeting to be determined. If you wish, the 
researcher responsible for the study will inform you of the results, as well as any other relevant data 
that is known during the study. 
Information on confidentiality and data protection. How will your personal data be processed? 
All participants will be assigned a code by which it is impossible to identify the participant with the 
answers given, fully guaranteeing confidentiality under the responsibility of the Catalan Institute of 
Health as data controller (hereinafter "the data controller").  
 
The data that will be obtained through their participation will not be used for any purpose other than 
that explained in this research and will become part of a data file for which the principal investigator 
will be fully responsible.  
 
This data will be collected, stored and protected through the use of the REDCap Web application. 
Only study researchers will be able to access it.  
 
The processing of the data will be carried out in compliance with the "Regulation (EU) 2016/679 of 
the European Parliament and of the Council", of 27 April 2016, on the protection of natural persons 
with regard to the processing of personal data and on the free movement of such data (GDPR), and 
the "Organic Law 3/2018, on Data Protection and Guarantee of Digital Rights",  (LOPD-GDD).  
 
In accordance with this law, you may exceed your rights of access, modification, opposition and 
cancellation of this data through the address of the Data Protection Officer (dpd@ticsalutsocial.cat) 
or by contacting Carme Sánchez, at CAP II Maresme, on 93 741 51 77, principal investigator of this 
project.  
 
By signing this document, you expressly consent to your data being processed for research purposes 
within the framework of this project, in accordance with articles 6.1.a, 9.2.a of the GDPR. This data 
will be kept for 5 years once the end of the project has been completed and communicated. No 
communication of personal data is contemplated, beyond those provided for by law. Nor will 
international data transfers be carried out.  
 
The publication and dissemination of the research results of the project will be carried out 
scrupulously respecting the anonymity of the participants in accordance with current legislation and 
previously described in this document.  

 
48 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
 
The research staff has signed the commitment to act in accordance with the good research practices 
contained in the Declaration of Helsinki and its updates (the last one signed in Fortaleza, Brazil 
2013). 
What if you decide to retire from the studio? 
You have the right to withdraw your consent to the processing of your data at any time and without 
having to give any explanation, by requesting the waiver form from any professional in the team, or 
by calling the CAP II Mataró-Maresme, telephone 93 741 51 77 (Carme Sánchez). You also have the 
right to file a complaint with the Catalan Data Protection Authority if you consider that any action by 
the data controller violates your rights. 
What if you have doubts about the project or about your participation? 
You can contact us through the email of the principal investigator of this project (Carme Sánchez): 
csanchezm.ics@gencat.cat, or by calling the Rehabilitation Service of the CAP II Mataró-Maresme 
(93 741 51 77). 
Thank you very much for participating.  
Name of the project collaborator (representing the research team) who delivers the document 
and informs the participant: ............................................................................................... The 
research team responsible for the study is the one who has informed him about the different aspects 
of the study. If you wish to ask any questions about the information presented or if you want some 
clarification of any doubts about the study, you can express it at any time. If you decide to participate 
in this study, you must give your consent freely. The promoters of the study and the principal 
investigator are grateful for their invaluable collaboration. 
Signed: ...................................................... 
Name and surname of the participant: 
D.N.I.:  
 
 
 
Age: 
 
 
         Data: 
 
 
 
 
 
 
 
 
 
 
 

 
49 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
 
PATIENT INFORMATION SHEET (HIP)  
Name of the candidate to participate in the study: 
Within the framework of a PhD project by the Doctoral School of the University of Vic - Central 
University of Catalonia (UVIC-UCC), the physiotherapist Carme Sánchez Mato, as a PhD student, 
promoter of the study and principal investigator, carries out the research project with the title: 
"Effectiveness of a combined therapy of the Super Inductive System (SIS) with a therapeutic 
exercise program of physiotherapy and health education in the lateral elbow tendinopathies". 
Objectives of the study 
The main objective of this study, for which we are asking for your collaboration, is to evaluate the 
effectiveness of SIS in cases of lateral elbow tendinopathies in people aged 18 years or older. The 
application of the SIS will be combined with an exercise and health education program, to reduce 
pain, improve the mobility and functionality of the upper extremity, increase grip strength and evaluate 
the quality of life of those who suffer from this problem. 
With this document we provide you with information and invite you to participate in the study. You 
can ask any questions and request more information on any aspect that you do not understand. Do 
not approve and sign this document until you are satisfied with the answers to your questions. 
The completion of this study has received the approval of the Research Ethics Committee of IDIAP 
Jordi Gol, which is responsible for ensuring the protection of the rights of the participants and that 
the methodology of the study is correct. 
Why is this study being conducted? 
Epicondylalgia is a musculoskeletal disorder that causes pain and dysfunction in the upper extremity. 
It is related to repetitive movements of the elbow and hand, during sports and work or domestic 
activities, which require intense force in inappropriate postures, causing limitations in daily work and 
activities of daily living. It is therefore a major public health problem. 
The symptoms that occur with epicondylalgia are pain in the area of insertion of the muscles that are 
inserted in the elbow, impairment of strength, functionality and quality of life. 
SIS is an innovative and non-invasive therapeutic technology. It reduces acute and chronic pain, 
improves joint mobility and muscle strengthening, among others. Its implementation could accelerate 
recovery from this pathology. The aim is to obtain evidence on its effectiveness and cost-efficiency, 
contributing to the reduction of the time of incapacity for work, treatment and recovery time, as well 
as expenditure on pharmacological treatment. 
What does the study consist of and what is expected of you as a participant? 
To be part of the study, participants will need to answer questions asked by the evaluators and then 
a series of questionnaires with specific questions about the aspects to be evaluated. Then, they must 
go for treatment for 8 days, and they will be evaluated again using the same questionnaires. Three 
and six months after finishing the program, he will be summoned again to answer these last 
questionnaires, again to see how he has evolved. The first visit will last approximately 45 minutes, 
the rest will last no more than 20 minutes. Treatment sessions last approximately 45 minutes. 

