PHY5104 Assessment 2 Assignment Sample

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Introduction

Lateral epicondylitis, more widely called tennis elbow, is an inflammatory condition that is part of the Musculoskeletal System’s category, resulting from the repetitive use of the wrist joint and the supination of the forearm, which causes damage to the cells of the ECRB tendon. It mainly causes lateral elbow pain that aggravates with gripping and lifting objects and dramatically reduces the quality of daily living, working, and sports. In terms of the biopsychosocial model, the biological aspect consists of tendon degeneration and pain. From a psychological perspective, patients may get anxious, frustrated, and fearful; hence, they engage in a number of avoidant behaviors that limit their activity. In social aspects, restricted performance in occupational activities and recreation, which includes racquet sports, may reduce the quality of life. Other goals of rehabilitation involve the management of pain, increase in tendon loading thus enhancing part functions, and tackling psychological factors.

PHY5104 Assessment 2 Assignment Sample

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Study samples and reference materials assist students in improving assignment structure and academic development. We provide cheap assignment help while ensuring originality. The PHY5104 Assessment 2 Assignment Sample explores tennis elbow rehabilitation, exercise therapy, pain management, and biopsychosocial recovery strategies. For learning and reference only.

Discussion

Exercise 1: Eccentric Wrist Extension

Description

The patient lies on a chair with her arm in a dependent position on a small table with her palm facing downward towards the table and with the wrist overhanging the table. They maintain a light dumbbell of 1-2 kg, use the unaffected hand to stabilize wrist extension, and then bring back the dumbbell slowly in a controlled 3-5 seconds functional eccentric contraction. This type of exercise requires to take 3 sets of 15 repetitions every day.

Figure 1: Eccentric Wrist Extension

Aim

This is to promote the healing process of the ECRB tendon and to alleviate pain as well as enhance load tolerance. Hence, by gradually loading the tendon, we depend again on the body’s ability to remodel the tissue for enhanced functionality.

Evidence

Eccentric training is one of the essential components of the rehabilitation program in tendinopathy cases. The authors illustrated that due to eccentric exercises, there is relief from pain and, therefore, an enhanced function in chronic tennis elbow (Lau et al. 2021). This process results in eccentric loading stimulating the tendon remodeling and the rearrangement of collagen fibers, as well as causing mechanical stimulation of mechanoreceptors and perceptions of analgesia (Chen and Baker, 2021). Eccentric training is a superior form of loading when compared with concentric or static exercise programs, with better clinical improvement at the final follow-up.

Exercise 2: Isometric Wrist Extension

Description

Positioning the forearm on a table in order to provide stability, the patient performs an isometric contraction based on extending the wrist to approximately 30 degrees against the resistance in the form of a resistive band or by using manual resistances; the managing time is about 30-45 seconds. This type of exercise is needed to recommend for 4-5 repetitions every day.

Figure 2: Isometric Wrist Extension

Aim

The goal focuses on the reduction of pain, sustaining and improving neuro muscular co-ordination, and increasing load tolerance of the tendon without worsening the signs. Psychologically, pain reduction allows minimizing fear-avoidance behavior and contributes to the patient’s confidence.

Evidence

There is sufficient literature already showing that isometric exercise has an immediate analgesic effect (Hanif et al. 2024). Hence, for the management of tendinopathy. It decreases cortical inhibition, enhances motor unit recruitment, and has an analgesic effect by neuromodulation. Isometric loading implies tendon load without stressing them, which makes it effective to be used during early stages of rehabilitation or during flair-ups (Pitts et al. 2021). In comparison, isometrics can have acute reductions in pain and allow people to remain active with the process of transitioning to other forms of exercises.

Exercise 3: Grip strengthening by Soft Ball

Description

Another form of grasp exercise entails the use of a soft ball, which can be a rolled towel, ensuring that the patient performs prolonged and frequent grip exercises. This involves applying force on the ball with a force considered average and holding it for a count of five seconds, or five seconds subsequently they let go. It is advised that two to three sets of 10 repetitions be performed daily, and as the program progresses, firmer balls and heavier loads be used.

