Comparison of Mobilization and MET Post-Traumatic Elbow Stiffness

Study Overview
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Brief Summary
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The purpose of this study is to find the effects of Mobilization and Muscle energy technique in patients with post-traumatic elbow stiffness.

Detailed Description
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A randomized control trial was conducted at Benazir Bhutto Hospital, Rawalpindi. The sample size with reference to parent article was 10 calculated through open epi tool. But 30 patients were included in the study to increase the statistical power of analysis. The participants were divided into two interventional groups i.e. Group A and Group B, each having 15 participants. The study duration was 1 year. Sampling Technique applied was non probability purposive sampling technique. Random Allocation will be through sealed envelope method into two treatment group i.e. Group A and Group B. Only 18-35 years old patients (both male and female) with Post-traumatic elbow stiffness were included in the study. Tools that were used in the study are NPRS, DASH questionnaire, TAMPA scale and Goniometer. Total duration of treatment for both groups was 3 weeks, 3 days a week. Pre and post assessment was done. Data was analyzed through SPSS version 23.

Official Title
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Comparison of Mobilization and Muscle Energy Technique in Patients With Post-Traumatic Elbow Stiffness

Conditions
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Elbow Fracture

Intervention / Treatment
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* Other: Mobilization
* Other: Muscle Energy Technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with post-operative elbow stiffness after distal end extra-articular humerus fractures. Patients with proximal radius ulna fractures. Minimum immobilization period of 3 weeks Exclusion Criteria: Any ligament injury Patients with Diabetes Patients with RA Patients with Pathological fractures Revision surgeries Neuro-vascular disorders.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mobilization<br>Mobilizations are performed with minimum 6 seconds distraction stretch followed by partial release then followed by slow intermittent stretch at 3-4 seconds intervals. Oscillations for 2 minutes at 2-3 oscillations per second. | Other: Mobilization<br>* Hot pack for ten minutes. Active and active-assisted exercises for the: Elbow flexion and extension Wrist flexion and extension Forearm supination and pronation Lock and key exercises. Shoulder flexion, extension, abduction, adduction, and rotation (10 repetitions x 1sets) Low-intensity isometric resistance exercises for; Elbow flexion and extension Forearm supination and pronation (10 sec hold) (10 repetitions x 1 set) Resistance will be provided manually by the therapist. Along all these exercises Mobilisations are performed with minimum 6 seconds distraction stretch followed by partial release then followed by slow intermittent stretch at 3-4 seconds intervals. 3 days per week for 3 weeks. Oscillations for 2 minutes at 2-3 oscillations per second.<br>* Other names: Isometrics;|
| Experimental: Muscle Energy Technique<br>Muscle Energy Technique is given in the form of post isometric relaxation with 5-7 sec hold for 8-10 repetitions followed by a gentle passive stretch. Only 20% resistance is offered to the isometric contraction. | Other: Muscle Energy Technique<br>* Hot pack for ten minutes. Active and active-assisted exercises for the: Elbow flexion and extension Wrist flexion and extension Forearm supination and pronation Lock and key exercises. Shoulder flexion, extension, abduction, adduction, and rotation (10 repetitions x 1sets) Low-intensity isometric resistance exercises for; Elbow flexion and extension Forearm supination and pronation (10 sec hold) (10 repetitions x 1 set) Resistance will be provided manually by the therapist. Along all these exercises Muscle Energy Technique is given in the form of post isometric relaxation with 5-7 sec hold for 8-10 repetitions followed by a gentle passive stretch. Only 20% resistance is offered to the isometric contraction. 3 days per week for 3 weeks.<br>* Other names: Isometrics;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric pain rating scale | Changes from baseline Numeric pain rating scale is a self-administered, or analyst reported, measuring instrument comprising of a scale that shows numerical ranges usually from 0-10 or 0-100. In this scale extreme or farthest point shows having 'no pain' to having 'extreme pain'. | 3rd week | 
| ROM Elbow (Flexion) | Changes from baseline range of motion( ROM) of elbow joint flexion is taken by using Goniometer. | 3rd week | 
| ROM Elbow (Extension) | Changes from baseline range of motion( ROM) of elbow joint extension is taken by using Goniometer. | 3rd week | 
| ROM Forearm (Supination) | Changes from baseline range of motion( ROM) of forearm supination is taken by using Goniometer. | 3rd week | 
| ROM Forearm (Pronation) | Changes from baseline range of motion (ROM) of forearm pronation is taken by using Goniometer. | 3rd week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disability | Changes from baseline disability is measured through DASH (Disability of the arm, shoulder and hand) questionnaire. DASH questionnaire is a self reported area specific outcome measuring tool for symptoms and disabilities in upper limb. It mainly comprise of a 30-items scale which is further consist of questions related to difficulty in performing normal daily activities, scored on 5 response options. Scores for these 30 items then calculate on a scale of 0 (no disability) to 100 (most severe disability) | 3rd week | 
| kinesiophobia (fear of movement) | Changes from baseline kinesiophobia is measured through Tampa scale which is a 17 item scale. Total scores of this scale ranges from 17-68. Where 17 means no kinesiophobia and 68 means severe kinesiophobia while score of ± 37 indicates that there is kinesiophobia. | 3rd week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Post Traumatic Elbow Stiffness, Pain, Elbow, Disability, Fracture