 
50 
Model protocol for submitting research projects to the CEI of the IDIAP Jordi Gol 
Version 02, 2025-05-17. 
 
This study involves a sample of users from three different Rehabilitation and Physiotherapy Services 
(Vallès, Sant Andreu de Barcelona and Astilleros de Barcelona), referred by the Family Doctor, 
Traumatologist, Rheumatologist or Rehabilitation Doctor or by the Traumatologist. The administrative 
staff has contacted you to make an appointment with the physiotherapist who will perform the 
evaluation. On this visit you will be given detailed information and invited to participate in the research 
study.  
Users will be divided into two groups. In one of them, an exercise program will be carried out to 
improve the mobility and strength of the muscles of the affected upper extremity. They will be given 
a sheet with recommendations (health education) on the pathology and the SIS will be applied, with 
the pre-established program for tendinopathies and with an intensity according to the motor threshold 
of each patient. The other group will carry out the same exercise and health education program, but 
the SIS will be applied with non-therapeutic doses. Randomly, they will assign it to one group or 
another. 
In both groups, a total of 8 sessions will be held, with a frequency of two days a week. The days that 
he does not attend rehabilitation he will have to do them at home. It will not take more than 20 minutes 
a day. 
If you have been included in the group in which the application of SIS parameters is not therapeutic 
and the results of the study are beneficial, please note that in the future you could benefit from this 
project. The participants in this group will not stop obtaining the conventional treatment that, until 
now, has been applied to tendinopathies; that is, the exercise program and health education. 
Your participation in this research study is entirely voluntary. If during the development of the study 
you decide to withdraw, you can do so freely at any time you consider appropriate, without any need 
to give explanations and without altering your relationship with the researchers and collaborators of 
the study. 
Who can participate in the study? 
All those adults who have pain in the external lateral area of the elbow, referred by the family doctor, 
traumatologist, rheumatologist or rehabilitation doctor, can participate in the project. Reasons for 
exclusion from the study will be those people who have had a recent traumatic history (less than 6 
months), who have a limitation of passive mobility of the elbow, and have received infiltration in the 
affected elbow in the last 6 weeks, are carriers of pacemakers or metal implants in the affected area, 
have cognitive or sensory difficulty that prevents their participation in the proposed treatment or suffer 
from some other condition that their doctor or evaluator considers a difficulty for their participation. 
What if I decided to participate in the study? 
You should know that your participation in this study is voluntary and that you can choose not to 
participate. You can change your decision and withdraw your consent at any time without altering 
your relationship with the doctor or physiotherapist or causing any prejudice to your care. If you 
decide to participate, with your signature you would be accepting that the care team and researcher 
in charge can analyze your clinical history with the sole purpose of knowing what your current clinical 
situation is and what your evolution is during the follow-up of this study. With your participation, you 
will help the scientific community to better understand the influence of SIS on lateral elbow 
tendinopathies in order to be able to address them excellently in the future. For his part, he will 
receive the current treatment established by protocol for the management of his ailment. 
 

 
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Data confidentiality 
The results of the various tests carried out, as well as the documentation relating to him, are 
absolutely confidential and will only be available to the research team and the competent health 
authorities, where appropriate. 
Publication of the results 
The research team recognizes the importance and significance of the study and, therefore, is willing 
to publish the results in a journal, publication or scientific meeting to be determined. If you wish, the 
researcher responsible for the study will inform you of the results, as well as any other relevant data 
that is known during the study. 
Information on confidentiality and data protection. How will your personal data be processed? 
All participants will be assigned a code by which it is impossible to identify the participant with the 
answers given, fully guaranteeing confidentiality under the responsibility of the Catalan Institute of 
Health as data controller (hereinafter the "data controller").  
 
The data that will be obtained through their participation will not be used for any purpose other than 
that explained in this research and will become part of a data file for which the principal investigator 
will be the maximum responsible.  
 
This data will be collected, stored and protected through the use of the REDCap Web application. 
Only the researchers of the study will be able to access them.  
 
The processing of the data will be carried out in compliance with the "Regulation (EU) 2016/679 of 
the European Parliament and of the Council", of 27 April 2016, on the protection of natural persons 
with regard to the processing of personal data and on the free movement of such data (GDPR), and 
the "Organic Law 3/2018, on Data Protection and guarantee of digital rights".   (LOPD-GDD).  
 
