Medial EpicondylitisNCT07187102
Ultrasonographic Response to Cervical and Upper Thoracic SNAG in Medial Epicondylitis
A study testing SNAG ( sustained natural apopheseal glide ) and (Conventional Physical Therapy) in people with Medial Epicondylitis, run by Beni-Suef University at 1 site in Egypt.
Trial summary
Aim of the work : 1. To detect if there is any change would occur in the neovascularity and echogenicity after using cervical and upper thoracic SNAG or not in ME patients. 2. To find the effect of cervical and upper thoracic SNAG on pain, function of upper extremities, grip strength in ME comparing with traditional… Read more about this study
- Who is it for?
- Ages 35 to 50 years
- Conditions the study is for
- Medial Epicondylitis
- What is being tested?
- SNAG ( sustained natural apopheseal glide ) and (Conventional Physical Therapy)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteEgypt
- Study dates
- 8 Sep 2025to 25 Mar 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 35 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age ranges from 35 to 50 years old in both sexes.
- Patients with LE that diagnosed by orthopedist.
- Pain onset is more than 3 months appear primarily with use or rest or in both, also , it appear with deep palpation of the medial epicondyle .
Who cannot join
- • Rheumatoid Arthritis .
- Skin infection.
- History of previous elbow surgery.
- Any pathology in the shoulder joint.
- Neurologic deficit in upper extremity.
- Cervical disc prolapse and radiculopathy C5,6.
Show all 13Show fewer
- Dislocation of elbow joint.
- Recent fractures of upper extremity.
- Arthrosis of the radiohumeral joint.
- Osteochondritis dissecans.
- Osteonecrosis.
- Plica synovialis.
- Participants receiving other treatment, in the form of physical therapy or medication, for the duration of the study that may interfere with the results of this study.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Ultrasonographic Response to Cervical and Upper Thoracic SNAG in Treatment of Chronic Medial Epicondylitis, a Randomized Controlled Trial
Aim of the work :
- To detect if there is any change would occur in the neovascularity and echogenicity after using cervical and upper thoracic SNAG or not in ME patients.
- To find the effect of cervical and upper thoracic SNAG on pain, function of upper extremities, grip strength in ME comparing with traditional treatment alone
Read the detailed description
medial epicondylitis(ME) of the elbow is a condition characterized by aggravation of pain in the outer part of the elbow during active wrist flexion , and presentation of pain on direct palpation of the medial epicondyle, or proximal muscle belly . Biomechanical and sensorimotor deficits can occur and adversely impact upper extremity function .These functional deficits may interfere with occupational tasks and activities of daily living The study's results: Measuring the changes that will be produced by using therapeutic growth of the cervical and thoracic vertebrae on the pathological changes that persist in the tendons of the tens of the tibialis cruciate ligaments in detecting excess weight resulting from the disease of the middle epicondyle, such as increased blood vessels in the tendon and decreased echogenicity of the tendon, in addition to measuring the changes that occurred in the extent of pain sensation and the extent of functional performance of the shoulder and elbow joints. Patients will be directly selected jointly according to the patient's specifications for the research and written consent will be obtained from the patient after a detailed explanation of the research steps and what is required of him. The vocal function of the tendon will be evaluated, with the exception of functional pain of the successful upper extremity and the strength of the hand muscles before and after the experiment.
- Conditions
- Medial Epicondylitis
- Being tested
- SNAG ( sustained natural apopheseal glide ), (Conventional Physical Therapy)
- Keywords
- Mobilization, Medial Epicondylitis, Ultrasonography, SNAGs, PRTEE, DASH, sympathetic activity
- Medical subject headings
- Elbow Tendinopathy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SNAG ( sustained natural apopheseal glide )Other
A postero-anterior glide was applied to the spinous process of the C6-7 cervical. Ten repetitions were held for 10 seconds each, followed by a 30-second rest period. The patient sat comfortably with their back resting on a straight seat and their head and neck in a relaxed neutral position.
After identifying the hypomobile segment, the clinician administered a single sub-therapeutic dose of thoracic SNAG at the specified treatment level. This technique involved performing one thoracic SNAG with a cephalad glide, applied parallel to the facet joint plane, aiming towards the patient's eyes. The clinician then positioned one arm around the patient's chest, just above the designated treatment level, ensuring that the ulnar border of the mobilizing hand was placed over the thoracic spinous process of the targeted level.
