Lateral EpicondylitisMWM-CYR-LENCT07424794
Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis
A study testing MWM and Cyriax techniques in people with Lateral Epicondylitis, run by Mohammad Affan at 1 site in Pakistan.
Trial summary
This randomized controlled trial aims to compare the effectiveness of Mobilization with Movement (MWM) and Cyriax techniques in athletes diagnosed with lateral epicondylitis (tennis elbow). Read more about this study
- Who is it for?
- Ages 25 to 40 years
- Conditions the study is for
- Lateral Epicondylitis
- What is being tested?
- MWM and Cyriax techniques
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 56 participants
- Where
- 1 sitePakistan
- Study dates
- 25 Feb 2026to 27 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 25 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both male and female population including sports persons(only throw ball players e.g racquet players)
- Population with age range of 25 - 40 years.
- Include only clinically diagnosed lateral epicondylitis patients
- Patients with proprioception impairments in affected limb
- Symptoms duration less than 3 months, not longer than 3 months
Who cannot join
- Other Elbow Pathologies such as cubital tunnel syndrome, radial tunnel syndrome, or osteoarthritis of the elbow.
- Recent Corticosteroid Injections in the affected elbow within the past 3 months.
- Neurological conditions affecting proprioception (e.g., multiple sclerosis, peripheral neuropathy).
- Autoimmune diseases, diabetes, or connective tissue disorders that may influence healing or proprioception.
- History of surgical intervention in the affected upper limb.(Karthikeyan) Pregnant or planning to become pregnant during the study period
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
University of Lahore Teaching Hospital, Lahore
Lahore, Punjab Province, 54000
About this study
This randomized controlled trial aims to compare the effectiveness of Mobilization with Movement (MWM) and Cyriax techniques in athletes diagnosed with lateral epicondylitis (tennis elbow). Lateral epicondylitis commonly causes pain, reduced grip strength, and impaired proprioception, particularly in racquet and throwing sports players. A total of 56 participants aged 25-40 years with symptoms of less than three months will be randomly assigned to either the MWM group or the Cyriax group. Both groups will receive treatment five times per week for four weeks. Outcomes including elbow proprioception (Joint Position Sense test), pain and functional disability (Patient-Rated Tennis Elbow Evaluation), and grip strength (Handheld Dynamometer) will be assessed at baseline, at 2 weeks, and at 4 weeks. The study aims to determine which treatment method provides superior improvement in pain reduction, functional recovery, and proprioceptive enhancement.
Read the detailed description
This study is a randomized controlled trial conducted at Sukkur Physiotherapy, Rehabilitation and Chiropractor Center and Hidayat Physiotherapy and Rehabilitation Center, Sukkur, over a period of nine months following ethical approval. Fifty-six clinically diagnosed lateral epicondylitis patients meeting inclusion criteria will be recruited using purposive sampling and randomly allocated into two groups using the sealed envelope method. Group A will receive Mobilization with Movement combined with progressive strengthening, proprioceptive training, and sport-specific exercises, while Group B will receive Cyriax techniques including deep transverse friction massage and Mill's manipulation along with strengthening and proprioceptive exercises. Both groups will undergo 16 treatment sessions over four weeks following standardized baseline care consisting of education, stretching, ice therapy, and light isometric exercises. Outcome measures include Joint Position Sense testing for proprioception (measuring absolute angular error), PRTEE questionnaire for pain and function, and grip strength measurement using a handheld dynamometer. Ethical guidelines will be strictly followed, informed consent will be obtained, confidentiality will be maintained, and participants will have the right to withdraw at any time without affecting their standard care.
- Conditions
- Lateral Epicondylitis
- Being tested
- MWM, Cyriax techniques
- Keywords
- Mobilization with Movement (MWM), Cyriax Technique, Deep Transverse Friction Massage, Mill's Manipulation
- Medical subject headings
- Tennis Elbow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MWMBehavioural
Mobilization with Movement (MWM) group will receive interventions five times per week. In the first week, the primary focus is on applying lateral glide mobilization to the elbow joint. The patient performs pain-free gripping or wrist extension activities while the therapist provides a sustained lateral glide, enhancing joint mechanics and reducing pain. This is complemented by isometric strengthening exercises for the wrist extensors (3 sets of 10 repetitions with 5-second holds) and proprioceptive neuromuscular facilitation (PNF) rhythmic stabilization techniques to begin improving joint position sense. Ice therapy may be used post-session to control inflammation.
In the second week, the MWM technique is continued with increased repetitions and resistance based on patient tolerance. Eccentric wrist extensor strengthening using resistance bands is introduced, performed in 3 sets of 10 repetitions. Light sport-specific tasks such as racquet swings with minimal resistance are incorporat
Cyriax techniquesBehavioural
Participants in the cyriax techniques group also receive treatment five times per week over four weeks. In the first week, the primary intervention is deep transverse friction massage (DTFM), applied for 10-15 minutes over the common extensor origin to break down adhesions and reduce localized pain. Isometric strengthening exercises for the wrist extensors are introduced with 3 sets of 10 repetitions, each held for 5 seconds. Ice therapy follows each session to reduce any post-treatment inflammation. Mill's manipulation is not used in the first week to allow tissue acclimatization to DTFM.
In the second week, DTFM is continued on alternate days. Mill's manipulation, a high-velocity, low-amplitude technique that stretches the affected tendon, is introduced once per week immediately following DTFM. Resistance ball exercises are added for grip strengthening, encouraging the return of functional muscle performance. Isometric exercises are continued to maintain muscle recruitment without ag
| Study group | Role | What they receive |
|---|---|---|
| interventional group Mobilization with Movement (MWM) | Experimental | Participants in this group will receive Mobilization with Movement (MWM) techniques applied to the elbow joint along with progressive wrist extensor strengthening, proprioceptive training, and sport-specific functional exercises. Treatment will be administered five times per week for four weeks (total 16 sessions). Ice therapy may be applied post-session as needed. Standardized baseline education, stretching, and isometric exercises will be provided before the intervention phase. Receives: Behavioral: MWM |
| interventional group Cyriax Technique | Experimental | Participants in this group will receive Cyriax techniques including deep transverse friction massage (DTFM) and Mill's manipulation, combined with progressive wrist extensor strengthening, grip exercises, proprioceptive drills, and sport-specific activities. Treatment will be delivered five times per week for four weeks (total 16 sessions). Ice therapy may be applied post-session. Standardized baseline education, stretching, and light isometric exercises will be provided prior to the intervention phase. Receives: Behavioral: Cyriax techniques |
What is being measured
The primary outcome is the main question the study is designed to answer.
Elbow Proprioception Assessed by Joint Position Sense (JPS) Test
Elbow proprioception will be assessed using the Joint Position Sense (JPS) test. Participants will be asked to actively reproduce a predetermined elbow flexion angle (e.g., 90°) with their eyes closed. The difference in degrees between the target angle and the reproduced angle (absolute error) will be recorded. Lower absolute error values indicate better proprioceptive accuracy. Three trials will be performed, and the average error will be calculated for analysis.
Measured: Baseline, Week 2, and Week 4
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Feb 2026
- Study start25 Feb 2026
- Primary completion26 Mar 2026
- Study completion27 Mar 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lateral EpicondylitisStudies 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
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 56 participants (actual)
Sponsor and investigators
- Lead sponsor
- Mohammad Affan
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Mohammad Affan, University of Lahore
- Investigators
- Mohammad Affan, MSPTN, Principal investigator, The University of Lahore, Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07424794
- Sponsor's protocol ID
- UOL/IREB/25/15/03/24
- Acronym
- MWM-CYR-LE
- Status last verified
- Feb 2026
- First submitted
- 14 Feb 2026
- Last updated
- 10 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 10 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis
- ClinicalTrials.gov ID
- NCT07424794
- Acronym / sponsor ID
- MWM-CYR-LE / UOL/IREB/25/15/03/24
- Conditions
- Lateral Epicondylitis
- Keywords
- Mobilization with Movement (MWM), Cyriax Technique, Deep Transverse Friction Massage, Mill's Manipulation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 56 participants (actual)
- Lead sponsor
- Mohammad AffanUniversity, hospital or other
- Study start
- 25 Feb 2026 (actual)
- Primary completion
- 26 Mar 2026 (actual)
- Study completion
- 27 Mar 2026 (actual)
- First posted
- 20 Feb 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 compare the effectiveness of Mobilization with Movement (MWM) and Cyriax techniques in athletes diagnosed with lateral epicondylitis (tennis elbow). Lateral epicondylitis commonly causes pain, reduced grip strength, and impaired proprioception, particularly in racquet and throwing sports players. A total of 56 participants aged 25-40 years with symptoms of less than three months will be randomly assigned to either the MWM group or the Cyriax group. Both groups will receive treatment five times per week for four weeks. Outcomes including elbow proprioception (Joint Position Sense test), pain and functional disability (Patient-Rated Tennis Elbow Evaluation), and grip strength (Handheld Dynamometer) will be assessed at baseline, at 2 weeks, and at 4 weeks. The study aims to determine which treatment method provides superior improvement in pain reduction, functional recovery, and proprioceptive enhancement.
