Lateral EpicodylitisNCT07847034
Comparative Effects of Multiple Angle Isometrics vs Standard Isometric Exercise in Lateral Epicondylitis
A study testing Multiple Angle Isometrics Exercises and Standard Isometric Exercsises in people with Lateral Epicodylitis, run by Ibadat International University, Islamabad at 1 site in Pakistan.
Trial summary
Lateral Epicondylitis is one of the most common musculoskeletal conditions affecting 1-3% of population.Various terminologies are used to describe the disease like tendinitis of extensor carpi radialis brevis muscle (ECRB), periostitis and radial epicondylitis, lateral epicondylitis is still the most used terminology… Read more about this study
- Who is it for?
- Ages 25 to 35 years
- Conditions the study is for
- Lateral Epicodylitis
- What is being tested?
- Multiple Angle Isometrics Exercises and Standard Isometric Exercsises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 11 Jan 2026to 10 Jun 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 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adults aged 25-35 years.
- Clinically diagnosed with acute or subacute lateral epicondylitis.
- Patients with ≥3 out of the following 5 positive clinical tests:
- Pain on palpation over the lateral epicondyle.
- Cozen's test positive.
- Mill's test positive.
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- Maudsley's test positive.
- Acute or subacute clinical presentation.
- Willing to participate and provide written informed consent.
Who cannot join
- Cervical spine disorders.
- Chronic lateral epicondylitis.
- Elbow deformity (fracture, previous surgery, contracture, etc.).
- Diabetes mellitus.
- Steroid injection at the lateral epicondyle within the previous 3 months.
- Rheumatoid arthritis or other neurological or muscular disorders.
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- Previous elbow injury.
- Arthritic changes or calcifications around the elbow joint on radiographs. Malignancy.
- Pregnancy.
- Corticosteroid injection to the lateral epicondyle within the previous 6 weeks.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Akbar Niazi Teaching Hospital
Islamabad, Punjab Province, 4000
About this study
Official title: Comparative Effects of Multiple Angle Isometrics vs Standard Isometric Exercise in Lateral Epicondylitis:A Randomized Controlled Trial
Lateral Epicondylitis is one of the most common musculoskeletal conditions affecting 1-3% of population.Various terminologies are used to describe the disease like tendinitis of extensor carpi radialis brevis muscle (ECRB), periostitis and radial epicondylitis, lateral epicondylitis is still the most used terminology in literature. Research shows that LE mainly targets population which is active with poor nutrition habits and biomechanical faults thus affecting their job and social life. Pain is seen to be activity dependent and is triggered via excessive muscle activity.
Read the detailed description
Lateral epicondylitis (tennis elbow) is a frequent musculoskeletal condition, which involves pain, decreased grip strength and functional impairments due to a degeneration of the common extensor tendon. Despite the fact that isometric exercises are widely applied in the conservative treatment of lateral epicondylitis for their analgesic and strengthening properties, the most effective way of isometric training is not known. Multiple Angle Isometric (MAI) exercises are designed to engage a larger number of muscle fibres, increase neuromuscular activation and strengthen muscles across their entire range of motion than single angle isometric exercises.
The objective of this randomized controlled trial is to determine the effectiveness of the Multiple Angle Isometric (MAI) exercise to reduce pain, strengthen the wrist extensor muscles and increase upper limb function in patients with lateral epicondylitis when compared with the Standard Isometric (SI) exercise. The total number of participants is 36 with acute and sub acute lateral epicondylitis and will be sampled by non-probability purposive sampling and divided into two intervention groups by random allocation. All subjects will then be given the same initial treatment (hot pack and Transcutaneous Electrical Nerve Stimulation [TENS]) and then their respective exercise protocols. The intervention will take place three times a week for four weeks.
