Clinical trial NCT04219488: Investigating the Effects of Neuromobilization in Lateral Epicondylitis
Official title: Comparison of the Effects of Neuromobilization and Conservative Rehabilitation Therapy on Pain, Grip Strength and Functional Status in Lateral Epicondylitis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Tennis Elbow
Lateral Epicondylitis
Keywords: eccentric exercise
radial nerve mobilization
Lead sponsor: KTO Karatay University
Sponsor class: OTHER
First posted: 2020-01-07
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Parallel Assignment
Primary purpose: TREATMENT

Brief summary: This study aimed to determine the effects of neuromobilization techniques and conservative rehabilitation therapy on pain, grip strength, and functional status in patients with lateral epicondylitis (LE). A total of 40 patients (26 females and 14 males; age: 42.80 ± 8.91 years) with a history of LE participated in the study. The patients were randomly assigned to two groups: the neuromobilization group and the control group. The neuromobilization group completed a 6-week conservative rehabilitation and radial nerve mobilization program, whereas the control group received conservative rehabilitation therapy only. Both groups underwent a 7-day weekly conservative home rehabilitation program. Pain severity, grip strength, pinch strength, joint mobility, and upper extremity functional level were assessed before treatment, at the third week, after treatment, and at the sixth week after treatment.

Detailed description: Lateral epicondylitis (LE) is a painful situation, which usually occurs due to the overuse of the wrist extensor muscles. The prevalence of LE is 1%-3% in both men and women, and it is highest in individuals aged \>40 years. Pain and tenderness over the lateral epicondyle of the humerus at the origin of the common extensor tendon are the main characteristics. Different conservative treatment methods have been used for treating LE; however, no standard protocol has been documented in the literature. Physiotherapy programs have focused on relieving pain, controlling inflammation, and increasing muscle strength and endurance. The use of eccentric strengthening programs has been supported by current research. Eccentric exercises have been demonstrated to reduce pain and increase function in patients with LE. Recently, neuromobilization techniques have been employed in treating musculoskeletal problems and various compression syndromes. These techniques aimed to provide nerve gliding via joint movements wherein a therapist extends the nerve length in one joint while shortening the same in the adjacent joint. This tensioning technique increases the distance between each end of the nerve, and this neural elongation ability significantly decreases in patients with LE. Neuromobilization techniques have been also proposed to modulate central sensitization and peripheral pain mechanisms in musculoskeletal disorders. Given that central sensitization plays an important role in the increased nociceptive reflex and hyperalgesia in LE, inducing hypoalgesia via neuromobilization techniques may provide pain relief in the long term.

Eligibility criteria: Inclusion Criteria:

* Patients aged \>18 years
* A symptom duration of \>3 months

Exclusion Criteria:

* Bilateral symptoms
* Rheumatologic diseases affecting the elbow and the wrist
* Musculoskeletal disorders due to connective tissue diseases
* Diffuse pain syndrome
* Cervical radiculopathy
* Nerve compression syndromes involving upper extremity
* Undergone surgery at the affected arm
* Received an LE treatment in the last 6 months
* An inability to perform the exercises

Primary outcomes:
measure: Pain severity
timeFrame: at the beginning of treatment
measure: Pain severity
timeFrame: 3 weeks later
measure: Pain severity
timeFrame: 6 weeks later
measure: Pain severity
timeFrame: 12 weeks later
measure: Grip strength
timeFrame: at the beginning of treatment
measure: Grip strength
timeFrame: 3 weeks later
measure: Grip strength
timeFrame: 6 weeks later
measure: Grip strength
timeFrame: 12 weeks later
measure: Tip pinch and key pinch
timeFrame: at the beginning of treatment
measure: Tip pinch and key pinch
timeFrame: 3 weeks later
measure: Tip pinch and key pinch
timeFrame: 6 weeks later
measure: Tip pinch and key pinch
timeFrame: 12 weeks later
Secondary outcomes:
measure: Wrist active range of motion (ROM)'s
timeFrame: at the beginning of treatment
measure: Wrist active range of motion (ROM)'s
timeFrame: 3 weeks later
measure: Wrist active range of motion (ROM)'s
timeFrame: 6 weeks later
measure: Wrist active range of motion (ROM)'s
timeFrame: 12 weeks later
measure: The functional status of the upper extremity
timeFrame: at the beginning of treatment
measure: The functional status of the upper extremity
timeFrame: 3 weeks later
measure: The functional status of the upper extremity
timeFrame: 6 weeks later
measure: The functional status of the upper extremity
timeFrame: 12 weeks later
Other outcomes:
Locations:
city: Konya
country: Turkey
facility: KTO Karatay University
Study officials:
affiliation: KTO Karatay University
name: Kamil Yılmaz, 1
role: PRINCIPAL_INVESTIGATOR
References: