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Trial registered on ANZCTR
Registration number
ACTRN12616001599460
Ethics application status
Approved
Date submitted
25/10/2016
Date registered
18/11/2016
Date last updated
27/02/2020
Date data sharing statement initially provided
27/02/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Effectiveness of a combined treatment of dry needling with an exercise program in patients with tennis elbow.
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Scientific title
Effectiveness of a combined treatment of dry needling with an isometric exercise program in patients with lateral epicondylalgia.
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Secondary ID [1]
290379
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Lateral epicondylalgia
300669
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Condition category
Condition code
Physical Medicine / Rehabilitation
300518
300518
0
0
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Physiotherapy
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Musculoskeletal
300649
300649
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0
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Other muscular and skeletal disorders
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Injuries and Accidents
300650
300650
0
0
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Dry needling combined with an isometric exercise program.
The intervention will be 4-week intervention program with 2 weekly treatment sessions.
-Dry needling will be performed once a week on the 1st weekly session using sterilized surgical steel disposable needles (0.3x40mm; APS (Registered Trademark), AGU-PUNT, S.L., Barcelona, Spain). The technique described by Hong will be used, which consist on fast in and out movements with the needle. The technique will be performed on the muscles of the lateral epicondyle. It will be performed by a physiotherapist with more than 10 years of clinical experience and knowledge on the technique. The duration of this part of the treatment is 10 minutes approximately.
-The isometric exercise program will be done twice a week. It consists of 3 series of 10 hand-grip isometric contractions mantained 10 seconds each, and 10 rest seconds between contractions. The force of the hand-grip will be performed 20% under the forced obtained on the pain free grip strenght test. For the treatment a Riester Minimus (Registered Trademark) II sphygmomanometer will be used. It will be supervised by a physiotherapist. The exercises will take approximately 20 minutes to be performed.
-During the first weekly session dry needling will be performed first, followed by a 5 minutes rest, and then the exercise program will be performed.
For monitoring the adherence of patients to the study an attendance sheet in which they will have to sign each session will be done.
-Intervention will be performed at Universidad de Alcala.
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Intervention code [1]
296190
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Rehabilitation
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Intervention code [2]
296311
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Treatment: Other
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Comparator / control treatment
Placebo dry needling combined with an isometric exercise program.
The intervention will be 4-week intervention program with 2 weekly treatment sessions.
-Placebo dry needling will be performed once a week on the 1st weekly session using placebo sterilized surgical steel disposable needles (0,25x40mm; Sham Needles, AcuPrime, Exeter, UK). The technique preparation is the same as for dry needling. The sham needles cause a picking sensation when pushed agains the skin. The needle disappears into the handle with increased pressure. It invoques a similar sensation to the one produced with dry needling.
-The isometric exercise program will be done twice a week. It consists of 3 series of 10 hand-grip isometric contractions mantained 10 seconds each, and 10 rest seconds between contractions. The force of the hand-grip will be performed 20% under the forced obtained on the pain free grip strenght test. For the treatment a Riester Minimus (Registered Trademark) II sphygmomanometer will be used.
-Intervention will be performed at Universidad de Alcala.
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Control group
Placebo
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Outcomes
Primary outcome [1]
299943
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Pain measured with a 100mm visual analogue scale
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Assessment method [1]
299943
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Timepoint [1]
299943
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Baseline, post treatment, 1 month post treatment, 3 months post treatment, 6 months post treatment.
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Secondary outcome [1]
328603
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Patient Rated Tennis Elbow Evaluation (PRTEE)
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Assessment method [1]
328603
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Timepoint [1]
328603
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Baseline post treatment, 1 month post treatment, 3 months post treatment, 6 months post treatment.
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Secondary outcome [2]
328604
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Pain free grip strength test using a dynamometer
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Assessment method [2]
328604
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Timepoint [2]
328604
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Baseline, post treatment, 1 month post treatment, 3 months post treatment, 6 months post treatment.
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Secondary outcome [3]
328606
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1st stretch sensation during writst flexion using a goniometer
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Assessment method [3]
328606
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Timepoint [3]
328606
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Baseline, post treatment, 1 month post treatment, 3 months post treatment, 6 months post treatment.
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Eligibility
Key inclusion criteria
-Lateral epicondylalgia symptoms confirmed with at least 2 of the 4 following test: a) pain during palpation of lateral epicondyle, b) pain on resisted wrist extension, c) pain on resisted middle finger extension, d) pain during hand-grip.
-Lateral epicondylalgia symptoms for more than 3 months
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
-History of fractures, luxations, surgery and/or musculoskeletal disorders in upper limb.
-Neurological disorders, inflammatory and/or degenerative diseases.