The Numeric Pain Rating Scale (NPRS) will be used to assess pain intensity, Camry digital hand dynamometer to assess wrist extensor grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire will be used to assess functional disability. Measurements will be taken pre- and post- and post-4 weeks after completion of the intervention. This study's results will give physiotherapists evidence for comparative effectiveness of the Multiple Angle Isometric and Standard Isometric exercise protocols to choose the most effective rehabilitation approach for lateral epicondylitis and optimal patient outcomes.
- Conditions
- Lateral Epicodylitis
- Being tested
- Multiple Angle Isometrics Exercises, Standard Isometric Exercsises
- Keywords
- Lateral Epicondylitis
- Medical subject headings
- Tennis Elbow
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Multiple Angle Isometrics ExercisesOther
Baseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total.
Standard Isometric ExercsisesOther
Baseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks).
| Study group | Role | What they receive |
|---|---|---|
| Group A-Multiple Angle Isometrics (MAI) | Experimental | Participants will be given baseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total. Receives: Other: Multiple Angle Isometrics Exercises |
| Group B - Standard Isometric Exercise | Active comparator | Participants will get the same baseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks). Receives: Other: Standard Isometric Exercsises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale (NPRS)
Assesses pain intensity using an 11-point numerical scale (0-10).
Measured: Baseline, Week2 , Week 4
Grip Strength (Camry Digital Hand Dynamometer)
Assess wrist extensor grip strength using a digital hand dynamometer.
Measured: Baseline, 2 Week, 4 Week
Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire
Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a standardized tool that relies on patient-reported outcomes to evaluate function and disability in the upper limbs. It includes 30 questions designed to assess how symptoms affect daily tasks and physical abilities. Scores are calculated on a scale from 0 to 100, where higher values reflect more severe disability.
Measured: Baseline, 2 Week, 4 Week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Sep 2026
- Study start11 Jan 2026
- Primary completion10 Mar 2026
- Study completion10 Jun 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lateral EpicodylitisStudies 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
- None (open label)
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ibadat International University, Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Maria Fatima Mughees, DPT, Principal investigator, Akbar Niazi Teaching Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07847034
- Sponsor's protocol ID
- Ref no: IIUI/RERC/ADT/2026/02/
- Status last verified
- Sep 2026
- First submitted
- 23 Sep 2026
- Last updated
- 29 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Multiple Angle Isometrics vs Standard Isometric Exercise in Lateral Epicondylitis:A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07847034
- Acronym / sponsor ID
- Ref no: IIUI/RERC/ADT/2026/02/
- Conditions
- Lateral Epicodylitis
- Keywords
- Lateral Epicondylitis
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Ibadat International University, IslamabadUniversity, hospital or other
- Study start
- 11 Jan 2026 (actual)
- Primary completion
- 10 Mar 2026 (actual)
- Study completion
- 10 Jun 2026 (actual)
- First posted
- 29 Sep 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.
Lateral Epicondylitis is one of the most common musculoskeletal conditions affecting 1-3% of population.Various terminologies are used to describe the disease like tendinitis of extensor carpi radialis brevis muscle (ECRB), periostitis and radial epicondylitis, lateral epicondylitis is still the most used terminology in literature. Research shows that LE mainly targets population which is active with poor nutrition habits and biomechanical faults thus affecting their job and social life. Pain is seen to be activity dependent and is triggered via excessive muscle activity.
Detailed description
Lateral epicondylitis (tennis elbow) is a frequent musculoskeletal condition, which involves pain, decreased grip strength and functional impairments due to a degeneration of the common extensor tendon. Despite the fact that isometric exercises are widely applied in the conservative treatment of lateral epicondylitis for their analgesic and strengthening properties, the most effective way of isometric training is not known. Multiple Angle Isometric (MAI) exercises are designed to engage a larger number of muscle fibres, increase neuromuscular activation and strengthen muscles across their entire range of motion than single angle isometric exercises.