In accordance with this law, you may exceed the rights of access, modification, opposition and 
cancellation of this data by contacting the Data Protection Officer (dpd@ticsalutsocial.cat) or by 
contacting Carme Sánchez, at CAP II Maresme, on 93 741 51 77, principal investigator of this project.  
 
By signing this document, you expressly consent to your data being processed for research purposes 
within the framework of this project, in accordance with article 6.1.a, 9.2.a of the GDPR. This data 
will be kept for 5 years after the completion and communication of the completion of the project. 
Communications of personal data are not contemplated, beyond those provided for by law. No 
international data transfers will be made either.  
 
The publication and dissemination of the research results of the project will be carried out 
scrupulously respecting the anonymity of the participants in accordance with the legislation in force 
and described in this document previously.  
 
The researchers have signed the commitment to act in accordance with the good research practices 
set out in the Declaration of Helsinki and its updates (the last one signed in Fortaleza, Brazil 2013). 
 
What if you decide to withdraw from the study? 
You have the right to withdraw your consent to the processing of the data at any time and without 
having to give any explanation, by requesting the resignation form from any professional in the team, 
or by calling CAP II Mataró-Vallès, telephone 93 741 51 77 (Carme Sánchez). You also have the 

 
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right to file a complaint with the Catalan Data Protection Authority if you consider that any action by 
the data controller violates your rights. 
What if you have questions about the project or your participation? 
You can contact us through the email of the principal investigator of this project (Carme Sánchez): 
csanchezm.ics@gencat.cat, or by calling the Rehabilitation Service of CAP II Mataró-Vallès (93 741 
51 77). 
Thank you very much for participating.  
Name of the project collaborator (representing the research team) who delivers the document 
and informs the participant: ............................................................................................... The 
research team responsible for the study has informed you about the different aspects of the study. If 
you have any questions about the information on display or if you would like clarification of any doubts 
about the study, you may ask them at any time. If you decide to participate in this study, you will be 
free to give your consent. The promoters of the study and the principal investigator are grateful for 
their invaluable collaboration. 
Signed: ...................................................... 
Name and surname of the participant: 
D.N.I.:  
 
 
 
Age: 
 
 
         Date: 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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ANNEX 2: INFORMED CONSENT 
 
INFORMED CONSENT (CI) 
Title of the study: Effectiveness of a combined therapy of the Super Inductive System (SIS) with a 
therapeutic exercise program of physiotherapy and health education in lateral tendinopathies of the 
elbow.  
I (Name and surname),................................................................................................., with D.N.I. nº 
.............................., over 18 years of age, acting in my own name and interest, declare that I have 
been informed in a clear, broad and satisfactory way, orally and I have read the information sheet to 
the participant that has been given to me.  
I have had the opportunity to ask all the questions I wanted about the study. I have received enough 
information about the study. I spoke to .........................................................................., who gave me 
the information and a copy of the consent. I understand that my participation is voluntary.  
I understand that I can withdraw from the study:  
1. whenever you want,  
2. without giving explanations, and  
3. without this having an impact on the medical or physiotherapy care they receive.  
In accordance with the provisions of Regulation (EU) 2016/679 of the European Parliament and of 
the Council of 27 April on Data Protection (GDPR) and Organic Law 3/2018, of 5 December, on Data 
Protection and Guarantee of Digital Rights, I declare that I have been informed of my rights, the 
purpose for which my data was collected and the recipients of the information. I freely consent to 
participate in this study.  
I GIVE MY CONSENT TO:  
1. To participate in "Effectiveness of a combined therapy of the Super Inductive System (SIS) 
with a therapeutic exercise program of physiotherapy and health education in lateral elbow 
tendinopathies".  
2. That Carme Sánchez Mato, as principal investigator, can manage my personal data and 
disseminate the information that the project generates. It is guaranteed that my identity and 
privacy will be preserved at all times, with the guarantees established in Organic Law 3/2018, 
of 5 December, on the Protection of Personal Data and guarantee of digital rights and 
General Regulation (EU) 2016/679, of 27 April 2016, on data protection and complementary 
regulations.  
3. That Carme Sánchez Mato keep all the records made about me in electronic format, with the 
guarantees and deadlines provided for by law, if they were established, and in the absence 
of legal provision, for the time necessary to fulfill the functions of the project for which the 
data were collected. 
 
 
 

 
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Name and surname of the participant and signature:                                
D.N.I.:  
 
 
 
Age: 
 
 
         Data: 
Principal Investigator: ................................................................................. 
Signature of the principal investigator: 
 
STATEMENT BY THE RESEARCHER 
The patient who signs this consent form has received, from the professional, detailed information, 
orally and in writing, of the process and nature of this research study, and has had the opportunity to 
ask any questions regarding the nature, risks and advantages of participating in this study. 
Signature of the researcher: Date: 
 