Detailed description
This study is a randomized controlled trial conducted at Sukkur Physiotherapy, Rehabilitation and Chiropractor Center and Hidayat Physiotherapy and Rehabilitation Center, Sukkur, over a period of nine months following ethical approval. Fifty-six clinically diagnosed lateral epicondylitis patients meeting inclusion criteria will be recruited using purposive sampling and randomly allocated into two groups using the sealed envelope method. Group A will receive Mobilization with Movement combined with progressive strengthening, proprioceptive training, and sport-specific exercises, while Group B will receive Cyriax techniques including deep transverse friction massage and Mill's manipulation along with strengthening and proprioceptive exercises. Both groups will undergo 16 treatment sessions over four weeks following standardized baseline care consisting of education, stretching, ice therapy, and light isometric exercises. Outcome measures include Joint Position Sense testing for proprioception (measuring absolute angular error), PRTEE questionnaire for pain and function, and grip strength measurement using a handheld dynamometer. Ethical guidelines will be strictly followed, informed consent will be obtained, confidentiality will be maintained, and participants will have the right to withdraw at any time without affecting their standard care.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| interventional group Mobilization with Movement (MWM) | Experimental | Behavioral: MWMParticipants in this group will receive Mobilization with Movement (MWM) techniques applied to the elbow joint along with progressive wrist extensor strengthening, proprioceptive training, and sport-specific functional exercises. Treatment will be administered five times per week for four weeks (total 16 sessions). Ice therapy may be applied post-session as needed. Standardized baseline education, stretching, and isometric exercises will be provided before the intervention phase. |
| interventional group Cyriax Technique | Experimental | Behavioral: Cyriax techniquesParticipants in this group will receive Cyriax techniques including deep transverse friction massage (DTFM) and Mill's manipulation, combined with progressive wrist extensor strengthening, grip exercises, proprioceptive drills, and sport-specific activities. Treatment will be delivered five times per week for four weeks (total 16 sessions). Ice therapy may be applied post-session. Standardized baseline education, stretching, and light isometric exercises will be provided prior to the intervention phase. |
Who may qualify
- Ages
- 25 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Both male and female population including sports persons(only throw ball players e.g racquet players)
- Population with age range of 25 - 40 years.
- Include only clinically diagnosed lateral epicondylitis patients
- Patients with proprioception impairments in affected limb
- Symptoms duration less than 3 months, not longer than 3 months
Key exclusion criteria (5 listed)
- Other Elbow Pathologies such as cubital tunnel syndrome, radial tunnel syndrome, or osteoarthritis of the elbow.
- Recent Corticosteroid Injections in the affected elbow within the past 3 months.
- Neurological conditions affecting proprioception (e.g., multiple sclerosis, peripheral neuropathy).
- Autoimmune diseases, diabetes, or connective tissue disorders that may influence healing or proprioception.
- History of surgical intervention in the affected upper limb.(Karthikeyan) Pregnant or planning to become pregnant during the study period
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 |
|---|---|---|
| MWMMobilization with Movement (MWM) group will receive interventions five times per week. In the first week, the primary focus is on applying lateral glide mobilization to the elbow joint. The patient performs pain-free gripping or wrist extension activities while the therapist provides a sustained lateral glide, enhancing joint mechanics and reducing pain. This is complemented by isometric strengthening exercises for the wrist extensors (3 sets of 10 repetitions with 5-second holds) and proprioceptive neuromuscular facilitation (PNF) rhythmic stabilization techniques to begin improving joint position sense. Ice therapy may be used post-session to control inflammation. In the second week, the MWM technique is continued with increased repetitions and resistance based on patient tolerance. Eccentric wrist extensor strengthening using resistance bands is introduced, performed in 3 sets of 10 repetitions. Light sport-specific tasks such as racquet swings with minimal resistance are incorporat | Behavioural | interventional group Mobilization with Movement (MWM) |
| Cyriax techniquesParticipants in the cyriax techniques group also receive treatment five times per week over four weeks. In the first week, the primary intervention is deep transverse friction massage (DTFM), applied for 10-15 minutes over the common extensor origin to break down adhesions and reduce localized pain. Isometric strengthening exercises for the wrist extensors are introduced with 3 sets of 10 repetitions, each held for 5 seconds. Ice therapy follows each session to reduce any post-treatment inflammation. Mill's manipulation is not used in the first week to allow tissue acclimatization to DTFM. In the second week, DTFM is continued on alternate days. Mill's manipulation, a high-velocity, low-amplitude technique that stretches the affected tendon, is introduced once per week immediately following DTFM. Resistance ball exercises are added for grip strengthening, encouraging the return of functional muscle performance. Isometric exercises are continued to maintain muscle recruitment without ag | Behavioural | interventional group Cyriax Technique |
Primary outcome
Elbow Proprioception Assessed by Joint Position Sense (JPS) Test
Time frame: Baseline, Week 2, and Week 4
Elbow proprioception will be assessed using the Joint Position Sense (JPS) test. Participants will be asked to actively reproduce a predetermined elbow flexion angle (e.g., 90°) with their eyes closed. The difference in degrees between the target angle and the reproduced angle (absolute error) will be recorded. Lower absolute error values indicate better proprioceptive accuracy. Three trials will be performed, and the average error will be calculated for analysis.
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 10 Jun 2026.
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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.
Mohammad Affan, MSPTN principal investigator
The University of Lahore, Lahore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing MWM and Cyriax techniques in people with Lateral Epicondylitis, run by Mohammad Affan 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 5 inclusion and 5 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 10 Jun 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?
Elbow Proprioception Assessed by Joint Position Sense (JPS) Test (time frame: Baseline, Week 2, and Week 4). 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 10 Jun 2026.