Figure 3: Exercise by soft ball

Aim

It is highly recommended to increase grip strength, enhance the ability to perform functional tasks, for instance, lifting force and carrying capacity and decrease pain on gripping. On the biosychoaspect, there is less psychological apprehension by patients in relation to re-injury and enhanced functional capacity in relation to work and sports.

Evidence

It can be concluded that grip strength is diminished among the individuals who have lateral epicondylitis because of pain and, hence, disuse (Bagcaci et al. 2023). This wrist band strengthening exercise helps to increase grip strength which, in turn increases extensor and flexor synergy of the forearm muscles. Therefore, the research concludes that the addition of progressive grip strengthening is beneficial because it decreased pain and served as a means of indirectly loading the extensor tendon (Uttamchandani et al. 2024) Research indicates that exercises that involve the loading of tendon with grip strengthening are more effective for functional improvement compared to exercises done singly.

Outcome Measurement

Thus, there are four measures used to assess the efficiency of the rehabilitation program for lateral epicondylitis. The Patient-Rated Tennis Elbow Evaluation is a tool that evaluates patients for pain that is tennis elbow-related, with higher values demonstrating less pain and improved arm usage. A hand dynamometer measures grip strength in terms of pain-free and maximum grip strength using hand dynamometer which in turn offers an ideal indicator of functional recovery. The Visual Analogue Scale is used to measure the perceived pain, and lessening of the pain indicates an improvement in the pain control situation. Lastly, the Fear-Avoidance Beliefs Questionnaire checks the psychological aspects of the patient, focusing on the fear of pain and avoiding movements. Change in these parameters indicates physical rehabilitation, less pain, and enhanced mental self-perception about engaging in daily activities.

Conclusion

This exercise therapy for lateral epicondylitis is an endeavour to decrease pain, enhance the bio-physical properties of the tendon, as well as address the biopsychosocial aspects of this condition. Therefore, with a well set out structure and right and achievable goals, this program can make them get well and go back to their normal activities. This rehabilitation program includes both high-intensity and high-quality documented evidence therapeutic approaches. This makes the assessment of both physiological and psychological changes valid by the use of validated outcome measures.

Reference List

Journals

• Bagcaci, S., Unuvar, B.S., Gercek, H., Ugurlu, I., Sert, O.A. and Yilmaz, K., 2023. A randomized controlled trial on pain, grip strength, and functionality in lateral elbow pain: Mulligan vs muscle energy techniques. Journal of Back and Musculoskeletal Rehabilitation, 36(2), pp.419-427.
• Chen, Z. and Baker, N.A., 2021. Effectiveness of eccentric strengthening in the treatment of lateral elbow tendinopathy: A systematic review with meta-analysis. Journal of hand therapy, 34(1), pp.18-28.
• Hanif, A., Hafeez, S., Arif, T. and Habib, S., 2024. Comparison of active release and post-isometric relaxation techniques on functional performance in patients with chronic lateral epicondylitis. Journal of Musculoskeletal Surgery and Research, 8(3), pp.240-246.
• Lau, W.Y., Blazevich, A.J., Newton, M.J., Wu, S.S.X. and Nosaka, K., 2021. Effects of wrist position on eccentric exercise‐induced muscle damage of the elbow flexors. Scandinavian Journal of Medicine & Science in Sports, 31(6), pp.1290-1300.
• Pitts, G., Uhl, T.L. and Day, J.M., 2021. Grip strength is more sensitive to changes in elbow position than isolated wrist extension strength in patients with lateral elbow tendinopathy. Journal of Hand Therapy, 34(3), pp.509-511.
• Uttamchandani, S.R., Phansopkar, P. and Uttamchandani Sr, S.R., 2024. Efficacy of PowerBall Versus Mulligan Mobilisation With Movement on Pain and Function in Patients With Lateral Epicondylitis: A Randomized Clinical Trial. Cureus, 16(3).