INFORMED CONSENT (CI) 
Study title: Effectiveness of a combined therapy of the Super Inductive System (SIS) with a 
therapeutic exercise program of physiotherapy and health education in lateral elbow tendinopathies.  
I (Name and surname),................................................................................................., with ID No. 
.............................., over 18 years of age, acting in my own name and interest, declare that I have 
been informed in a clear, comprehensive and satisfactory manner, orally and I have read the 
information sheet to the participant that has been given to me.  
I have had the opportunity to ask all the questions I have wanted about the study. I have received 
enough 
information 
about 
the 
study. 
I 
have 
spoken 
to 
.........................................................................., who has given me the information and a copy of the 
consent. I understand that my participation is voluntary.  
I understand that I can withdraw from the study:  
1. when you want,  
2. without giving explanations, and  
3. without this having an impact on the medical or physiotherapy care they receive.  
In accordance with the provisions of Regulation (EU) 2016/679 of the European Parliament and of 
the Council of 27 April on Data Protection (GDPR) and Organic Law 3/2018, of 5 December, on data 
protection and guarantee of digital rights, I declare that I have been informed of my rights, the 
purpose of collecting my data and the recipients of the information. I freely consent to participate in 
this study.  
I CONSENT TO:  

 
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1. Participate in "Effectiveness of a combined therapy of the Super Inductive System (SIS) with 
a therapeutic exercise program of physiotherapy and health education in lateral elbow 
tendinopathies".  
2. That Carme Sánchez Mato, as principal investigator, can manage my personal data and 
disseminate the information that the project generates. It is guaranteed that my identity and 
privacy will be preserved at all times, with the guarantees established in Organic Law 3/2018, 
of 5 December, on the Protection of Personal Data and guarantee of digital rights and the 
General Regulation (EU) 2016 / 679, of 27 April 2016, on data protection and complementary 
regulations.  
3. That Carme Sánchez Mato keep all the records made about me in electronic format, with the 
guarantees and deadlines provided for by law, if established, and in the absence of legal 
provision, for the time necessary to fulfil the functions of the project for which the data were 
collected. 
 
Name and surname of the participant and signature:                                
  
D.N.I.:  
 
 
 
Age: 
 
 
         Date: 
Principal Investigator: ................................................................................. 
Signature of the principal investigator: 
 
STATEMENT OF THE RESEARCHER 
The patient who signs this consent form has received, from the professional, detailed information, 
orally and in writing, of the process and nature of this research study, and has had the opportunity to 
ask any questions regarding the nature, risks and advantages of participating in this study. 
Signature of the researcher: Date: 
 
 
 
 
 
 
 
 

 
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ANNEX 3: WAIVER FORM 
FULL RESIGNATION 
Title of the study:  Effectiveness of a combined therapy of the Super Inductive System (SIS) with a 
therapeutic exercise program of physiotherapy and health education in lateral tendinopathies of the 
elbow.  
I (Name and surname),.................................................................................................., with D.N.I. nº 
............................................, declare that it is my desire to abandon the study in which I have been 
participating. 
I declare that there has been no pressure or insistence on giving my personal reasons for resigning, 
in accordance with the rules and procedures for inclusion in the study.  
I 
have 
to 
talk 
to 
(Name 
of 
the 
researcher 
who 
has 
given 
the 
information): 
................................................................................................................................ 
I understand that my participation was, at all times, voluntary and it is my desire to leave the studio. 
I understand that I can withdraw from the study: 
1° at the time I wish, 
2° without having to give any explanation, and 
3° without this fact having an impact on my relationship with the researchers or 
promoters of the study. 
In conclusion, I renounce to continue participating in this study. 
Principal Investigator: ........................................................................................ 
Signature of the principal investigator: 
Data: 
WAIVER SHEET 
Study title:  Effectiveness of a combined therapy of the Super Inductive System (SIS) with a 
therapeutic exercise program of physiotherapy and health education in lateral elbow tendinopathies.  
I (Name and surname),.................................................................................................., with ID No. 
............................................, declare that it is my wish to leave the studio in which I have been 
participating. 
I declare that there has been no pressure or insistence on giving my personal reasons for resigning, 
in accordance with the rules and procedures for inclusion in the study.  
I 
have 
spoken 
to 
(Name 
of 
the 
researcher 
who 
gave 
the 
information): 
................................................................................................................................ 
I understand that my participation was, at all times, voluntary and it is my desire to leave the studio. 
I understand that I can withdraw from the study: 
1° at the time I wish, 

 
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2° without having to give any explanation, and 
3° without this fact having an impact on my relationship with the researchers or 
promoters of the study. 
In conclusion, I renounce to continue participating in this study. 
Principal Investigator: ........................................................................................ 
Signature of the principal investigator: 
Date: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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ANNEX 4: DATA COLLECTION SHEET 
 
DATA COLLECTION SHEET 
Date:  
 
 
 
 
 
Identifier: 
Sociodemographic data: 
Origin of the referral (Family Doctor/Traumatologist/Rehabilitation Doctor): 
Reference Primary Care Centre: 
Center where the intervention will be carried out (Mataró/Sant Andreu/Drassanes Rehabilitation 
Service): 
Age: Gender: 
 
