Scapular PNF Versus Shoulder Strengthening Exercises in Patients With Lateral Epicondylitis.

Mahmoud Essam Abu Elfetouh Ghallab

Status: Enrolling

Conditions: Lateral Epicondylitis

Treatments: Other: Shoulder strengthening exercises; Other: Scapular PNF

Study type: Interventional

Funder types: Other

Identifiers

NCT05947968

Lateral epicondylitis

Details and patient eligibility

About

The purpose of this study is to compare between the effect of scapular proprioceptive neuromuscular facilitation versus shoulder and scapular strengthening exercise on pain, functional outcome and grip strength in patients with lateral epicondylitis.

Full description

There is no standard treatment for lateral epicondylitis, it is always a combination of physical therapy modalities aimed to reduce pain and increase the ability to return functional activities participation. Accordingly, many researchers have added shoulder strengthening exercise to the rehabilitation plan for treating lateral epicondylitis.

Consequently, development of new concept of scapula motor control exercise using proprioceptive neuromuscular facilitation to add proximal stability to patients with lateral epicondylitis may be beneficial. We believe that this study can serve as a step toward documenting the evidence of scapular proprioceptive neuromuscular facilitation exercise in the treatment of patients with lateral epicondylitis which was not available before.

Patients with lateral epicondylitis will be recruited after approval of ethical committee of the faculty of physical therapy, Cairo University. All participants will sign a written informed consent form. After group assignment, patients' demographics will be collected, and then assessment of pain, function and grip strength will be performed. The same assessment procedure will be conducted by the end of the treatment (by the end of the 12th visit).

The study will be two comparative groups, pre-post experimental design, the subjects will be randomly assigned into one of two groups:

• Group (I) : will receive scapular proprioceptive neuromuscular facilitation exercises.
• Group (II) : will receive shoulder strengthening exercises.

Enrollment: 52 estimated patients

Sex: All

Ages: 20 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients will be included if they have the following criteria:

  • Fifty-two male and female subjects.
  • Patients complaining of chronic lateral epicondylitis (more than three months).
  • Age between 20-50.

Exclusion criteria

• Patients will be excluded if they had any of the following conditions:

  • Received physiotherapy in last 3 months.
  • Received corticosteroids injection in lateral epicondyle in last 3 months.
  • Receiving anti-inflammatories medications on regular basis.
  • Had neurologic problems in shoulder, neck and thoracic regions.
  • Had history of rheumatic disease.
  • Had cooperation difficulties due to cognitive disorders. All Patients will be instructed to keep away from activities that aggravate the symptoms such as grasping, lifting, knitting and using a screwdriver during the treatment period.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

52 participants in 2 patient groups

Group A (Scapular PNF)

Experimental group

Description:

will receive scapular proprioceptive neuromuscular facilitation exercise plus conventional treatment of lateral epicondylitis for 12 sessions (3 sessions per week for four weeks). The conventional treatment of lateral epicondylitis will be: 1. Pulsed ultrasound over the lateral epicondyle for 5 min. 2. Five minutes of deep friction massage. It will be consisted of deep circular motions using the fingertips over the area of maximal tenderness at the lateral epicondyle. 3. Stretching exercise for extensor carpi radialis longus and brevis for 3 repetitions, each repetition will be 45 seconds with 30 seconds' rest. 4. Strengthening exercise for wrist extensors, eccentric exercise for wrist extensors will be as follow: 3 sets, 10 repetitions, 1 min rest interval between each set.

Treatment:

Other: Scapular PNF

Group B (Shoulder exercises)

Experimental group

Description:

will receive shoulder strengthening exercise plus conventional treatment of lateral epicondylitis for 12 sessions (3 sessions per week for four weeks). Same conventional treatment in group (A)

Treatment:

Other: Shoulder strengthening exercises