Tennis ElbowNCT06765798
Adding Neural Mobilization to Mulligan Technique for Treatment of Patients With Chronic Tennis Elbow
A study testing Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy, Group B receive neural mobilization for radial nerve and conventional and Group C receive Mulligan mobilization with movement and conventional in people with Tennis Elbow, run by Safaa Radi Saber at 1 site in Egypt.
Trial summary
The study aimed to assess the combined effect of neural mobilization and mulligan technique on pain ,functional disability and grip strength in patients with tennis elbow Read more about this study
- Who is it for?
- Ages 20 to 60 yearsHealthy volunteers can take part
- Conditions the study is for
- Tennis Elbow
- What is being tested?
- Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy, Group B receive neural mobilization for radial nerve and conventional and Group C receive Mulligan mobilization with movement and conventional
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Jan 2025to 1 Jun 2025
- 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 20 to 60 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Patient aged 20-60 years old
- . Diagnosed with chronic tennis elbow
- experienced discomfort in their dominant arm, tenderness over the lateral epicondyle of the elbow joint, and exhibited signs and symptoms of tennis elbow persisting for three months
- Increased pain with resistant elbow extension, wrist extension, gripping, and supination
- ULTT 2 b (radial nerve) should be positive ) pain referral throughout the dorsal and radial aspect of the forearm and, sometimes, an "electrical shock-like" pain on the radial side of the right wrist (
Who cannot join
- patients who had a history of or were suffering from psychogenic stress
- acute strain, fractures of the humerus, radius, and ulna,
- History of Rheumatoid diseases
- Subjects on steroids or any other medications for pain at present were excluded
- severe edema, infection
- malignancy
Show all 10Show fewer
- osteoporosis
- unstable joints
- severe neck or shoulder pain, neurological conditions \ impacting the upper extremity Cervical radiculopathy
- Bilateral Symptoms of Tennis elbow
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Adding Neural Mobilization to Mulligan Technique in Chronic Tennis Elbow
The study aimed to assess the combined effect of neural mobilization and mulligan technique on pain ,functional disability and grip strength in patients with tennis elbow
Read the detailed description
Tennis elbow, known as lateral epicondylitis (LE) describes an overuse injury secondary to an eccentric overload of the common extensor tendon at the origin of the extensor carpi radialis brevis (ECRB) tendon. Tennis elbow primarily results from the repetitive strain caused by activities that involve loaded and repeated gripping and/or wrist extension. It is common in individuals who play tennis, squash, badminton, or any activity involving repetitive wrist extension, radial deviation, and/or forearm supination.
Patients with tennis elbow usually report pain or tenderness at the lateral epicondyle of the humerus, decreased gripping strength, and weakness when turning their palms up and straightening their wrists. Pain and inflammation of make it difficult to move the elbow joint through its full range of motion because of the pain and affect function of joint (ECRB)
Radial nerve mobilization exercises, has been used to treat musculoskeletal problems, including LE. Nerve mobilization or neurodynamic mobilization, defined by David Butler, is aimed at restoring homeostasis in and around the nervous system through facilitating movement between neural structures and their surroundings. It is stated that neural shifting reduces adhesions between the nerve and surrounding tissue, improves neural vascularity, and improves the axoplasmic flow Mulligan mobilization with movement (MWM) is a form of manual therapy that includes a sustained lateral glide to the elbow joint with concurrent physiological movement. This mobilization technique is often used to correct the faulty position of the elbow joint. It is the primary modality for the correction of positional fault of the elbow joint complex mimicking a contractile element pathology of the common extensor bundle." Which result in reducing pain, improvement of pain-free grip strength (PFGS), and increased ability to tolerate resisted isometric wrist extension
- Conditions
- Tennis Elbow
- Being tested
- Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy, Group B receive neural mobilization for radial nerve and conventional, Group C receive Mulligan mobilization with movement and conventional, Group D receive conventional
- Keywords
- Tennis Elbow, Mulligan mobilization with movement, Neural Mobilization
- Medical subject headings
- Tennis Elbow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional TherapyOther
Group A :Neural Mobilization for radial nerve, Mulligan Mobilization with Movement and Conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for
Group B receive neural mobilization for radial nerve and conventionalOther
Group B receive neural mobilization for radial nerve and conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group C receive Mulligan mobilization with movement and conventionalOther
Group C receive Mulligan mobilization with movement and conventional
Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
Group D receive conventionalOther
Group D receive conventional :
Ultrasound therapy , stretching and strengthening for wrist flexors and extensors
| Study group | Role | What they receive |
|---|---|---|
| group A | Experimental | Group A received neural mobilization for radial nerve, mulligan mobilization with movement and conventional therapy Receives: Other: Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy |
| group B | Experimental | Group B received neural mobilization for radial nerve and conventional therapy Receives: Other: Group B receive neural mobilization for radial nerve and conventional |
| Group C | Experimental | Group C received mulligan mobilization with movement and conventional therapy Receives: Other: Group C receive Mulligan mobilization with movement and conventional |
| Group D | Active comparator | Group D received conventional therapy Receives: Other: Group D receive conventional |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain by visual analgue scale
pain will be assessed by visual analogue scale (VAS) which involves having them mark along a 10 cm-long line with a number ranging from 0 to 10. "0" denotes no discomfort, and "10" denotes the most agonizing pain possible They are generally completed by patients themselves. The patients marks on the line the point that they feel represents their perception of their current state of pain.
