Influence of Proximal Motor Control in Treating Lateral Epicondylitis

Not Applicable

• Conditions: Lateral Epicondylitis
• Interventions: Other: Strength of lower trapezius; Other: Strength of middle trapezius; Other: Strength of serratus anterior; Other: Pulsed ultrasound; Other: Stretching of extensor carpi radialis brevis muscle; Other: Eccentric exercises of wrist extensors

• Registration Number: NCT05447468
• Lead Sponsor: Cairo University

Brief Summary

This study will be conducted to investigate the effect of scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening on pain, pain free hand grip strength and functional outcome added to conventional physical therapy in patients with chronic Lateral Epicondylitis.

Detailed Description

This study will try to investigate if scapular muscles strengthening have an effective role on pain, pain free hand grip strength and function when added to conventional physical therapy in patients with LE.

Study Timeline

• Status Verified: 2022-07
• Study First Submitted: 2022-07-01
• Study First Submitted QC: 2022-07-01
• Last Update Submitted: 2022-07-01
• Study First Posted: 2022-07-07
• Last Update Posted: 2022-07-07
• Study Start: 2022-07-15
• Primary Completion: 2022-10-15
• Study Completion: 2022-11-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 52

Inclusion Criteria

1. Symptoms of lateral epicondylitis from at least the past 3 months.
2. Pain in at least two of the following four tests; Tomsen test, Maudsley test, Mill's test and handgrip dynamometer test.
3. Their ages range from 30-50 years old.

Exclusion Criteria

Subjects will be excluded from the study if they have:

1. Peripheral neuropathy.
2. Lesions of upper limb nerves.
3. History of surgery in the affected elbow 6 months ago.
4. Cervical radiculopathy.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
scapular muscles strengthning group	Strength of serratus anterior	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
scapular muscles strengthning group	Pulsed ultrasound	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
scapular muscles strengthning group	Stretching of extensor carpi radialis brevis muscle	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
scapular muscles strengthning group	Eccentric exercises of wrist extensors	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
conventional physiotherapy group	Stretching of extensor carpi radialis brevis muscle	Patients in this group B will receive conventional physiotherapy only (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) 3 sessions per week for 6 weeks.
scapular muscles strengthning group	Strength of lower trapezius	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
scapular muscles strengthning group	Strength of middle trapezius	Patients in this group A will receive scapular muscles (lower trapezius, middle trapezius and serratus anterior) strengthening along with conventional physiotherapy (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) for 6 weeks.
conventional physiotherapy group	Pulsed ultrasound	Patients in this group B will receive conventional physiotherapy only (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) 3 sessions per week for 6 weeks.
conventional physiotherapy group	Eccentric exercises of wrist extensors	Patients in this group B will receive conventional physiotherapy only (pulsed ultrasound, static stretching of ECRB muscle and eccentric exercises of wrist extensors) 3 sessions per week for 6 weeks.

Primary Outcome Measures

Name	Time	Method
Assessment of change in pain intensity	at baseline and after 6 weeks of intervention	Using Visual analouge scale (VAS), a continuous 10 cm line ranges from no pain to very severe pain which is valid and reliable tool. The patient marks on the line the point that they feel represents their pain intensity.
Assessment of change in hand grip strength	at baseline and after 6 weeks of intervention	Patient stands with the elbow in complete extension and the shoulder and radioulnar joints in neutral rotation. Ask the patient to slowly squeeze the dynamometer and to stop the instant discomfort is first felt. It will be performed three repetitions separated by a 20-second rest interval. Average of three trials will be recorded. The measurement is valid and reliable.
Assessment of change in function	at baseline and after 6 weeks of intervention	Using PRTEEQ. It is a 15-item self-reported questionnaire to measure perceived pain and disability in people with LE. It has three subscales: pain, usual activities and specific activities. Each of the items of the Patient rated tennis elbow evaluation questionnaire (PRTEEQ) is scored on a 0-10 scale, where 0 is 'no pain' or 'no difficulty' and10 is 'worst ever' or 'unable to do. Ask the patients to rate the pain and difficulty that they have experienced in the last week by marking the suitable response that reflects their current state. The total score ranges from 0 to 100, where high scores indicate greater pain and disability.

Trial Locations

Locations (1)

Outpatient clinic, Faculty of Physical Therapy, Cairo university; 🇪🇬 Dokki, Egypt