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J Back Musculoskelet Rehabil. 2019 May 10. doi: 10.3233/BMR-181135. [Epub ahead of print]

The effects of Mulligan's mobilization with movement technique in patients with lateral epicondylitis.

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Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Turkey.
Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Turkey.



Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the use of mobilization with movement for LE.


To investigate the effects of Mulligan's mobilization with movement (MWM) in LE.


Forty patients were included in the study and randomly assigned to group 1 (n= 20), who received MWM, exercise and cold therapy, or group 2 (n= 20), who received exercise and cold therapy. The sessions were conducted five times a week for two weeks. All measures were conducted at baseline, after treatment, at 1st and 3rd months follow-ups. Mann-Whitney U test, a visual analogue scale (VAS) for pain intensity, Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire for pain intensity and functional disability and a dynamometer for hand grip strength were applied.


VAS activity pain significantly decreased in group 1 after treatment (p= 0.001), at the 1st (p< 0.001) and 3rd months (p= 0.040). There was a significant decrease in VAS night pain in group 1 (p= 0.024), and a significant increase in pain-free grip strength (p= 0.002) after treatment. PRTEE-Pain scores decreased in group 1 after treatment (p< 0.001), 1st (p< 0.001) and 3rd months (p= 0.001).


MWM plus exercise and cold therapy is a safe and effective alternative with positive effects on elbow pain, functional capacity, and pain-free, maximum grip strength.


Lateral epicondylitis; Mulligan’s mobilization technique; cold therapy; exercise


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