Comparing the effectiveness of Mulligan mobilization versus Cyriax approach in the management of patients with subacute lateral epicondylitis
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(4):17 J Pak Med Assoc. 2021 Jan;71(1(A)):12-15.What this means for my practice?
Results of this study may suggest that whilst pain scores were significantly in favour of the Cyriax group and functional scores were significantly in favour of the mobilization group, the improvement in overall clinical outcomes after 4 weeks of treatment is similar between the two interventions in patients with sub-acute lateral epicondylitis. This study was limited by the small sample size and short follow-up time, as well as the lack of blinding of the outcome assessors. Future trials with larger follow-up and longer follow-up to compare the long-term effects of the two treatments are required.
Study Summary
Sixty patients with subacute lateral epicondylitis were randomized to receive 12 session of the Cyriax method (deep transverse friction massage plus Mill's manipulation; n=30) or Mulligan mobilization with movement (n=30), over a 4 week period. The outcomes of interest was the patient-rated tennis elbow evaluation (PRTEE) pain score, functional disability score, and total score (pain + function scores), assessed at 1, 2, 3 and 4 weeks follow-up. Results revealed no statistical significant differences between the two groups in the PRTEE total scores at all time-points (p>0.05 for all). However, PRTEE pain scores were statistically significantly in favour of the Cyriax group at 2, 3 and 4 weeks follow-up (p<0.01 for all), whilst PRTEE function scores were statistically significantly in favour of the mobilization group at 2 and 3 weeks follow-up (p<0.01 for both).
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