Telerehabilitation vs Supervised Physiotherapy for Medial Epicondylitis
Effectiveness of Telerehabilitation Versus Supervised Physiotherapy on Pain, Function, Strength, and Musculoskeletal Ultrasound Parameters in Patients With Medial Epicondylitis: A Randomized Controlled Trial
Benha University
60 participants
May 14, 2026
INTERVENTIONAL
Conditions
Summary
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
Inclusion Criteria5
- Age 18 to 60 years
- Clinical diagnosis of medial epicondylitis
- Symptoms duration ≥6 weeks
- Pain with resisted wrist flexion
- Local tenderness at medial epicondyle
Exclusion Criteria5
- Previous elbow surgery
- Corticosteroid injection within the past 3 months
- Cervical radiculopathy
- Systemic inflammatory disease
- Bilateral symptoms
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Interventions
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.
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
Locations(1)
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NCT07582510