Affected limb: Dominant Hand: 
Medical diagnosis: Time of pain evolution: 
Health History: 
Previous traumatic history? (date): Surgical intervention on the affected elbow? (date):   
Infiltration? (date): 
Educational level: 
Marital status:  
Coexistence: 
Employment: 
Physical and sports activity: YES/NO Type: Dedication time: 
Pain (rhythm and characteristics):  
    Type: Without/with irradiation: Duration: Aggravation: Evolution time: 
    Daytime / Night:                     
    EVA at rest (average of the last week): 
    Mechanical EVA (average of the last week): 
Current pain-related pharmacological treatment/dosage: 
Use of orthosis for the affected elbow: YES/NO Time of use: 
Situation of temporary disability due to the reason for the study:     Start date: Duration: 
Diagnostic tests performed (X-ray, ultrasound, MRI)/date of performance: 
Previous treatments (Rehabilitation, infiltrations, private physiotherapy,...): 
Exploration: 
    Joint balance: 
    Cozen maneuver (resisted carpal extension / chair test): 
    Miller maneuver: 

 
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    Palpation:  
 
Epicondyle-common extensor tendon: 
 
Radiohumeral joint: 
Trigger points (triceps, anconium, brachiradial, extensor carpi radial, extensor fingers): 
NOTE:  
- 
Reasons for exclusion from the study: Medial epicondyalgia of the elbow, recent traumatic 
history (<6 months), limitation in passive joint mobility (elbow fracture, surgery), infiltration in 
the affected elbow (6 weeks prior to the first visit), pain due to inflammatory, autoimmune or 
infectious systemic disease, pregnant women, metastatic disease, metal implants in the 
affected elbow area,  pacemakers, Frohse's arch syndrome, blood clotting disorders. 
- 
In the event of involvement of both elbows, priority will be given to treating only one, as part 
of the study. In the event that you subsequently need to receive treatment for the other elbow, 
this second process will no longer be part of the study. 
 
Main variable: 
Pain: 
EVA 
Previous 
Post-intervention 
Control 3 months 
Control 6 months 
 
 
 
 
 
Algometry 
Previous 
Post-intervention 
Control 3 months 
Control 6 months 
 
 
 
 
 
Gonometry (joint mobility): 
 
Previous 
Post-
intervention 
Control 
3 
months 
Control 
6 
months 
Elbow flexion 
 
 
 
 
Elbow extension 
 
 
 
 
Elbow pronation 
 
 
 
 
Elbow supination 
 
 
 
 
Elbow 
affection 
flexion 
 
 
 
 
Elbow 
Affect 
Extension 
 
 
 
 
Elbow 
affection 
pronation 
 
 
 
 
Elbow 
affect, 
supination 
 
 
 
 
 
 

 
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Dynamometry (gripping force): 
Previous 
Post-intervention 
Control 3 months 
Control 6 months 
 
 
 
 
 
Functionality (QuickDASH): 
Previous 
Post-intervention 
Control 3 months 
Control 6 months 
 
 
 
 
 
Quality of Life (EQ-5D-5L): 
Previous 
Post-intervention 
Control 3 months 
Control 6 months 
 
 
 
 
 
Number of treatment sessions performed: 
Adherence to treatment:    % (of the total number of days per week, how many have exercised). 
Adverse effects: (included in the adverse effects collection sheet) 
He believes that he has been applied the SIS program for epicondylitis or the SIS with a non-
therapeutic dose: (blinding assessment) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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ANNEX 5: ASSESSMENT SCALES 
- 
QUICKDASH: 
 
 
 
 
 

 
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- 
EQ-5D-5L: 
 
Identifier 
 
 
 
 
 
 
 
 
Date: 
 
                           
 

 
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ANNEX 6: MEASURING INSTRUMENTS 
 
- 
EVA: 
 
 
 
- 
Goniometer: 
 
 
- 
Manual pressure algometer (PAIN TEST TM FPX 50): 
 
 
 
- 
JAMAR Hydraulic Hand Dynamometer: 
 
 
 

 
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ANNEX 7: THERAPEUTIC EXERCISE PROTOCOL FOR LATERAL ELBOW 
TENDINOPATHY 
Recommendations for carrying out the exercises / Recommendations for carrying out the exercises: 
- 
Frequency of performance: 4 days a week. / Frequency of performance: 4 days per week. 
- 
Repetitions: 2 sets of 10 repetitions. / Reps: 2 sets of 10 reps. 
- 
Objective: to work on mobility, strength, endurance and functionality. / Objective: to work on 
mobility, strength, endurance and functionality. 
- 
On the days that you attend physiotherapy (two days a week), you can take the opportunity 
to perform the exercises at the center and the rest of the days, you will have to do them at 
home. / The days you attend physiotherapy (two days a week), you can take advantage of it 
to perform the exercises at the center and the rest of the days, you must do them at home. 
- 
Progression criteria:  
o 
Increase/decrease the load of exercises with weight, repetitions, joint range or speed 
depending on the pain presented or the ease of execution. / Increase/decrease the 
load of exercises with weight, repetitions, joint range or speed depending on the pain 
you present or the ease of execution. 
o 
If there is no increase in pain during the 24 hours after performing the exercises. / If 
there is no increase in pain during the 24 hours after performing the exercises. 
- 
Cannot exceed an EVA of 5 during the performance of the exercises (feeling of discomfort 
but not intense pain) / Cannot exceed an EVA of 5 during the performance of the exercises 
(feeling of discomfort but not intense pain). 
- 
One day a week the physiotherapist will carry out an assessment to decide on the 
progression of the exercises. / One day a week the physiotherapist will carry out an 
assessment to decide on the progression of the exercises. 
 
