Health TrialsbyHealthPanel

Telerehabilitation vs Supervised Physiotherapy for Medial Epicondylitis

ConditionsMedial EpicondylitisTelerehabilitationPhysiotherapy
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-60
SponsorBenha University

About this trial

This randomized controlled trial aims to compare the effectiveness of telerehabilitation and supervised physiotherapy in patients with medial epicondylitis. The primary outcome is improvement in pain and function using the Patient-Rated Elbow Evaluation (PREE). Secondary outcomes include pain intensity, grip strength, musculoskeletal ultrasound findings, adherence, and upper limb disability measured by Quick DASH.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Age 18 to 60 years

Clinical diagnosis of medial epicondylitis

Symptoms duration ≥6 weeks

Pain with resisted wrist flexion

Disqualifiers

Previous elbow surgery

Corticosteroid injection within the past 3 months

Cervical radiculopathy

Systemic inflammatory disease

Trial design

Design model

Parallel

Treatments tested in this trial

  • Telerehabilitation Exercise Program

    Other intervention

    Participants will perform a home-based progressive loading program targeting the wrist flexor-pronator muscles three times per week for 8 weeks. The protocol will progress from isometric exercises in weeks 1-2 (4-5 × 30-45 s holds), to eccentric loading in weeks 3-4 (3 × 15 repetitions), followed by combined concentric-eccentric training in weeks 5-6 (3-4 × 10-12 repetitions), and heavy slow resistance in weeks 7-8 (3-4 × 6-8 repetitions at \~70-85% 1RM). Exercise intensity will be guided by a pain-monitoring model (≤5/10), with progression based on tolerance. Participants will receive weekly video consultations, instructional materials, and adherence will be tracked via digital logs.

  • Supervised Physiotherapy Program

    Other intervention

    Participants will undergo an identical progressive loading program targeting the wrist flexor-pronator muscles, administered three times per week for 8 weeks under direct physiotherapist supervision. The intervention will follow the same staged progression: will progress from isometric exercises in weeks 1-2 (4-5 × 30-45 s holds), to eccentric loading in weeks 3-4 (3 × 15 repetitions), followed by combined concentric-eccentric training in weeks 5-6 (3-4 × 10-12 repetitions), and heavy slow resistance in weeks 7-8 (3-4 × 6-8 repetitions at \~70-85% 1RM). Exercise intensity will be guided by a pain-monitoring model (≤5/10), with progression based on tolerance. This supervised approach ensures correct technique, optimal load progression and adherence to the protocol

Treatment groups

60 Participants
are divided into 2 treatment groups
Group A: TelerehabilitationExperimental treatment 1 intervention
Group B: Supervised PhysiotherapyActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Change in Patient-Rated Elbow Evaluation (PREE) Score

The PREE is a 15-item questionnaire assessing pain and functional disability. Scores range from 0 to 100, with higher scores indicating worse pain and function.

Time frame
Baseline and 8 Weeks

Secondary outcomes

1

Colour Ultrasonography

Change in tendon hypervascularity and hypoechogenicity will be assessed using color Doppler ultrasonography and graded on a four-point scale (Grade 1-Grade 4). Ultrasonographic evaluation will include assessment of hypoechoic changes within the common flexor tendon, tendon sheath thickening, partial or full-thickness tendon ruptures, neovascularization detected by Doppler imaging, and cortical irregularities or damage at the medial epicondyle.

Time frame
Baseline and 8 Weeks
2

Grip Strength (hand dynamometer)

Measured using a hand dynamometer. Hand grip strength will be assessed using a calibrated hydraulic hand dynamometer with participants seated comfortably, shoulder adducted and neutrally rotated, elbow flexed to 90°, forearm in neutral position, and wrist positioned between 0-30° extension according to standardized testing procedures. Participants will be instructed to perform maximal voluntary grip contraction for approximately 3-5 seconds. Three trials will be recorded for the affected upper limb with a 30-60 second rest interval between attempts, and the mean value in kilograms (kg) will be used for statistical analysis.

Time frame
Baseline and 8 Weeks
3

Pain Intensity (Visual Analog Scale)

Pain intensity will be assessed using a 10-cm Visual Analog Scale (VAS) ranging from 0 ("no pain") to 10 ("worst imaginable pain") at rest and during resisted wrist flexion.

Time frame
Baseline and 8 Weeks

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Benha University

Lead sponsor

Source ClinicalTrials.gov
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