Effects of the Tyler Twist Versus Eccentric Exercises
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Tyler Twist Exercises, Traditional Eccentric Wrist Extensor Exercises.
- Who it may be relevant to
- Registry conditions: Lateral Epicondylalgia. Basic parameters: 20 years — 40 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Pakistan
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Effects of the Tyler Twist Versus Eccentric Exercises in Patients With Lateral Epicondylagia
Overview
This study aims to compare the effects of the Tyler Twist exercise versus traditional eccentric exercises on pain, grip strength, and functional outcomes in patients diagnosed with lateral epicondylalgia. The primary objective is to determine which intervention offers greater improvement in clinical symptoms and overall function over a defined treatment period.
Detailed description
Conservative management is typically the first line of treatment, with eccentric exercises widely recognized for their effectiveness in promoting tendon healing and reducing pain. The "Tyler Twist," exercise is a variation using the TheraBand FlexBar, that has emerged as a superior potential alternative, that combines both eccentric and concentric loading in a functional and controlled way. However, direct comparative evidence between the Tyler Twist and conventional eccentric exercises has remained limited.
Interventions
- Other Tyler Twist Exercises
* Position: * The patient holds the FlexBar in both hands. * The affected arm is placed in front with the elbow extended and wrist in slight extension. * The unaffected hand grips the other end of the FlexBar. * Twisting Motion: 1. The patient uses the unaffected hand to twist the FlexBar into a taut position while the affected hand resists the motion (eccentric loading). 2. Once the FlexBar is twisted, the patient extends the arms in front and slowly untwists the bar with the affected wris - Other Traditional Eccentric Wrist Extensor Exercises
* Position: * Patient seated with the forearm resting on a table, palm facing down, wrist hanging off the edge. * Elbow flexed to \~90 degrees. * Eccentric Movement: 0\. The patient uses the unaffected hand to assist the affected wrist into extension (starting position). 1. The affected wrist then slowly lowers the weight into flexion (eccentric contraction). 2. The cycle is repeated, focusing on slow movement (2-4 seconds lowering phase). 3. 3 sets of 10-15 reps, once daily. 4. Weigh
Primary outcome measures
- Numeric pain rate scale (NPRS) for pain [Time frame: 6 weeks]
- Handheld dynamometer for grip strength: [Time frame: 6 weeks]
- Patient-Rated Tennis Elbow Evaluation (PRTEE) for functional disability [Time frame: 6 weeks]
Eligibility criteria
Inclusion criteria
- ● Males and female patients suffering from lateral epicondylagia in subacute and chronic phase.
- Age between 20yrs-40yrs.
- Patients screened with positive Cozen's test, positive Mill's test, positive Maudsley's test \[14\].
- NPRS pain score ≥ 4 on activity.
- Tenderness on palpation over the lateral epicondyle of humerus,
- Pain with gripping, Pain with resisted wrist extension.
Exclusion criteria
- History of recent trauma or surgery of elbow.
- Acute stage of lateral epicondylagia.
- Corticosteroid injection within the last 3 months.
- Neurological defeciency of the affected limb \[16\].
- Systemic inflammatory diseases, such as rheumatoid arthritis, lupus, or fibromyalgia.
- Diabetes mellitus (uncontrolled) due to its influence on tendinopathy.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
Pakistan · 1 center
- Ghurki Hospital Lahore — Lahore
Publications
- Cancela-Cilleruelo I, Rodriguez-Jimenez J, Fernandez-de-Las-Penas C, Cleland JA, Arias-Buria JL. Widespread Pressure Pain Hyperalgesia Is Not Associated With Morphological Changes of the Wrist Extensor Tendon in Unilateral Lateral Epicondylalgia: A Case-Control Study. Phys Ther. 2024 Sep 4;104(9):pzae075. doi: 10.1093/ptj/pzae075. PMID 38832712
- Karabinov V, Georgiev GP. Lateral epicondylitis: New trends and challenges in treatment. World J Orthop. 2022 Apr 18;13(4):354-364. doi: 10.5312/wjo.v13.i4.354. eCollection 2022 Apr 18. PMID 35582153
Identifiers
NCT: NCT07626632 · REC/RCR&AHS/25/0121