Over four weeks, each patient had three therapy sessions per week, with a maximum of 12 sessions total.
(Conventional Physical Therapy)Other
Conventional treatment, includes five sets of 30-second self-wrist flexor stretching; a total of 5 minutes of ultrasound therapy at a frequency of 3.3 MHz and a duty cycle of 1.2 W/cm²; five minutes of cross-friction massage focused on the most painful area; and fifteen minutes of heat application.
Over four weeks, each patient had three therapy sessions per week, with a maximum of 12 sessions total.
| Study group | Role | What they receive |
|---|---|---|
| Experimental group | Experimental | Not described Receives: Other: SNAG ( sustained natural apopheseal glide ); Other: (Conventional Physical Therapy) |
| control group | Other | Not described Receives: Other: (Conventional Physical Therapy) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Colour Ultrasonography
Change in hypervascularity and hypoechogencity measured by colour sonography ( grade 1: grade 4) include: hypo-echoic variations within the common flexor tendon, tendon sheath thickening, ruptures of varying thickness, neovascularization as seen by Doppler, and cortical damage at the medial epicondyle
Measured: Baseline and after one month
Secondary outcomes (4)
The Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire
30-question outcome measure provided by patients to assess upper-limb function. For those involved in sports and occupational assessments, an additional eight questions are available. The questionnaire employs a Likert scale ranging from one to five (where one indicates no difficulty and five signifies incapacity). The cumulative DASH rating runs between 0 and 100, with higher numbers reflecting bigger disability.
Measured: Baseline and after one month
A Patient-Rated Elbow Evaluation (PREE) questionnaire.
A questionnaire consisting of 20 items designed to assess pain and impairment associated with elbow conditions. It is divided into two main sections: function and pain. The pain category contains 5 items, while the function category includes 15 aspects. Within the functional section, there exist other subdivisions: Eleven items concentrate on specific activities, while four items relate to routine activities. Every item is evaluated on a scale from 0 to 10. The final ratingrelies on a 100-point scale, with impairment and pain weighted similarly. Pain and disability increase with a higher PREE total score
Measured: Baseline and after one month
The hydraulic hand dynamometer.
It is the most often utilized tool in research, has undergone extensive validation, and is the standard by which other tools are evaluated.
Participants were positioned upright, either sitting with their knees and hips at a 90-degree angle and, if back support was available, in an elevated long-sitting position, or in bed. The dominant arm was positioned laterally, with the elbow extended at 90° and unsupported, while the wrist remained in neutral posture. Individuals were advised to use their main hand to force the dynamometer as strong as possible. For each device, three trials were recorded, and the one with the greatest score was maintained for review. Following the initial set of measurements, the volunteers took a 30-minute break before repeating the process with the second device.
Measured: Baseline and after one month
Visual analog scale
Pain intensity for the elbow was measured using a ten-centimeter straight visual analogue scale (VAS), with 0 reflecting painlessness and 10 meaning the highest discomfort ever experienced.
Measured: Baseline and after one month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Sep 2025
- Study start8 Sep 2025
- Primary completion25 Mar 2026
- Study completion25 Mar 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Medial EpicondylitisStudies of the same condition, open and under way.
- More trials run by Beni-Suef UniversityThe 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
- one group receive SNAG plus traditional treatment second group receive traditional treatment
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- Beni-Suef University
- Sponsor type
- University, hospital or other
- Collaborators
- Benha University
- Responsible party
- Principal investigator, Sahar Mowad Abdelmutilibe, Beni-Suef University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07187102
- Sponsor's protocol ID
- FMBSUREC/07092025/Ahmed
- Status last verified
- Sep 2025
- First submitted
- 15 Sep 2025
- Last updated
- 30 Mar 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 30 Mar 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Ultrasonographic Response to Cervical and Upper Thoracic SNAG in Treatment of Chronic Medial Epicondylitis, a Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07187102
- Acronym / sponsor ID
- FMBSUREC/07092025/Ahmed
- Conditions
- Medial Epicondylitis
- Keywords
- Mobilization, Medial Epicondylitis, Ultrasonography, SNAGs, PRTEE, DASH, sympathetic activity
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- Beni-Suef UniversityUniversity, hospital or other
- Collaborators
- Benha University
- Study start
- 8 Sep 2025 (actual)
- Primary completion
- 25 Mar 2026 (actual)
- Study completion
- 25 Mar 2026 (actual)
- First posted
- 22 Sep 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.