Measured: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
Functional disability
Functional Disability will be assessed by Arabic version of DASH Questionnaire DASH Arabic contains 30 items, like the original DASH, each item has five response choices that range from 1, ''without any difficulty or no symptoms exist'' to 5, ''unable to engage in activity or very severe symptoms''. In order for a score to be calculated, a minimum of 27 of the 30 items must be completed. The assigned values for all completed responses are added and averaged to yield a score of 5 or less; this value is then transformed to 100 by subtracting 1 and multiplying by 25, to make it easy to compare with other measures that are scaled from 0 to 100: the higher the score, the greater the disability
Measured: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
Maximum grip strength
Maximum grip strength by Jamer hand dynamometer The gold standard for measuring grip strength is the JAMAR® Hydraulic Hand Dynamometer. Where possible, participants were positioned sitting upright in a chair, with their knees and hips at 90° and with back support. For those unable to mobilize out of bed, the head of the bed was raised as far as possible, ensuring an upright long-sitting position. The shoulder on the dominant side was adducted against the body, the elbow positioned in 90° flexion (unsupported) and the wrist in a neutral position. Participants were then instructed to grip the dynamometer as strongly as they possibly could, using their dominant hand .The measurements of both extremities were repeated 3 times with resting interval of 30 s between each measurement. The average of the three trials was recorded in kilograms (kg).
Measured: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jan 2025
- Study start1 Jan 2025
- Primary completion1 Jun 2025
- Study completion1 Jun 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Tennis ElbowStudies of the same condition, open and under way.
- 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
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Safaa Radi Saber
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Safaa Radi Saber, Cairo University
- Investigators
- Maher Ahmed Elkeblawy Professor of physical Therapy,Department of Basic Science, Professor of physical Therapy, Study director, Professor of physical Therapy ,Department of Basic Science , Faculty of Physical Therapy Cairo UniversityMariam Omran Grace Lecturer of Physical Therapy .Basic Science . cairo university, Lecturer of Physical Therapy ., Study director, Lecturer of Physical Therapy .Basic Science . cairo universityMohamed Ali Hashish Lecturer of orthopedic and spine surgery, Cairo university,, Lecturer, Study director, Lecturer of orthopedic and spine surgery , Cairo university ,kasr Al-ainy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06765798
- Sponsor's protocol ID
- P.T.REC/012/005457
- Status last verified
- Dec 2024
- First submitted
- 27 Dec 2024
- Last updated
- 19 Dec 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 19 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Adding Neural Mobilization to Mulligan Technique in Chronic Tennis Elbow
- ClinicalTrials.gov ID
- NCT06765798
- Acronym / sponsor ID
- P.T.REC/012/005457
- Conditions
- Tennis Elbow
- Keywords
- Tennis Elbow, Mulligan mobilization with movement, Neural Mobilization
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Safaa Radi SaberUniversity, hospital or other
- Study start
- 1 Jan 2025 (actual)
- Primary completion
- 1 Jun 2025 (actual)
- Study completion
- 1 Jun 2025 (actual)
- First posted
- 9 Jan 2025 (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.
The study aimed to assess the combined effect of neural mobilization and mulligan technique on pain ,functional disability and grip strength in patients with tennis elbow
Detailed description
Tennis elbow, known as lateral epicondylitis (LE) describes an overuse injury secondary to an eccentric overload of the common extensor tendon at the origin of the extensor carpi radialis brevis (ECRB) tendon. Tennis elbow primarily results from the repetitive strain caused by activities that involve loaded and repeated gripping and/or wrist extension. It is common in individuals who play tennis, squash, badminton, or any activity involving repetitive wrist extension, radial deviation, and/or forearm supination.
