Comparative effect of Action Observation Therapy with Conventional Therapy and Conventional Therapy alone on kinesiophobia, pain and functional disability in patients with lateral epicondylitis: a randomized controlled trial.

The aim of this study is to compare the effect of Action Observation Therapy with Conventional Therapy and Conventional Therapy alone on kinesiophobia, pain and functional disability in patients with lateral epicondylitis. 54 patients clinically diagnosed with lateral epicondylitis between 35 to 50 years of age will be recruited based upon the inclusion criteria and were divided into 2 groups by random allocation, using chit method. Patients in Group A will receive Action Observation Therapy along with Conventional Therapy.  Patients in Group B will receive only Conventional Therapy. Tampa Scale of Kinesiophobia 11 and Patient Rated Tennis Elbow Evaluation Scale will be used as outcome measures to assess kinesiophobia and pain and functional disability respectively. Data will be collected at 3 different timelines that is pre intervention, post intervention at 2nd week and post intervention 4th week.  Collected data will be illustrated in tabular form and analyzed.

Lateral epicondylitis (tennis elbow) describes an overuse injury due to overload of the common extensor tendon origin.  The point of maximal tenderness is usually over the lateral epicondyle. Activity worsens the pain and produces kinesiophobia that is fear of movement, and affect the functional activities of daily living. There are techniques to modulate the pain perception through corticothalamic networks and neural plasticity Action Observation Therapy is one such technique which involves observing purposeful actions with the intention of imitating and then practicing those actions. This approach works through the mirror-neural system of the brain. Addition of Action Observation to conventional physiotherapy can control kinesiophobia and functional disability associated with lateral epicondylitis. Kinesiophobia can have negative influence on the functional outcome and long term recovery.Action Observation therapy might provoke the cortical activations similar to the actual movement execution and reverse the maladaptive neuroplastic changes associated with pain. The associated functional disability might get lessened and produce a greater rehabilitation outcome. Thus, there is a need to find the effect of Action observation therapy on kinesiophobia, pain and functional disability in patients with lateral epicondylitis.

The objectives of this study is to assess kinesiophobia in patients with lateral epicondylitis using Tampa scale of Kinesiophobia TSK 11,  pain and functional disability using Patient Rated Tennis Elbow Evaluation, the effect of Action Observation Therapy with Conventional Therapy on kinesiophobia, pain and functional disability in patients with lateral epicondylitis  and the effect of Conventional Therapy alone on kinesiophobia, pain and functional disability in patients with lateral epicondylitis. The objectives also include comparing the effect of Action Observation Therapy with Conventional Therapy and Conventional Therapy alone on kinesiophobia, pain and functional disability in patients with lateral epicondylitis.

The materials required will be electronic device to showcase videos for action observation therapy, pen, paper, plinth and chair. The tools required will be Numerical pain rating scale to include patients having pain intensity from 3 to 7, Tampa scale of kinesiophobia to asses kinesiophobia and Patient Rated Tennis Elbow Evaluation scale to asses pain and functional disability.

Thus the study will find out whether adding Action Observation Therapy to Conventional Therapy will make a difference in effect in patients with lateral epicondylitis.