Comparison of The Effects of Different Stretching Techniques in Overhead Athletes

NCT ID: NCT04687696

Last Updated: 2023-01-10

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 78 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-02-28
• Study Completion Date: 2024-12-31

Brief Summary

78 overhead athletes with Glenohumeral Internal Rotation Deficit (GIRD) will be included in this study. Participants will be randomly divided into 3 different groups of 26 people. In each group will be applied posterior shoulder stretching exercises (PSSE) performed with different Muscle Energy Techniques (MET).

Detailed Description

Post Isometric Relaxation Group (PIRG) participants will perform a PSSE with post isometric relaxation (PIR) technique, Isolytic Stretching Group (ISG) participants will perform a a PSSE with isolytic stretching technique and Static Stretching Group Group (SSG) participants will perform a PSSE with static stretching technique. All exercises will be performed in the modified crossbody position, for 5 times a week total of 6 weeks. Subacromial space, posterior capsule and muscle tendon thicknesses will be measured using a 7-12 MHz linear transducer with USG (LOGIQ e Ultrasound, GE Healthcare, USA). Athletes' GIRD results and rotational ROM measurements and Posterior shoulder tightness will be measured and recorded using a bubble inclinometer (Fabrication End Inc, New York, USA). Scapula kinematics (posterior tilt, upward rotation) will be evaluated with a digital inclinometer. Shoulder and scapular muscles will be evaluated with hend held dynamometer. Tightness of Levator scapulae and pectoralis minor will be assessed. The upper extremity functional performance of the athletes will be evaluated with the Functional Throwing Performance Index (FTPI). Evaluations will be performed before training program and repeated after 6 weeks of training, and at the 1st, 3th and 6th months after training program is completed and the effects of different muscle energy techniques (MET) will be compared. Investigators hypothesized 6 weeks of PSSE with different MET would have different effects on Acromio-Humeral Distance, posterior capsule thickness, muscle tendon thickness, rotational ROM measurements, scapula kinematics, muscle strength, posterior shoulder tightness and performance on overhead athletes with GIRD and the effects of MET would be superior to static stretching.

Conditions

Glenohumeral Internal Rotation Deficit

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Post Isometric Relaxation Group

The participants in this group will perform post isometric relaxation stretching in modified cross body position for 6 weeks.

Group Type: EXPERIMENTAL

Post Isometric Relaxation Group

Intervention Type: OTHER

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier barrier. The participants will be asked to perform an isometric contraction for 5 seconds in the horizontal abduction direction with 20% of the maximum muscle strength. After the relaxation, the arm will be moved towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between contractions.This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Isolytic Stretching Group

The participants in this group will perform isolytic stretching in modified cross body position for 6 weeks..

Group Type: EXPERIMENTAL

Isolytic Stretching Group

Intervention Type: OTHER

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier barrier. The participants will be asked to perform a contraction in the horizontal abduction direction with 20% of the maximum muscle strength. When the muscle contraction occurs, the arm will be moved quickly in 2-4 seconds towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between stretches. This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Static Stretching Group Group

The participants in this group will receive static stretching in modified cross body position for 6 weeks.

Group Type: EXPERIMENTAL

Static Stretching Group Group

Intervention Type: OTHER

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier. Then, the arm will be moved towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between stretching exercises. This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Interventions

Post Isometric Relaxation Group

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier barrier. The participants will be asked to perform an isometric contraction for 5 seconds in the horizontal abduction direction with 20% of the maximum muscle strength. After the relaxation, the arm will be moved towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between contractions.This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Intervention Type: OTHER

Isolytic Stretching Group

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier barrier. The participants will be asked to perform a contraction in the horizontal abduction direction with 20% of the maximum muscle strength. When the muscle contraction occurs, the arm will be moved quickly in 2-4 seconds towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between stretches. This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Intervention Type: OTHER

Static Stretching Group Group

Athletes will be positioned in a modified cross-body position. They will be asked to actively bring their underlying arm in the direction of horizontal adduction up to the physiological barrier. Then, the arm will be moved towards horizontal adduction and 15 seconds active-assistive stretching will be applied. Participants will be given a 5-second rest period between stretching exercises. This stretching exercise will be applied in 5 repetitions in one session for 6 weeks 5 times a week.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Being overhead athlete
• Glenohumeral internal rotation range of motion of the affected shoulder should be less than other shoulder and bilateral shoulder internal rotation range of motion difference should be ≥15 º

Exclusion Criteria

• Shoulder pain required medical attention for the last year.
• Current shoulder pain
• Cervical pain during upper extremity movement
• History of fracture to the shoulder girdle
• Systemic musculoskeletal disease
• History of shoulder surgery,
• Glenohumeral instability (positive apprehension, relocation, or positive sulcus test) or positive findings for a full thickness rotator cuff tear (positive lag sign, positive drop arm test, or marked weakness with shoulder external rotation)

• Minimum Eligible Age: 13 Years
• Maximum Eligible Age: 40 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Dokuz Eylul University

OTHER

Sponsor Role: lead

Responsible Party

Gonca Şahiner Pıçak

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Sevgi S Yeşilyaprak, Phd

Role: STUDY_DIRECTOR

Dokuz Eylul University

Central Contacts

Gonca Şahiner Pıçak, MSc

Role: CONTACT

gncshnr@gmail.com

+905058081268

Other Identifiers

5003-GOA

Identifier Type: -

Identifier Source: org_study_id