Lateral EpicondylitisNCT07604454
Muscle Energy Technique Combined With Mulligan Technique in Tennis Elbow
A study testing Muscle Energy Technique Combined With Mulligan Technique and Mulligan Mobilization With Movement in people with Lateral Epicondylitis and Tennis Elbow, run by University of Lahore at 1 site in Pakistan.
Trial summary
This randomized controlled trial aims to evaluate the effectiveness of Muscle Energy Technique (MET) combined with Mulligan Mobilization With Movement (MWM) in patients with lateral epicondylitis (tennis elbow). The study compares the combined intervention with Mulligan technique and routine physical therapy alone. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Lateral Epicondylitis, Tennis Elbow
- What is being tested?
- Muscle Energy Technique Combined With Mulligan Technique and Mulligan Mobilization With Movement
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 26 Sep 2025to 25 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age between 18 and 45 years
- Both genders
- Unilateral lateral epicondylitis
- Diagnosed by senior physiotherapist
- Pain duration of at least 6 weeks
- Pain score ≥7 on NPRS/VAS
- Positive symptoms during extensor carpi radialis brevis and longus isometric contraction
Who cannot join
- Previous elbow or shoulder surgery
- Manual therapy within previous 6 months
- History of fracture, dislocation, or tendon tear
- Steroid or pain medication use
- Peripheral nerve entrapment
- Cervical radiculopathy
- Osteoporosis or metastasis involving elbow
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
University of Lahore Teaching Hospital, Lahore
Lahore, Punjab Province
About this study
Official title: Effectiveness of Muscle Energy Technique Combined With Mulligan Mobilization Among Patients With Lateral Epicondylitis: A Randomized Controlled Trial
This randomized controlled trial aims to evaluate the effectiveness of Muscle Energy Technique (MET) combined with Mulligan Mobilization With Movement (MWM) in patients with lateral epicondylitis (tennis elbow). The study compares the combined intervention with Mulligan technique and routine physical therapy alone. Outcomes including pain intensity, functional disability, and quality of life will be assessed using NPRS, PRTEE, and SF-8 questionnaires over a four-week treatment period.
Read the detailed description
Lateral epicondylitis, commonly known as tennis elbow, is a musculoskeletal disorder characterized by pain and reduced functional ability affecting the lateral aspect of the elbow. It commonly results from repetitive wrist extension and forearm movements leading to overuse of the extensor tendons.
Conservative physiotherapy management including manual therapy and therapeutic exercises is widely used for the treatment of lateral epicondylitis. Mulligan Mobilization With Movement (MWM) has shown beneficial effects in reducing pain and improving grip strength and functional mobility. Muscle Energy Technique (MET) is another manual therapy approach that may help improve joint mobility, muscle flexibility, and pain reduction through controlled isometric contractions.
This study aims to determine whether combining MET with Mulligan technique provides superior clinical outcomes compared to Mulligan technique alone in patients with tennis elbow.
Participants will be randomly allocated into two groups:
Experimental Group: MET + MWM + Routine Physical Therapy Control Group: MWM + Routine Physical Therapy
Treatment will be provided five sessions per week for four weeks. Outcomes will be assessed at baseline and after completion of the intervention period.
- Conditions
- Lateral Epicondylitis, Tennis Elbow
- Being tested
- Muscle Energy Technique Combined With Mulligan Technique, Mulligan Mobilization With Movement
- Keywords
- Tennis Elbow, Lateral Epicondylitis, Muscle Energy Technique, Mulligan Technique, Mobilization With Movement
- Medical subject headings
- Tennis Elbow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Muscle Energy Technique Combined With Mulligan TechniqueProcedure or surgery
Muscle Energy Technique will be applied using resisted isometric contractions of forearm supination and pronation. Mulligan Mobilization With Movement will be applied using sustained lateral glide during pain-free gripping activity. Treatment sessions will be conducted five times weekly for four weeks.