The objective of this randomized controlled trial is to determine the effectiveness of the Multiple Angle Isometric (MAI) exercise to reduce pain, strengthen the wrist extensor muscles and increase upper limb function in patients with lateral epicondylitis when compared with the Standard Isometric (SI) exercise. The total number of participants is 36 with acute and sub acute lateral epicondylitis and will be sampled by non-probability purposive sampling and divided into two intervention groups by random allocation. All subjects will then be given the same initial treatment (hot pack and Transcutaneous Electrical Nerve Stimulation [TENS]) and then their respective exercise protocols. The intervention will take place three times a week for four weeks.
The Numeric Pain Rating Scale (NPRS) will be used to assess pain intensity, Camry digital hand dynamometer to assess wrist extensor grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire will be used to assess functional disability. Measurements will be taken pre- and post- and post-4 weeks after completion of the intervention. This study's results will give physiotherapists evidence for comparative effectiveness of the Multiple Angle Isometric and Standard Isometric exercise protocols to choose the most effective rehabilitation approach for lateral epicondylitis and optimal patient outcomes.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A-Multiple Angle Isometrics (MAI) | Experimental | Other: Multiple Angle Isometrics ExercisesParticipants will be given baseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total. |
| Group B - Standard Isometric Exercise | Active comparator | Other: Standard Isometric ExercsisesParticipants will get the same baseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks). |
Who may qualify
- Ages
- 25 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- Adults aged 25-35 years.
- Clinically diagnosed with acute or subacute lateral epicondylitis.
- Patients with ≥3 out of the following 5 positive clinical tests:
- Pain on palpation over the lateral epicondyle.
- Cozen's test positive.
Key exclusion criteria (10 listed)
- Cervical spine disorders.
- Chronic lateral epicondylitis.
- Elbow deformity (fracture, previous surgery, contracture, etc.).
- Diabetes mellitus.
- Steroid injection at the lateral epicondyle within the previous 3 months.
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 |
|---|---|---|
| Multiple Angle Isometrics ExercisesBaseline treatment with a hot pack and Transcutaneous Electrical Nerve Stimulation (TENS), then the exercises will be therapist-supervised multiple angle isometric wrist extensors at neutral, 15° and 30° wrist extension. There will be 3 sets of 10 repetitions for each exercise with 6-second hold (Weeks 1-2) followed by 12-second hold (Weeks 3-4) with 1-minute rest between sets, 3 times per week, 4 weeks total. | Other | Group A-Multiple Angle Isometrics (MAI) |
| Standard Isometric ExercsisesBaseline treatment (hot pack and TENS) and then do therapist supervised standard isometric wrist extensor exercises at a single (neutral) wrist position, with the same dosage and frequency (3 sets × 10 repetitions, 6-second hold during Weeks 1-2, 12-second hold during Weeks 3-4, 3 sessions per week for 4 weeks). | Other | Group B - Standard Isometric Exercise |
Primary outcome
Numeric Pain Rating Scale (NPRS)
Time frame: Baseline, Week2 , Week 4
Assesses pain intensity using an 11-point numerical scale (0-10).
Grip Strength (Camry Digital Hand Dynamometer)
Time frame: Baseline, 2 Week, 4 Week
Assess wrist extensor grip strength using a digital hand dynamometer.
Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire
Time frame: Baseline, 2 Week, 4 Week
Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is a standardized tool that relies on patient-reported outcomes to evaluate function and disability in the upper limbs. It includes 30 questions designed to assess how symptoms affect daily tasks and physical abilities. Scores are calculated on a scale from 0 to 100, where higher values reflect more severe disability.
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 29 Sep 2026.
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.
Maria Fatima Mughees, DPT principal investigator
Akbar Niazi Teaching Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Multiple Angle Isometrics Exercises and Standard Isometric Exercsises in people with Lateral Epicodylitis, run by Ibadat International University, Islamabad 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 9 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 29 Sep 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?
Numeric Pain Rating Scale (NPRS) (time frame: Baseline, Week2 , Week 4). 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 29 Sep 2026.