1- Simple Grip & Counter-Resistance / Simple & Counter-Resistance Grip: 
 
 
 
PROGRESSION OF 
EXERCISES/PROGRESSION OF 
EXERCISES: 
A) FIRST WEEK / FIRST WEEK: 
close your hand for 5 seconds and 
open it / close your hand for 5 
seconds and open it. 
B) SEGONA SETMANA / SECOND 
WEEK: to hold the most 5 seconds 
prement a pilot and relax / close 
the hand for 5 seconds, squeezing 
a ball and relaxing. 
C) THIRD WEEK / THIRD WEEK: 
throwing the ball against the 
ground and catching it / throwing 

 
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2- Wrist extension without and with weight / Wrist extension without and with weight: 
 
 
 
 
 
      
 
 
 
 
 
 
     
 
 
PROGRESSION OF 
EXERCISES/PROGRESSION OF 
EXERCISES: 
A) FIRST WEEK / FIRST WEEK: hold wrist 
extension by resisting with the opposite 
hand, for 5 seconds and relax / hold 
wrist extension by resisting with the 
opposite hand, for 5 seconds and relax. 
B) SEGUNDA SEMANA / SEGUNDA 
SEMANA: wrist extension with weight 
(1/2 liter bottle) for 5 seconds and relax / 
wrist extension with weight (1/2 liter 
bottle) for 5 seconds and relax. 
C) THIRD WEEK / THIRD WEEK: wrist 
extension with weight (1 liter bottle) for 5 
seconds and relax / wrist extension with 
weight (1 liter bottle) for 5 seconds and 
relax. 

 
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3- Opening and extension of fingers against resistance / Opening and extension of fingers 
against resistance: 
 
 
 
 
    
 
 
 
 
   
        
 
 
      
 
 
 
PROGRESSION OF 
EXERCISES/PROGRESSION OF 
EXERCISES: 
FIRST WEEK / FIRST WEEK: to separate 
fingers from the hand against the resistance 
of an eraser / to separate fingers from the 
hand using the resistance of an eraser. 
SEGUNDA SEMANA / SEGUNDA SEMANA: 
separate fingers of the hand against the 
resistance of two erasers / separate fingers of 
the hand using the resistance of two erasers. 

 
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4- Supination without and with elastic band / Supination without and with elastic band: 
 
 
 
 
 
 
 
 
 
 
     
 
 
     
 
 
 
 
PROGRESSION OF EXERCISES/PROGRESSION OF 
EXERCISES: 
A) PRIMERA SEMANA / PRIMERA SEMANA: 
starting from the pronation, go towards the 
supination with the hand on the table (palm of the 
hand up and down) / starting from the pronation, 
go towards the supination with the hand on the 
table (palm of the hand up and down). 
B) SEGUNDA SEMANA / SEGUNDA SEMANA: use 
a glove or rubber band to turn the palm upwards / 
use a glove or rubber band to turn the palm of the 
hand upwards. 
C) THIRD WEEK / THIRD WEEK: use double glove / 
use double glove. 

 
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5- Radial deviation without and with weight. Functionality / Radial deviation without and with 
weight. Functionality: 
 
 
 
 
 
 
 
 
 
     
 
 
     
 
 
PROGRESSION OF 
EXERCISES/PROGRESSION OF 
EXERCISES: 
A) FIRST WEEK / FIRST WEEK: place the 
arm in a neutral position with the thumb 
facing the ceiling. Raise and lower your 
thumb. / Place your arm in a neutral 
position with your thumb facing the 
ceiling. Raise and lower your thumb. 
B) SEGUNDA SEMANA / SEGUNDA 
SEMANA: same previous exercise using 
a half liter bottle / mismo ejercicio anterior 
usando una botella de medio litro. 
C) THIRD WEEK / THIRD WEEK: fer com si 
estigués bevent aigua d'una ampolla de 
litre i mig / to make as if he were drinking 
water from a liter and a half bottle. 

 
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6- Epicondylia musculature stretching / Epicondylar musculature stretching: 
 
 
 
 
 
 
 
PROGRESSION OF EXERCISES/PROGRESSION OF 
EXERCISES: 
A) FIRST WEEK / FIRST WEEK: flex the wrist with 
the open fist. Hold the position for 15 seconds / 
bend the wrist with the fist open. Hold the position 
for 15 seconds. 
B) SEGUNDA SEMANA / SEGUNDA SEMANA: flex 
the wrist with the fist closed. Hold the position for 
15 seconds / bend the wrist with the fist closed. 
Hold the position for 5 seconds. 

 
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7- Epitrochlear muscle stretching / Epitrochlear muscle stretching: 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
8- Self-massage of the epicondylar muscles / Self-massage of the epicondylar muscles: 
 
 
 
                                                              
 
PROGRESSION OF EXERCISES/PROGRESSION 
OF EXERCISES: 
Extend the wrist with the fist open. Hold the position 
for 15 seconds / Extend the wrist with the fist open. 
 