Mulligan Mobilization With MovementProcedure or surgery
Mulligan Mobilization With Movement technique will be applied using sustained glide of the forearm while participants perform pain-free gripping activities. Sessions will be conducted five times weekly for four weeks.
| Study group | Role | What they receive |
|---|---|---|
| Experimental Group (MET + MWM + Routine Physical Therapy) | Experimental | Participants in this group will receive Muscle Energy Technique combined with Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises for wrist extensors. Receives: Procedure: Muscle Energy Technique Combined With Mulligan Technique |
| Control Group (MWM + Routine Physical Therapy) | Active comparator | Participants in this group will receive Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises. Receives: Procedure: Mulligan Mobilization With Movement |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)
Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
Measured: Baseline and after 4 weeks of intervention
Secondary outcomes (2)
Functional Disability Measured by PRTEE Questionnaire
Functional disability will be assessed using the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire.
Measured: Baseline and after 4 weeks of intervention
Quality of Life Measured by SF-8 Questionnaire
Quality of life will be assessed using the Short Form-8 (SF-8) questionnaire. The SF-8 is an 8-item questionnaire that evaluates physical functioning, general health, pain, vitality, social functioning, emotional role, mental health, and physical role limitations. Higher scores indicate better quality of life.
Measured: Baseline and after 4 weeks of intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 May 2026
- Study start26 Sep 2025
- Primary completion28 Oct 2025
- Study completion25 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Lateral EpicondylitisStudies of the same condition, open and under way.
- More trials run by University of LahoreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomly assigned into two parallel groups. One group will receive Muscle Energy Technique combined with Mulligan Mobilization With Movement and routine physical therapy, while the control group will receive Mulligan Mobilization With Movement with routine physical therapy alone.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Lahore
- Sponsor type
- University, hospital or other
- Collaborators
- University of Lahore Hospital (ULH)
- Responsible party
- Principal investigator, Aman Zahra, University of Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07604454
- Sponsor's protocol ID
- UOL/IREB/25/12/0027
- Status last verified
- May 2026
- First submitted
- 17 May 2026
- Last updated
- 22 May 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared because this study was conducted as an academic research project. The informed consent obtained from participants did not include provisions for public data sharing, and the dataset contains sensitive personal health information. Data will be stored securely and used only for academic and research purposes in accordance with institutional ethics approval.
Publications
Bowman EN. Current concepts: pathology in the overhead athlete's lateral elbow. J Shoulder Elbow Surg. 2024 Feb;33(2):507-511. doi: 10.1016/j.jse.2023.08.017. Epub 2023 Sep 27.
PubMed 37774828Blanchette MA, Normand MC. Augmented soft tissue mobilization vs natural history in the treatment of lateral epicondylitis: a pilot study. J Manipulative Physiol Ther. 2011 Feb;34(2):123-30. doi: 10.1016/j.jmpt.2010.12.001.
PubMed 21334545Bazancir Z, Firat T. A potential factor in the pathophysiology of lateral epicondylitis: The long sarcomere length of the extensor carpi radialis brevis muscle and implications for physiotherapy. Med Hypotheses. 2019 Sep;130:109278. doi: 10.1016/j.mehy.2019.109278. Epub 2019 Jun 12.
PubMed 31383324Bagcaci S, Unuvar BS, Gercek H, Ugurlu I, Sert OA, Yilmaz K. A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. J Back Musculoskelet Rehabil. 2023;36(2):419-427. doi: 10.3233/BMR-220061.
PubMed 36120766Alagaesan, J., & Nirmala, J. G. (2024). Effectiveness of Mulligan Mobilization Technique Versus Cyriax Technique for Lateral Epicondylitis: A Pilot Study. Indian Journal of Physiotherapy & Occupational Therapy, 18.
Akbar H, Akbar S, Saddique MN, Sarfraz MS. Prevalence of lateral epicondylitis among housewives in Lahore: a cross-sectional study. BMC Musculoskelet Disord. 2024 Oct 15;25(1):815. doi: 10.1186/s12891-024-07889-x.
PubMed 39407258Ahmed A, Ibrar M, Arsh A, Wali S, Hayat S, Abass S. Comparing the effectiveness of Mulligan mobilization versus Cyriax approach in the management of patients with subacute lateral epicondylitis. J Pak Med Assoc. 2021 Jan;71(1(A)):12-15. doi: 10.47391/JPMA.186.
PubMed 33484510Afzal, M., Zakaullah, S., Memon, S. I., Nisar, A., Touqeer, H., & Shabir, H. (2021). Prevalence and risk factors of lateral epicondylitis among restaurant cooks at district Gujranwala: A cross-sectional study. Rawal Medical Journal, 46(2), 338.
