Effect of mulligan technique on the pathogenesis of lateral epicondylitis / Sahar Mowad Abdelmutilib ; Supervised Lilian Albert Zaky , Ali M. E Elzawahry , Ghada Mohamed Rashad Koura

Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Musculolosbeletal Dissorders

Background:Mulligan's MWM is widely used in management of musculoskeletal disorders andis effective in the treatment of LE . Aim : The aim of this study was to investigate the effect of mulligan technique on the pathogensis of Lateral Epicondylitis .Materials and methods:Thirty patients in each group participated in the study and selected randomly in both groups. In group A , the mean of age was 39.13±5.04:mean weight was 84.2±8.94 kg, mean height was 166.4±5.58:and the mean of body mass index was 29.29±3.49.The patient divided into 2 groups when group A received MWM following by rigid tapping plus traditional treatment, while group B received traditional treatment only. pain was measured by VAS , pain free grip muscle strength(PFGS) was measured by digital hand held dynamometer :functional disability of affected upper limb was measured by PRTEE , hypoechogencity in common extensor tendon was measured by gray scale sonography and hypervascularity was measured by colour Doppler sonography. The results: this study included that there was significant improvement of pain level(VAS) in both groups but in group A there was better improvement than group B , as the change in VAS in group A was 75.78% but in group B , it was 20.42% :p < 0.05. There was significant improvement of PFGS in both groups but improvement in group A is better than group B , as the change in group A equal 65.45% but in group B equal 16.73% :p < 0.05 :functional disability was improved in both groups but also group A is better improvement than group B as in DASH score in group A, the change equal 68.1% but in group B equal 28.11% :p < 0.05 while in PRTEE score, in group A the change equal 72.64% but in group B equal 14.02 %. For sonographic measurement, there was significant decreasing in the size of hypoechogenecity in group A but there was no significant reduction in it in group B, where the change in group A equal 65.11% but in group B equal 0%. For hypervascularity , the number of vessels decreased in group A by change 71.42% but in group B , there was no change in it 0%:p < 0.05. Conclusion: MWM followed by tapping is more effective than traditional treatment in patients of lateral epicondylitis

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