Aim of the work :
- To detect if there is any change would occur in the neovascularity and echogenicity after using cervical and upper thoracic SNAG or not in ME patients.
- To find the effect of cervical and upper thoracic SNAG on pain, function of upper extremities, grip strength in ME comparing with traditional treatment alone
Detailed description
medial epicondylitis(ME) of the elbow is a condition characterized by aggravation of pain in the outer part of the elbow during active wrist flexion , and presentation of pain on direct palpation of the medial epicondyle, or proximal muscle belly . Biomechanical and sensorimotor deficits can occur and adversely impact upper extremity function .These functional deficits may interfere with occupational tasks and activities of daily living The study's results: Measuring the changes that will be produced by using therapeutic growth of the cervical and thoracic vertebrae on the pathological changes that persist in the tendons of the tens of the tibialis cruciate ligaments in detecting excess weight resulting from the disease of the middle epicondyle, such as increased blood vessels in the tendon and decreased echogenicity of the tendon, in addition to measuring the changes that occurred in the extent of pain sensation and the extent of functional performance of the shoulder and elbow joints. Patients will be directly selected jointly according to the patient's specifications for the research and written consent will be obtained from the patient after a detailed explanation of the research steps and what is required of him. The vocal function of the tendon will be evaluated, with the exception of functional pain of the successful upper extremity and the strength of the hand muscles before and after the experiment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- one group receive SNAG plus traditional treatment second group receive traditional treatment
| Arm | Type | Receives |
|---|---|---|
| Experimental group | Experimental | Other: SNAG ( sustained natural apopheseal glide ), Other: (Conventional Physical Therapy) |
| control group | Other | Other: (Conventional Physical Therapy) |
Who may qualify
- Ages
- 35 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Age ranges from 35 to 50 years old in both sexes.
- Patients with LE that diagnosed by orthopedist.
- Pain onset is more than 3 months appear primarily with use or rest or in both, also , it appear with deep palpation of the medial epicondyle .
Key exclusion criteria (13 listed)
- • Rheumatoid Arthritis .
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 |
|---|---|---|
| SNAG ( sustained natural apopheseal glide )A postero-anterior glide was applied to the spinous process of the C6-7 cervical. Ten repetitions were held for 10 seconds each, followed by a 30-second rest period. The patient sat comfortably with their back resting on a straight seat and their head and neck in a relaxed neutral position. After identifying the hypomobile segment, the clinician administered a single sub-therapeutic dose of thoracic SNAG at the specified treatment level. This technique involved performing one thoracic SNAG with a cephalad glide, applied parallel to the facet joint plane, aiming towards the patient's eyes. The clinician then positioned one arm around the patient's chest, just above the designated treatment level, ensuring that the ulnar border of the mobilizing hand was placed over the thoracic spinous process of the targeted level. Over four weeks, each patient had three therapy sessions per week, with a maximum of 12 sessions total. | Other | Experimental group |
| (Conventional Physical Therapy)Conventional treatment, includes five sets of 30-second self-wrist flexor stretching; a total of 5 minutes of ultrasound therapy at a frequency of 3.3 MHz and a duty cycle of 1.2 W/cm²; five minutes of cross-friction massage focused on the most painful area; and fifteen minutes of heat application. Over four weeks, each patient had three therapy sessions per week, with a maximum of 12 sessions total. | Other | Experimental group, control group |
Primary outcome
Colour Ultrasonography
Time frame: Baseline and after one month
Change in hypervascularity and hypoechogencity measured by colour sonography ( grade 1: grade 4) include: hypo-echoic variations within the common flexor tendon, tendon sheath thickening, ruptures of varying thickness, neovascularization as seen by Doppler, and cortical damage at the medial epicondyle
4 secondary outcomes
The Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire
Time frame: Baseline and after one month
A Patient-Rated Elbow Evaluation (PREE) questionnaire.
Time frame: Baseline and after one month
The hydraulic hand dynamometer.
Time frame: Baseline and after one month
Visual analog scale
Time frame: Baseline and after one month
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 30 Mar 2026.
- Individual participant dataSharing planned: Undecided
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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 SNAG ( sustained natural apopheseal glide ) and (Conventional Physical Therapy) in people with Medial Epicondylitis, run by Beni-Suef University 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 3 inclusion and 13 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 30 Mar 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 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?
Colour Ultrasonography (time frame: Baseline and after one month). 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 30 Mar 2026.