Patients with tennis elbow usually report pain or tenderness at the lateral epicondyle of the humerus, decreased gripping strength, and weakness when turning their palms up and straightening their wrists. Pain and inflammation of make it difficult to move the elbow joint through its full range of motion because of the pain and affect function of joint (ECRB)
Radial nerve mobilization exercises, has been used to treat musculoskeletal problems, including LE. Nerve mobilization or neurodynamic mobilization, defined by David Butler, is aimed at restoring homeostasis in and around the nervous system through facilitating movement between neural structures and their surroundings. It is stated that neural shifting reduces adhesions between the nerve and surrounding tissue, improves neural vascularity, and improves the axoplasmic flow Mulligan mobilization with movement (MWM) is a form of manual therapy that includes a sustained lateral glide to the elbow joint with concurrent physiological movement. This mobilization technique is often used to correct the faulty position of the elbow joint. It is the primary modality for the correction of positional fault of the elbow joint complex mimicking a contractile element pathology of the common extensor bundle." Which result in reducing pain, improvement of pain-free grip strength (PFGS), and increased ability to tolerate resisted isometric wrist extension
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| group A | Experimental | Other: Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional TherapyGroup A received neural mobilization for radial nerve, mulligan mobilization with movement and conventional therapy |
| group B | Experimental | Other: Group B receive neural mobilization for radial nerve and conventionalGroup B received neural mobilization for radial nerve and conventional therapy |
| Group C | Experimental | Other: Group C receive Mulligan mobilization with movement and conventionalGroup C received mulligan mobilization with movement and conventional therapy |
| Group D | Active comparator | Other: Group D receive conventionalGroup D received conventional therapy |
Who may qualify
- Ages
- 20 to 60 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Patient aged 20-60 years old
Key exclusion criteria (10 listed)
- patients who had a history of or were suffering from psychogenic stress
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 |
|---|---|---|
| Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional TherapyGroup A :Neural Mobilization for radial nerve, Mulligan Mobilization with Movement and Conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for | Other | group A |
| Group B receive neural mobilization for radial nerve and conventionalGroup B receive neural mobilization for radial nerve and conventional neural mobilization for radial nerve: The physiotherapist holds the patient's arm and wrist while the patient reclined on his side then depress the shoulder, extend the elbow and then internally rotated the patient's arm. The patient's wrist, thumb, and fingers were all flexed, and the patient's ulnar was brought to deviation. While the patient's position was maintained, and the arm was abducted and then contralateral cervical side bending conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors | Other | group B |
| Group C receive Mulligan mobilization with movement and conventionalGroup C receive Mulligan mobilization with movement and conventional Mulligan mobilization with movement manual lateral glide MWM with gripping: Patient: Supine with upper limb fully supported on a treatment table. Treated body part: Relaxed extension of the elbow, shoulder internal rotation, with pronation of the forearm. Hands loosely around the grip dynamometer handles. Apply 6-10 repetitions in a set, with 3-5 sets in a treatment session, conventional ; Ultrasound therapy , stretching and strengthening for wrist flexors and extensors | Other | Group C |
| Group D receive conventionalGroup D receive conventional : Ultrasound therapy , stretching and strengthening for wrist flexors and extensors | Other | Group D |
Primary outcome
pain by visual analgue scale
Time frame: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
pain will be assessed by visual analogue scale (VAS) which involves having them mark along a 10 cm-long line with a number ranging from 0 to 10. "0" denotes no discomfort, and "10" denotes the most agonizing pain possible They are generally completed by patients themselves. The patients marks on the line the point that they feel represents their perception of their current state of pain.
Functional disability
Time frame: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
Functional Disability will be assessed by Arabic version of DASH Questionnaire DASH Arabic contains 30 items, like the original DASH, each item has five response choices that range from 1, ''without any difficulty or no symptoms exist'' to 5, ''unable to engage in activity or very severe symptoms''. In order for a score to be calculated, a minimum of 27 of the 30 items must be completed. The assigned values for all completed responses are added and averaged to yield a score of 5 or less; this value is then transformed to 100 by subtracting 1 and multiplying by 25, to make it easy to compare with other measures that are scaled from 0 to 100: the higher the score, the greater the disability
Maximum grip strength
Time frame: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment
Maximum grip strength by Jamer hand dynamometer The gold standard for measuring grip strength is the JAMAR® Hydraulic Hand Dynamometer. Where possible, participants were positioned sitting upright in a chair, with their knees and hips at 90° and with back support. For those unable to mobilize out of bed, the head of the bed was raised as far as possible, ensuring an upright long-sitting position. The shoulder on the dominant side was adducted against the body, the elbow positioned in 90° flexion (unsupported) and the wrist in a neutral position. Participants were then instructed to grip the dynamometer as strongly as they possibly could, using their dominant hand .The measurements of both extremities were repeated 3 times with resting interval of 30 s between each measurement. The average of the three trials was recorded in kilograms (kg).
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 19 Dec 2025.
- Individual participant dataSharing planned: No
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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.
Maher Ahmed Elkeblawy Professor of physical Therapy,Department of Basic Science, Professor of physical Therapy study director
Professor of physical Therapy ,Department of Basic Science , Faculty of Physical Therapy Cairo University
Mariam Omran Grace Lecturer of Physical Therapy .Basic Science . cairo university, Lecturer of Physical Therapy . study director
Lecturer of Physical Therapy .Basic Science . cairo university
Mohamed Ali Hashish Lecturer of orthopedic and spine surgery, Cairo university,, Lecturer study director
Lecturer of orthopedic and spine surgery , Cairo university ,kasr Al-ainy
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Group A : receive neural mobilization for radial nerve , mulligan mobilization with movement and conventional Therapy, Group B receive neural mobilization for radial nerve and conventional and Group C receive Mulligan mobilization with movement and conventional in people with Tennis Elbow, run by Safaa Radi Saber at 1 site in Egypt.
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 5 inclusion and 10 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 19 Dec 2025. 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 Egypt. 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 by visual analgue scale (time frame: from enrollment to the end of treatment at 4 weeks , assessment will be done pre and post treatment). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 19 Dec 2025; AzTrials last refreshed its copy on 7 Nov 2026.