Aben A, De Wilde L, Hollevoet N, Henriquez C, Vandeweerdt M, Ponnet K, Van Tongel A. Tennis elbow: associated psychological factors. J Shoulder Elbow Surg. 2018 Mar;27(3):387-392. doi: 10.1016/j.jse.2017.11.033.
PubMed 29433642Abd Elrahim, R. M., Ali, M. F., Elwerdany, S. H., Salama, A. M., & Elsayed, M. (2022). Mulligan mobilisation with movement versus deep friction massage in patients with lateral epicondylitis. J Pharm Negat Results, 13, 5184-5192.
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effectiveness of Muscle Energy Technique Combined With Mulligan Mobilization Among Patients With Lateral Epicondylitis: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07604454
- Acronym / sponsor ID
- UOL/IREB/25/12/0027
- Conditions
- Lateral Epicondylitis, Tennis Elbow
- Keywords
- Tennis Elbow, Lateral Epicondylitis, Muscle Energy Technique, Mulligan Technique, Mobilization With Movement
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- University of LahoreUniversity, hospital or other
- Collaborators
- University of Lahore Hospital (ULH)
- Study start
- 26 Sep 2025 (actual)
- Primary completion
- 28 Oct 2025 (actual)
- Study completion
- 25 Jan 2026 (actual)
- First posted
- 22 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized controlled trial aims to evaluate the effectiveness of Muscle Energy Technique (MET) combined with Mulligan Mobilization With Movement (MWM) in patients with lateral epicondylitis (tennis elbow). The study compares the combined intervention with Mulligan technique and routine physical therapy alone. Outcomes including pain intensity, functional disability, and quality of life will be assessed using NPRS, PRTEE, and SF-8 questionnaires over a four-week treatment period.
Detailed description
Lateral epicondylitis, commonly known as tennis elbow, is a musculoskeletal disorder characterized by pain and reduced functional ability affecting the lateral aspect of the elbow. It commonly results from repetitive wrist extension and forearm movements leading to overuse of the extensor tendons.
Conservative physiotherapy management including manual therapy and therapeutic exercises is widely used for the treatment of lateral epicondylitis. Mulligan Mobilization With Movement (MWM) has shown beneficial effects in reducing pain and improving grip strength and functional mobility. Muscle Energy Technique (MET) is another manual therapy approach that may help improve joint mobility, muscle flexibility, and pain reduction through controlled isometric contractions.
This study aims to determine whether combining MET with Mulligan technique provides superior clinical outcomes compared to Mulligan technique alone in patients with tennis elbow.
Participants will be randomly allocated into two groups:
Experimental Group: MET + MWM + Routine Physical Therapy Control Group: MWM + Routine Physical Therapy
Treatment will be provided five sessions per week for four weeks. Outcomes will be assessed at baseline and after completion of the intervention period.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomly assigned into two parallel groups. One group will receive Muscle Energy Technique combined with Mulligan Mobilization With Movement and routine physical therapy, while the control group will receive Mulligan Mobilization With Movement with routine physical therapy alone.
| Arm | Type | Receives |
|---|---|---|
| Experimental Group (MET + MWM + Routine Physical Therapy) | Experimental | Procedure: Muscle Energy Technique Combined With Mulligan TechniqueParticipants in this group will receive Muscle Energy Technique combined with Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises for wrist extensors. |
| Control Group (MWM + Routine Physical Therapy) | Active comparator | Procedure: Mulligan Mobilization With MovementParticipants in this group will receive Mulligan Mobilization With Movement along with routine physical therapy including eccentric strengthening and stretching exercises. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age between 18 and 45 years
- Both genders
- Unilateral lateral epicondylitis
- Diagnosed by senior physiotherapist
- Pain duration of at least 6 weeks
Key exclusion criteria (7 listed)
- Previous elbow or shoulder surgery
- Manual therapy within previous 6 months
- History of fracture, dislocation, or tendon tear
- Steroid or pain medication use
- Peripheral nerve entrapment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Muscle Energy Technique Combined With Mulligan TechniqueMuscle Energy Technique will be applied using resisted isometric contractions of forearm supination and pronation. Mulligan Mobilization With Movement will be applied using sustained lateral glide during pain-free gripping activity. Treatment sessions will be conducted five times weekly for four weeks. | Procedure or surgery | Experimental Group (MET + MWM + Routine Physical Therapy) |
| Mulligan Mobilization With MovementMulligan Mobilization With Movement technique will be applied using sustained glide of the forearm while participants perform pain-free gripping activities. Sessions will be conducted five times weekly for four weeks. | Procedure or surgery | Control Group (MWM + Routine Physical Therapy) |
Primary outcome
Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)
Time frame: Baseline and after 4 weeks of intervention
Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).
