Telerehabilitation vs Supervised Physiotherapy for Medial Epicondylitis

Effectiveness of Telerehabilitation Versus Supervised Physiotherapy on Pain, Function, Strength, and Musculoskeletal Ultrasound Parameters in Patients With Medial Epicondylitis: A Randomized Controlled Trial

This randomized controlled trial aims to compare the effectiveness of telerehabilitation and supervised physiotherapy in patients with medial epicondylitis. The primary outcome is improvement in pain and function using the Patient-Rated Elbow Evaluation (PREE). Secondary outcomes include pain intensity, grip strength, musculoskeletal ultrasound findings, adherence, and upper limb disability measured by Quick DASH.

Medial epicondylitis is a tendinopathy affecting the common flexor origin of the elbow, resulting in pain and functional limitation. Supervised physiotherapy is commonly used; however, telerehabilitation provides an accessible and scalable alternative. Evidence comparing these two delivery models is limited.

This randomized controlled trial will compare telerehabilitation and supervised physiotherapy over an 8-week intervention period. Clinical outcomes will be assessed using PREE, pain intensity, grip strength, and QuickDASH. Musculoskeletal ultrasound will be used to evaluate tendon structural characteristics. The study will also explore the relationship between imaging findings and clinical outcomes.

Inclusion Criteria:

• Age 18 to 60 years
• Clinical diagnosis of medial epicondylitis
• Symptoms duration ≥6 weeks
• Pain with resisted wrist flexion
• Local tenderness at medial epicondyle

Exclusion Criteria:

• Previous elbow surgery
• Corticosteroid injection within the past 3 months
• Cervical radiculopathy
• Systemic inflammatory disease
• Bilateral symptoms