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Effects of the Tyler Twist Versus Eccentric Exercises

1. juni 2026 opdateret af: Riphah International University

Effects of the Tyler Twist Versus Eccentric Exercises in Patients With Lateral Epicondylagia

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.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

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.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

38

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • Ghurki Hospital Lahore
        • Kontakt:
        • Kontakt:
        • Ledende efterforsker:
          • Hafiza Nukhba SIBGHAT, MSOMPT

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

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.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Tyler Twist Exercises
The Tyler Twist is a specific eccentric exercise using the TheraBand FlexBar, designed to target the extensor carpi radialis brevis (ECRB), which is primarily involved in lateral epicondylalgia.
Andet: 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 wrist, creating a controlled eccentric contraction.
    3. Emphasis is placed on slow, controlled movement (2-3 seconds for untwist).
    4. 3 sets of 15 repetitions, once daily.
    5. Progress to higher resistance FlexBars as tolerated (e.g., from red to green to blue).
    6. Supervision during clinical visits (twice per week), rest is home-based
Aktiv komparator: Traditional Eccentric Wrist Extensor Exercises
This protocol involves eccentric strengthening of the wrist extensor muscles (primarily ECRB)using a dumbbell (1-2 kg) or wrist cuff weight.
Andet: 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. Weight increased progressively based on pain-free performance.
    5. Supervised sessions 2x/week; home exercise on other days

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Numeric pain rate scale (NPRS) for pain
Tidsramme: 6 weeks
To determine the degree of pain that the patient will report, the Numeric Pain Rating Scale (NPRS) will be utilized. This scale consists of 11 points ranging from 0-10, where zero indicates no pain, five represents moderate pain intensity, and ten signifies severe pain intensity
6 weeks
Handheld dynamometer for grip strength:
Tidsramme: 6 weeks
For pain-free grip strength assessment, the patient's arm is positioned comfortably with the shoulder adducted and neutrally rotated, the elbow flexed to 90 degrees.20, the forearm in a neutral position, and the wrist in slight extension and ulnar deviation. The patient is instructed to squeeze as tightly as possible for 3-5 seconds, with multiple trials and an average of three repetitions recorded. A brief pause is provided between trials to prevent muscle fatigue. Hand-held dynamometers have been shown to have excellent internal validity and reliability, with reported values of 0.31-0.69 in the upper extremities
6 weeks
Patient-Rated Tennis Elbow Evaluation (PRTEE) for functional disability
Tidsramme: 6 weeks
The PRTEE questionnaire is one of the most widely-used outcome measures that appreciates elbow
6 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Riphah International University

Efterforskere

  • Ledende efterforsker: Hira Shaukat, Mphill, Riphah International University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

15. juni 2026

Primær færdiggørelse (Anslået)

10. oktober 2026

Studieafslutning (Anslået)

13. november 2026

Datoer for studieregistrering

Først indsendt

1. juni 2026

Først indsendt, der opfyldte QC-kriterier

1. juni 2026

Først opslået (Faktiske)

4. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Andre undersøgelses-id-numre

  • REC/RCR&AHS/25/0121

Plan for individuelle deltagerdata (IPD)

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