Effects of the Tyler Twist Versus Eccentric 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

* 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