Comparison of Muscle Energy Technique and Oscillating Energy Manual Therapy in Chronic Lateral Epicondylitis

Riphah International University

Status: Completed

Conditions: Lateral Epicondylitis

Treatments: Other: muscle energy technique; Other: oscillating manual energy therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT05354167

REC 01053 Huma mehrin

Details and patient eligibility

About

Lateral epicondylitis (LE) is a painful musculoskeletal condition caused by overuse. The condition is also called tennis elbow because it affects 50% of tennis players, notably beginners learning the one-handed backhand. Nonetheless, only 10% of all patients with LE play tennis. Lateral Epicondylitis (LE) or tennis elbow affects about 1-3% of general population.

Muscle energy technique was developed by osteopathic physician, Fred Mitchell, Sr. It was refined and systematized by Fred Mitchell, Jr., and has continued to evolve with contributions from many individuals.

Full description

Lateral epicondylitis (LE) is a painful musculoskeletal condition caused by overuse. The condition is also called tennis elbow because it affects 50% of tennis players, notably beginners learning the one-handed backhand. Nonetheless, only 10% of all patients with LE play tennis. Lateral Epicondylitis (LE) or tennis elbow affects about 1-3% of general population.

patients with Lateral Epicondylitis complains of pain, functional difficulty affecting activities of daily living related to wrist and forearm movements . The grip strength is affected due to voluntary decline of effort to avoid pain and due to wasting of affecting muscles seen in long standing conditions. The symptoms exacerbate with stressful activities in overuse syndromes but pain may persist even at rest as the condition progress.

Muscle energy technique was developed by osteopathic physician, Fred Mitchell, Sr. It was refined and systematized by Fred Mitchell, Jr., and has continued to evolve with contributions from many individuals. Muscle energy technique (MET) is used by practitioners from different professions and has been advocated for the treatment of shortened muscles, weakened muscles, restricted joints, and lymphatic drainage. In addition to using muscle effort to mobilize joints and tissues, MET is considered by some to be a biomechanics-based analytic diagnostic system that uses precise physical diagnosis evaluation procedures to identify and qualify articular range of motion restriction. MET are defined as a manual treatment in which a patient produces a contraction in a precisely controlled position and direction against a counterforce applied by a manual therapist. MET have been also used in asymptomatic subjects in order to increase mobility. There is varying evidence that when a joint has a functional limitation, the application of a MET can increase its Range of Motion.

A comparative study concluded that oscillating energy manual therapy and muscle energy technique had shown the improvement in Numeric Rating Scale, grip strength and PRTEE in lateral epicondylitis subjects, but more significant improvement was observed in the subjects who were treated with muscle energy technique than oscillating energy manual therapy.

Enrollment: 34 patients

Sex: All

Ages: 25 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Presence of tenderness point on lateral epicondyle.
• Positive cozen test, mills test, Maudsley's test
• Negative Radial nerve test

Exclusion criteria

• Cervical spine disorder
• Peripheral neuropathy
• Fractures
• Major upper limb surgery
• Steroid injections in last 6 months
• Tumor or wound
• take any kind of physiotherapy treatment

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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34 participants in 2 patient groups

muscle energy technique

Experimental group

Description:

the subject to sit comfortably and then stabilize the subject's distal humerus with one hand, then the forearm was supinated with the therapist another hand until resistance appeared. Holding the position the subject was asked to slowly pronate the forearm that is Isometric contraction against resistance for a period of 6-10 seconds with inhale and exhale, followed by slightly increasing supination until resistance was met once again. After 5 seconds of relaxation, the procedure was repeated 5 times during a single treatment session.

Treatment:

Other: muscle energy technique

oscillating manual energy therapy

Experimental group

Description:

It is also known as V-spread .The subject was asked to sit on a chair with the affected painful arm resting on the treatment table. Tender points were palpated. Then the therapist places the index and middle fingers of one hand in a V-shape around the tender point and placed the index finger of the other hand in the medial side of the elbow, diagonally across the located tender point. Gentle pressure was applied a few times using fingertips to the tissues alternatively from the medial and lateral sides to start the oscillations. On the initiation of oscillations, the application of pressure should be stopped and allow the oscillations to continue between the two points of contact on the subject's elbow. This technique was repeated until there were no tender points on palpation. The duration varied from 30 seconds to 2 minutes.

Treatment:

Other: oscillating manual energy therapy