PROGRESSION OF EXERCISES/PROGRESSION 
OF EXERCISES: 
SELF-MASSAGE: perform self-massage of the 
forearm muscles (between elbow and wrist), gently, 
between 2 and 5 minutes / perform self-massage of 
the forearm muscles (between elbow and wrist), 
gently, between 3 and 5 minutes. 

 
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ANNEX 8: HEALTH EDUCATION SHEET. RECOMMENDATIONS 
 
HEALTH INFORMATION SHEET: EPICONDYLITIS 
What is tennis player's epincondylitis or elbow? 
 Tennis elbow epicondylitis is characterized by pain on the outside of the elbow, where the tendons 
of the extensor muscles of the wrist are inserted. It is an injury frequently related to repetitive 
movements of the elbow and hand, during sports and work or domestic activities, which require 
intense force in inappropriate postures. 
                  
 
It is manifested by pain and sensitivity on the outside of the elbow accompanied by a lack of claw 
strength and the functionality of the upper limb that makes it difficult to perform usual tasks such as 
lifting a glass, shaking hands, holding a tool, getting dressed... It affects, therefore, the quality of life 
of the individual. 
                        
 
In order to manage pain, improve strength and recover previous function, in addition to rehabilitative 
treatment, health education and modification of activity are recommended. 
It can be prevented by trying to avoid forced and repetitive movements: 
- 
Repetitive movements with the elbow in extension with or without resistance. 
- 
Forced wrist movements. 
- 
Prolonged periods keeping the arms elevated. 
- 
Handling of heavy loads >20 Kg plus 10 times a day. 
- 
Repetitive movements for more than 2 hours a day. 
 
                               
 
Therefore, it is recommended: 
- 
Avoid fast, repetitive and forced movements. 
- 
Avoid static and uncomfortable/immobile positions:  
o 
Elbow at 90º.  
o 
Arms attached to the body. 

 
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o 
Wrist in neutral position.    
 
                 
                  
 
o 
Use both hands to pick up weights. 
 
 
- 
Use light utensils and wide, ergonomic handles. 
- 
Alternate periods of activity and rest.  
 
 
 
- 
Encourage the change of tasks or modify those that cause pain. 
- 
Use adaptations or support products to carry out daily tasks. 
              
        
   
 
Bibliographic reference: 
 
- 
UPTODATE. AUTHOR: Neeru Jayanthi, MD  SECTION EDITOR:Karl B Fields, MD 
DEPUTY EDITOR Jonathan S Grayzel, MD. Contributor Disclosures. All topics are updated 
as new evidence becomes available and ourpeer review processis complete. Literature review 
current through:Jan 2025. This topic last updated:Oct 11, 2024. 
- 
Tran T, Falkmer T, Ciccarelli M. Do hand therapists have a role in workplace-based education 
to manage tennis elbow? Beliefs about effective treatments among Australian hand therapists 
and medical practitioners. Work. 2020; 66(3):539-549. doi: 10.3233/WOR-203196. PMID: 
32623416. 
- 
Images: https://www.istockphoto.com/ 
 
 

 
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HEALTH INFORMATION SHEET: EPICONDYLITIS 
  
What is epincondylitis or tennis elbow? 
 Epicondylitis or tennis elbow is characterized by pain on the outside of the elbow, where the tendons 
of the wrist extensor muscles are inserted. It is an injury frequently related to repetitive movements 
of the elbow and hand, during sports and work or domestic activities, which require intense force in 
inappropriate postures. 
            
                  
 
It is manifested by pain and sensitivity to the outside of the elbow accompanied by a lack of claw 
strength and functionality of the upper limb that makes it difficult to perform usual tasks such as lifting 
a glass, shaking hands, holding a tool, getting dressed... It therefore affects the quality of life of the 
individual. 
                        
 
For pain management, improvement of strength and recovery of previous function, in addition to 
rehabilitation treatment, health education and activity modification are recommended. 
It can be prevented by trying to avoid forced and repetitive movements: 
- Repetitive movements with the elbow in extension with or without resistance. 
- Forced wrist movements. 
- Prolonged periods of keeping your arms elevated. 
- Handling of heavy loads >20 kg, more than 10 times a day. 
- Repetitive movements for more than 2 hours a day. 
  
                               
 
Therefore, it is recommended: 
- Avoid fast, repetitive and forced movements. 
- Avoid static and uncomfortable/immobile positions: 
the Codo at 90º. 
o Arms close to the body. 
o Wrist in neutral position. 

 
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o Use both hands to pick up weights. 
 
 
 
- Use light utensils and wide, ergonomic handles. 
- Alternate periods of activity and rest. 
  
 
  
- Encourage the change of tasks or modify those that cause pain. 
- Use adaptations or support products to carry out daily activities. 
              
