Effects of Cyriax Manual Therapy versus Mulligan Technique on Grip Strength and Functional Outcomes in Patients with Lateral Epicondylitis

Abstract

Objective: To examine the effects of Cyriax manual therapy and Mulligan technique on Grip strength and functional outcomes among the patients of lateral epicondylitis.

Methodology: This was a randomized control trial conducted in a duration of eighteen months. 66 diagnosed patients from Gosha E Shifa Hospital were recruited for the study and were randomized through computer number generator into group A and B. The two primary outcomes were measured i.e. Dynamometer for grip strength and Patient-Rated Tennis Elbow Evaluation Questionnaire for functional outcomes. Research assessor assessed patients before treatment i.e. t1, between treatment i.e. t2 and after treatment i.e. t3.The response rate of overall study was 91.33% thus complying with rule of 85% follow up.

Results: The patients who were in group A had mean age of 36.12 ± 7.56 years and 33.91 ± 3.4 years patients in group B. Grip strength measured by hand grip dynamometer was found to be 32.7 ± 1.41 and 33.3 ± 1.34 at Pre-treatment level (p=0.07 i.e. non-significant), 42.1 ± 1.30 and 38.6 ± 2.82 at mid treatment level (p=0.00 i.e. significant) and 53.5 ± 2.13&42.3 ± 1.97 at post treatment level (p=0.00 i.e. significant). Functional outcomes measured by Patient-Rated Tennis Elbow Evaluation Questionnaire was found to be 78.06 ± 2.76 and 76.93 ± 1.71 at Pre-treatment level (p=0.053 |i.e. non-significant), 60.61 ± 3.78 and 38.06 ± 5.73 at mid treatment level (p=0.00 i.e. significant), 26.86 ± 2.43 and 7.66   ± 1.64 at post treatment level (p=0.00 i.e. significant).

Conclusion: The present study concluded that Grip strength was improved by Cyriax manual therapy better than mulligan technique, while Functional status was improved by Mulligan techniques better than Cyriax manual therapy.

Keywords: Cyriax Manual Therapy, Lateral Epicondylitis, Mulligan Technique, Patient-Rated Tennis Elbow Evaluation