-Having received as treatment techniques that involve needles on the previous 6 months to study enrollment, or having received dry needling as a treatment before.
-Cervical pathology, fibromyalgia, unstable cardiovascular diseases, pregnant women or under suspect of pregnancy.
-Contraindications of dry needling: anticoagulant therapy, needle phobia, diabetes, hypothyroidism, lymphoedema, muscular diseases).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomization by computer using Random Allocation Software V1.0.0
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
21/12/2016
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Actual
21/12/2016
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Date of last participant enrolment
Anticipated
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Actual
30/06/2017
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Date of last data collection
Anticipated
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Actual
15/01/2018
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Sample size
Target
38
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Accrual to date
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Final
38
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Recruitment outside Australia
Country [1]
8343
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Spain
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State/province [1]
8343
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Madrid
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Funding & Sponsors
Funding source category [1]
294757
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University
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Name [1]
294757
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Universidad de Alcala
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Address [1]
294757
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Edificio de Fisioterapia Campus Universitario
Ctra Madrid-Barcelona Km 33,6000 E-28871
Alcala de Henares , Madrid, E-28871
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Country [1]
294757
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Spain
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Primary sponsor type
University
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Name
Universidad de Alcala (physiotherapy and pain group)
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Address
Edificio de Fisioterapia Campus Universitario
Ctra Madrid-Barcelona Km 33,6000 E-28871
Alcala de Henares , Madrid, E-28871
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Country
Spain
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Secondary sponsor category [1]
293621
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None
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Name [1]
293621
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Address [1]
293621
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Country [1]
293621
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296181
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Comite etica de la investigacion y de experimentacion animal de la Universidad de Alcala
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Ethics committee address [1]
296181
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Colegio de San Ildefonso, Plaza de San Diego s/n 28801 Alcala de Henares (Madrid)
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Ethics committee country [1]
296181
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Spain
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Date submitted for ethics approval [1]
296181
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21/06/2016
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Approval date [1]
296181
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26/09/2016
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Ethics approval number [1]
296181
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CEIM/HU/2016/13
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Summary
Brief summary
The objective of the study is to analyze the effect of dry needling combined with an isometric exercise program in patients with lateral epicondylalgia. The hypothesis proposed for this study is that dry needling combined with an isometric exercise program is more effective than placebo dry needling combined with the same exercise program for treating patients with lateral epicondylalgia regarding pain, functionality and pain free grip strength. The study design is a randomized clinical trial with blind evaluator. The population of the study are patients with lateral epicondylalgia that met the inclusion and exclusion criteria proposed and accept enrollment in the study. The study will have two groups, which will receive the same isometric exercise program combined with dry needling (group A) or placebo dry needling (group B). The isometric exercise program has a duration of 4 weeks with 2 weekly sessions, and needling will be performed in the forearm muscles once a week. The main variable of the study is pain, measured by a 100 mm visual analogue scale (VAS). Secondary variables of the study are Patient Rated Tennis Elbow Evaluation (PRTEE), pain free grip strength, pressure pain threshold, 1st stretch sensation during wrist flexion and surface electromyography (sEMG). There will be 5 assessments during the study (baseline, post-intervention, and at 1 month, 3 months and 6 months of post-intervention). All variables will be collected in every assessment except sEMG that will be recorded at baseline, post-intervention and 3 months post-intervention. For data collection a clinic history of each patient will be complete. Statistical analysis will be done with intention to treat, using the statistic software SPSS 22.0.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
69786
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Mr JOSUE PLAZA RODRIGUEZ
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Address
69786
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Edificio de Fisioterapia Campus Universitario
Ctra Madrid-Barcelona Km 33,6000 E-28871
Alcala de Henares , Madrid, E-28871
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Country
69786
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Spain
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Phone
69786
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+34664357327
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Fax
69786
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Email
69786
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[email protected]
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Contact person for public queries
Name
69787
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JOSUE PLAZA RODRIGUEZ
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Address
69787
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Edificio de Fisioterapia Campus Universitario
Ctra Madrid-Barcelona Km 33,6000 E-28871
Alcala de Henares , Madrid, E-28871
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Country
69787
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Spain
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Phone
69787
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+34664357327
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Fax
69787
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Email
69787
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[email protected]
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Contact person for scientific queries
Name
69788
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JOSUE PLAZA RODRIGUEZ
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Address
69788
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Edificio de Fisioterapia Campus Universitario
Ctra Madrid-Barcelona Km 33,6000 E-28871
Alcala de Henares , Madrid, E-28871
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Country
69788
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Spain
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Phone
69788
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+34664357327
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Fax
69788
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Email
69788
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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