EFFECT OF MULTIMODAL APPROACH ON REHABILITATION OF THE PATIENTS WITH LATERAL EPICONDYLITIS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Lateral elbow tendinopathy is associated with pain, reduced grip strength, and limitations in daily activities. Exercise and manual therapy are commonly used, but the short-term comparative effect of a multimodal program versus a conventional physiotherapy protocol remains clinically relevant.

Objective: To compare a multimodal rehabilitation program with conventional physiotherapy for pain, grip strength, and patient-reported function in adults with lateral epicondylitis.

Methods: Clinical trial (NCT06686732) a single-blind randomized controlled trial included 40 participants aged 18–45 years allocated by sealed-envelope method to conventional treatment (n = 20) or multimodal treatment (n = 20). Both groups received 12 treatment sessions over 3 weeks. Outcomes were assessed at baseline and after treatment using a visual analogue scale (VAS), hand-held dynamometry, and the Patient-Rated Tennis Elbow Evaluation (PRTEE). Data were analyzed using SPSS version 25; statistical significance was set at p < 0.05.

Results: At post-treatment, VAS pain was lower in the multimodal group than in the conventional group (median 1.0 [IQR 0.0] vs 2.0 [IQR 1.0], p = 0.001). Grip strength was higher in the multimodal group for the right hand (median 16.0 [IQR 13.5] vs 14.0 [IQR 5.5], p = 0.032) and left hand (14.0 [IQR 12.0] vs 12.0 [IQR 4.0], p = 0.024). PRTEE scores favored multimodal treatment for pain (12.05 ± 1.93 vs 13.55 ± 2.28, p = 0.031), usual activities (15.50 ± 1.84 vs 17.75 ± 3.78, p = 0.022), and total score (27.20 ± 3.65 vs 31.40 ± 4.41, p = 0.002); the specific-activities difference was not significant (p = 0.201).

Conclusion: Both programs were associated with improvement over 3 weeks, while the multimodal program showed better post-treatment results for pain, grip strength, and several PRTEE domains. Interpretation is limited by the small sample and short follow-up, and the statistical analysis should be verified against the raw dataset before submission.