Efficacy of powerball versus mulligan mobilization with movement on pain and function in patients with lateral epicondylitis: a randomised control trial

Abstract

Background: Lateral epicondylitis (LE), most commonly referred to as Lateral Elbow Tendinopathy (LET) or Tennis Elbow is one of the commonest repetitive stress syndromes seen in elbow joint. Tendinopathy, an injury to forearm extensor muscles. These muscles arise from the distal end of humerus from lateral epicondylar region. In many cases, involvement of extensor carpi radialis brevis muscle’s insertion is seen. This study focuses on the treatment of a person with LE which occurs in repeated upper extremity movements. There is no such research relevant to PowerBall device exercises on Lateral epicondylitis patients' pain and function. “PowerBall device” exercise is considered to be an effective resistance training, putting extrinsic and intrinsic pressure on wrist, elbow and shoulder muscles and has been shown to improve strength, function, ROM, tennis elbow pain and quality of life. Whereas MMWM has been proven to reduce the pain in patients with LE. Methods/Design: The participants (n=50) with lateral epicondylitis will be included in a single-blinded, randomised control trial. Participants will be categorised into either a control group or an intervention group after performing baseline assessments and randomization. The participants in the control group will be given Mulligan Mobilisation with Movement, and those in the intervention group will be given “PowerBall device” exercise and conventional physiotherapy. Basic exercises and ultrasound will be given to both groups with the given protocol. We will evaluate pain, function, grip strength and Range of motion, pre and post intervention period. Discussion: Efficacy of the intervention is evaluated by analysing the pain and function in patients with lateral epicondylitis using PRTEE scale, and grip strength using Hand-held Dynamometer. The results from the study will significantly provide affirmation on the application of “PowerBall device” exercise and Mulligan Mobilisation with Movement on the patients with lateral epicondylitis.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033363.

Comparison of Mulligan Mobilization with Movement and Progressive Strengthening Exercises in Patient with Lateral Epicondylitis

“…These findings are consistent with previous research. Lucado et al (2019) demonstrated that MWM significantly improved VAS pain ratings and grip strength in patients with lateral elbow tendinopathy (10)(11)(12)(13)(14). Similarly, Basak et al (2018) found that both wrist manipulation and progressive exercises significantly improved elbow pain and grip strength, with combined treatments showing even greater improvements (11).…”

“…In conclusion, while both treatment modalities are beneficial, MWM appears to be more effective in reducing pain and improving functional disability, whereas Progressive Strengthening Exercises excel in enhancing grip strength (14)(15). This study underscores the importance of tailored treatment approaches based on individual patient needs and highlights the potential for combining these modalities to optimize clinical outcomes in patients with lateral epicondylitis.…”