Clinical Research Directory

Effects of Peripheral Repetitive Peripheral Magnetic Stimulation on Individuals With Elbow or Wrist Chronic Pain

This pilot, randomized, sham-controlled, single-blind study will evaluate the effectiveness of repetitive peripheral magnetic stimulation (rPMS) in reducing pain in adults with tennis/golfer's elbow or carpal tunnel syndrome. Approximately 40 participants will be randomly assigned to active or sham stimulation delivered over two consecutive days. Outcomes, including pressure pain threshold, subjective pain ratings, and local tissue oxygenation (fNIRS), will be assessed at baseline, immediately post-intervention, and during follow-up up to 6 months to evaluate both clinical effects and underlying physiological mechanisms.

Comparative Effect of Tyler Twist Technique and Muscle Energy Technique on Lateral Epicondylitis.

This thesis, titled "Comparative Effects of Muscle Energy Technique and Tyler Twist Technique on Grip Strength, Pain, and Function in Patients with Lateral Epicondylitis," investigates the efficacy of two widely used physical therapy methods for treating lateral epicondylitis (tennis elbow). Lateral epicondylitis is a common musculoskeletal illness characterised by pain across the lateral side of the elbow, reduced grip strength, restricted upper-limb function, and difficulty performing daily and professional responsibilities. If treatment is not received, the illness, which frequently affects people who do repeated wrist and forearm motions, can significantly lower quality of life. In this randomised clinical investigation, 34 people between the ages of 20 and 40 were split into two therapy groups. One group received the Muscle Energy Technique (MET), a manual therapy approach that improves neuromuscular function, joint mobility, and muscle flexibility by using controlled isometric contractions followed by stretching. The second group performed the Tyler Twist Technique, an eccentric strengthening exercise that targets the wrist extensor muscles and has gained popularity as a tennis elbow treatment, using a flex bar. The baseline examination, which revealed that both groups were similar in terms of demographic characteristics including age and gender as well as initial pain levels, demonstrated that the groups were well matched prior to the intervention. The results of the study demonstrated significant clinical improvements in both groups following treatment. Both the Tyler Twist and MET groups had a significant decrease in pain intensity from baseline on the Numerical Pain Rating Scale (NPRS), suggesting that both therapies were effective in lowering pain associated with lateral epicondylitis. Although each group saw a considerable reduction in pain, there was no statistically significant difference between the groups, suggesting that both approaches provide comparable benefits in terms of pain relief. To assess functional impairment, the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire was employed. Upper-limb function significantly improved with both treatments, and disability scores decreased. However, during follow-up, PRTEE scores increased more in individuals who got the Tyler Twist Technique, indicating a better improvement in functional performance and the ability to do daily chores. Additionally, grip strength measurements showed significant increases in both groups, with the Tyler Twist group seeing somewhat larger gains. These findings support the hypothesis that eccentric strengthening exercises may aid individuals suffering from tennis elbow in regaining hand function and muscle performance. However, it was shown that the Muscle Energy Technique was better at improving elbow flexion range of motion and wrist flexion and wrist extension mobility. Improvements in neuromuscular relaxation, improved joint mechanics, and reduced soft-tissue stiffness brought about by the manual therapy component of MET may have contributed to greater mobility and flexibility around the elbow and wrist complex. When quality of life was assessed using the Short Form-36 (SF-36) questionnaire, both treatment groups demonstrated significant improvements in several aspects. This suggests that increases in physical functioning, engagement in everyday activities, and general well-being coincided with decreases in pain and impairment. The study's findings show that both the Muscle Energy and Tyler Twist approaches improve function, grip strength, pain relief, and overall quality of life for those with lateral epicondylitis. While MET was more successful in improving wrist and elbow mobility, the Tyler Twist approach produced better benefits in grip strength and functional recovery. These findings show that the therapy plan can be customised to the patient's demands, using Tyler Twist for strength and function and MET for range of motion gains. Because there were only 34 participants in the research, the results could not have been as relevant to bigger groups. Because of the short trial period, the therapy's long-term effects could not be evaluated. The study's applicability to elder patients was reduced by the participants' limited age range of 20-40 years. To increase the generalisability of the results, bigger and more varied sample sizes are advised for subsequent research. Long-term follow-up studies should be planned in order to assess the long-term impacts of the Muscle Energy method and the Tyler Twist method. To determine the combined impact, the outcomes of a treatment plan that includes both the Tyler Twist and the Muscle Energy Technique treatments should be examined for people with lateral epicondylitis.

Blood Flow Restriction Training in Tennis Elbow

Lateral epicondylitis (LE) is a common musculoskeletal disorder caused by repetitive overuse of the forearm extensor muscles. It is characterized by pain over the lateral epicondyle of the humerus, which may radiate to the surrounding tissues at the origin of the wrist extensor tendons. LE is one of the most frequent causes of lateral elbow pain, with a reported prevalence of approximately 1-3% in the general population. Among conservative interventions, exercise-based rehabilitation is considered a cornerstone of management. In particular, exercise programs incorporating eccentric contractions have demonstrated superior clinical outcomes compared with several other exercise approaches and are therefore widely recommended. Blood flow restriction training (BFRT) has recently emerged as an alternative rehabilitation strategy that promotes neuromuscular adaptations while using low mechanical loads. BFRT involves the application of a pneumatic cuff, tourniquet, or elastic band around the proximal portion of an extremity to partially restrict arterial inflow while substantially reducing venous return, thereby creating localized metabolic and hemodynamic stress during exercise. The primary aim of this randomized controlled trial was to investigate the effects of BFRT on pain, functional status, pain-free grip strength, health-related quality of life, and ultrasonographic characteristics of the common extensor tendon in patients with lateral epicondylitis.