2 secondary outcomes
Functional Disability Measured by PRTEE Questionnaire
Time frame: Baseline and after 4 weeks of intervention
Quality of Life Measured by SF-8 Questionnaire
Time frame: Baseline and after 4 weeks of intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2026.
- Background: PubMed 37774828Bowman EN. Current concepts: pathology in the overhead athlete's lateral elbow. J Shoulder Elbow Surg. 2024 Feb;33(2):507-511. doi: 10.1016/j.jse.2023.08.017. Epub 2023 Sep 27.
- Background: PubMed 21334545Blanchette MA, Normand MC. Augmented soft tissue mobilization vs natural history in the treatment of lateral epicondylitis: a pilot study. J Manipulative Physiol Ther. 2011 Feb;34(2):123-30. doi: 10.1016/j.jmpt.2010.12.001.
- Background: PubMed 31383324Bazancir Z, Firat T. A potential factor in the pathophysiology of lateral epicondylitis: The long sarcomere length of the extensor carpi radialis brevis muscle and implications for physiotherapy. Med Hypotheses. 2019 Sep;130:109278. doi: 10.1016/j.mehy.2019.109278. Epub 2019 Jun 12.
- Background: PubMed 36120766Bagcaci S, Unuvar BS, Gercek H, Ugurlu I, Sert OA, Yilmaz K. A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. J Back Musculoskelet Rehabil. 2023;36(2):419-427. doi: 10.3233/BMR-220061.
- BackgroundAlagaesan, J., & Nirmala, J. G. (2024). Effectiveness of Mulligan Mobilization Technique Versus Cyriax Technique for Lateral Epicondylitis: A Pilot Study. Indian Journal of Physiotherapy & Occupational Therapy, 18.
- Background: PubMed 39407258Akbar H, Akbar S, Saddique MN, Sarfraz MS. Prevalence of lateral epicondylitis among housewives in Lahore: a cross-sectional study. BMC Musculoskelet Disord. 2024 Oct 15;25(1):815. doi: 10.1186/s12891-024-07889-x.
- Background: PubMed 33484510Ahmed A, Ibrar M, Arsh A, Wali S, Hayat S, Abass S. Comparing the effectiveness of Mulligan mobilization versus Cyriax approach in the management of patients with subacute lateral epicondylitis. J Pak Med Assoc. 2021 Jan;71(1(A)):12-15. doi: 10.47391/JPMA.186.
- BackgroundAfzal, M., Zakaullah, S., Memon, S. I., Nisar, A., Touqeer, H., & Shabir, H. (2021). Prevalence and risk factors of lateral epicondylitis among restaurant cooks at district Gujranwala: A cross-sectional study. Rawal Medical Journal, 46(2), 338.
- Background: PubMed 29433642Aben A, De Wilde L, Hollevoet N, Henriquez C, Vandeweerdt M, Ponnet K, Van Tongel A. Tennis elbow: associated psychological factors. J Shoulder Elbow Surg. 2018 Mar;27(3):387-392. doi: 10.1016/j.jse.2017.11.033.
- BackgroundAbd Elrahim, R. M., Ali, M. F., Elwerdany, S. H., Salama, A. M., & Elsayed, M. (2022). Mulligan mobilisation with movement versus deep friction massage in patients with lateral epicondylitis. J Pharm Negat Results, 13, 5184-5192.
- Individual participant dataSharing planned: No. Individual participant data will not be shared because this study was conducted as an academic research project. The informed consent obtained from participants did not include provisions for public data sharing, and the dataset contains sensitive personal health information. Data will be stored securely and used only for academic and research purposes in accordance with institutional ethics approval.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Muscle Energy Technique Combined With Mulligan Technique and Mulligan Mobilization With Movement in people with Lateral Epicondylitis and Tennis Elbow, run by University of Lahore at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 22 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain Intensity Measured by Numeric Pain Rating Scale (NPRS) (time frame: Baseline and after 4 weeks of intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07604454, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2026.