        
   
 
 
 
 
 
 
 
 

 
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ANNEX 9: RECORD OF EXERCISES CARRIED OUT 
Record of exercises carried out 
DATA 
Exercises carried out 
Dedication time 
Comments 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
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ANNEX 10: SUPER INDUCTIVE SYSTEM MANUAL 
The BTL Super Inductive System (SIS) can be consulted at the following link: 
https://www.fisioterapia-madrid.com/btl-6000-sistema-super-inductivo/ 
"BTL–6000 SUPER INDUCTIVE SYSTEM: What is it, how does it work and what is it used for? 
The Super Inductive System (SSI) is an innovative technology that uses high-intensity 
electromagnetic fields to stimulate biological tissues. The BTL-6000 is a medical device that applies 
this technology for therapeutic and rehabilitation purposes. 
What is the super inductive system? 
The super-inductive system is a non-invasive method that generates a high-frequency, high-intensity 
pulsed electromagnetic field. This field penetrates the human body and produces an electric current 
in the cells, causing a number of beneficial physiological effects. 
How does the super inductive system work? 
The super-inductive system is based on the principle of electromagnetic induction, which consists of 
generating an electric current in a conductor when it is exposed to a variable magnetic field. The 
BTL-6000 uses a special coil that creates a pulsed magnetic field of up to 2.5 Tesla, which is 
equivalent to 50,000 times the Earth's magnetic field. 
The magnetic field generated by the coil induces an electric current in biological tissues, especially 
muscles, nerves, and bones. This current stimulates cell activity, improves blood circulation, reduces 
inflammation, relieves pain and promotes tissue regeneration. 
What is the super inductive system used for? 
The super-inductive system has multiple clinical applications, both in the field of sports medicine and 
in neurological and orthopaedic rehabilitation.  
Some of the most common indications are: 
– 
Treatment of chronic and acute pain of musculoskeletal origin, such as lumbar, cervical, joint 
or myofascial pain. 
– 
Functional recovery from muscle, tendon, ligamentous or joint injuries, such as sprains, 
strains, fibrillar ruptures or osteoarthritis. 
– 
Prevention and treatment of muscle atrophy due to disuse or nerve injury. 
– 
Muscle strengthening and improvement of sports performance. 
– 
Stimulation of bone healing in fractures or pseudoarthrosis. 
– 
Stimulation of the healing of wounds and skin ulcers. 
The super inductive system is a safe, effective and comfortable therapy for the patient, as it does not 
require any direct contact with the skin or cause any undesirable side effects. The BTL-6000 allows 
the treatment parameters to be adjusted according to the needs and tolerance of each person, 
offering fast and long-lasting results." 
 
 
 
 
 
 
 

 
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ANNEX 11: CE MARKING OF THE SIS 
 
 
 
 
 
 
 
 
 
 

 
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ANNEX 12: DIVERSION AND INTERVENTION CIRCUIT 
 
 
RHEUMATOLO
GIST 

 
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ANNEX 13: PROJECT SCHEDULE 
 
SCHEDULE 
 
 
 
2025 
2026 
2027 
Phases 
Activity 
G 
F 
M 
A 
Mg 
J 
E-
Ma
il 
S 
O
r 
N 
D 
G 
F 
M 
A 
Mg 
J 
Jl 
S 
O 
N 
D 
G 
F 
M 
A 
m
g 
J 
Jl 
S 
O 
N 
D 
PREPARATION 
Project design 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Literature review 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Feasibility analysis 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Prepare draft and report 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Obtain permits and CEIC 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Search for funding 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Training of professionals 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sample Selection (Convenience Sampling) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Contacting participants 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EXECUTION 
Interview with participants (CI, FIP, GI-GC 
assignment) 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Initial questionnaire - Intervention 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Follow-up at 3 and 6 months 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Data collection and statistical analysis 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Obtaining results 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
FI 
Prepare results report 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Dissemination of project results 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
G: January, F: February, M: March, A: April, Mg: May, J: June, Jl: July, S: September, O: October, N: November, D: December 
 

 
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ANNEX 14: PARTICIPATING CENTRES AND IPS OF THE CENTRES 
 
PARTICIPATING CENTRES AND IPS OF THE CENTRES 
IP Name 
Research center/University 
 Professional 
category 
Role in the project 
M. Carmen Sánchez Mato 
 CAP-II 
Mataró-Maresme 
Rehabilitation 
Service. 
North 
Metropolitan Territorial Management. Catalan Institute of 
Health. 
 Physiotherapist 
Principal Investigator 
Luisa Acosta Moreno 
Sant Andreu Rehabilitation and Physiotherapy Unit. Territorial 
Management of Barcelona. Catalan Institute of Health. 
 Physiotherapist 
Research collaborator 
Mario Martín Sánchez 
Drassanes Rehabilitation and Physiotherapy Unit. Coastal 
Territorial Management / Left of Barcelona. Catalan Institute of 
Health. 
 Physiotherapist 
Research collaborator 
Anna Escribà Salvans 
University of Vic – Central University of Catalonia (UVIC-UCC). 
 Physiotherapist 
Doctor 
Doctoral Thesis Director 
Ramón Arroyo Aljaro 
Sant Andreu Rehabilitation and Physiotherapy Unit, Drassanes, 
Numancia. Territorial Management of Barcelona. Catalan 
Institute of Health. 
 Rehabilitation 
Doctor. PhD 
Doctoral Thesis Director 
 
Primary IP Contact:  
- 
Mail: csanchezm.ics@gengat.cat 
- 
Telephone: 667 61 73 54