The Effectiveness of Neuromuscular Training-Based Exercise Program

NCT ID: NCT06385743

Last Updated: 2024-04-26

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 28 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-04-17
• Study Completion Date: 2024-12-30

Brief Summary

This randomised controlled study aimed to investigate the effectiveness of a neuromuscular training-based exercise program on pain, function, risk factors specific to shoulder injuries and performance in overhead athletes with shoulder pain.

The main hypothesis is;

H0: There is no difference between the "Thrower's Ten" exercise program and the neuromuscular training-based exercise program applied to overhead athletes with shoulder pain, on pain, function, risk factors specific to shoulder injuries, and performance.

H1: The effects of a neuromuscular training-based exercise program on pain, function, risk factors specific to shoulder injuries and performance in overhead athletes with shoulder pain are superior to the effects of "Thrower's Ten" exercise program

Detailed Description

Overhead athletes with shoulder pain who met the inclusion criteria applied to Yeditepe University Hospital Orthopedics and Traumatology Clinic for a randomized controlled study will be included to demonstrate the effectiveness of a neuromuscular training-based exercise program in overhead athletes with shoulder pain.

Athletes will be included in two different exercise programs (Thrower's Ten and Neuromuscular Training Based groups) by simple randomization.

Athletes evaluated by the orthopaedic surgeon will be included in the study if willing to participate in the rehabilitation program. The treatment program to be applied, hands-off treatment, was determined as exercise therapy. In our study, the athletes participating in the Neuromuscular Training-Based Exercise Program (Group 1) and the ''Thrower's Ten'' Exercise Program (Group 2) will participate in 24 physiotherapy sessions, three days a week, for eight weeks.

Before starting the treatment program, the participants' sociodemographic characteristics, comorbidities, dominant sides, sports histories, training routine (frequency/week, duration, etc.), and previous injury histories will be questioned with a structured evaluation form. Before randomization, a clinical examination for shoulder pain will be done by the orthopaedic surgeon. Pain intensity, pressure pain threshold, muscle tone, shoulder functional status, risk factors specific to shoulder injuries, sportive performance and kinesiophobia will be evaluated before treatment, at the end of the eight-week exercise program,

Conditions

Pain, Shoulder; Sports Physical Therapy

Study Design

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

Study Groups

Neuromuscular Training-based Exercise Program Group

Patient Education: Both groups will be given patient education on pain mechanism, posture/posture, exercise training, the role of the shoulder joint in shooting mechanics, situations, and positions to be avoided.

Neuromuscular Training-based Exercise Program: This group will be given a neuromuscular training-based exercise program in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks. In addition to shoulder strength, stabilization and kinetic chain exercises, this program includes internal and external focus (sound, touch, light, dual task, etc.), sport-specific exercises and plyometric exercises (speed, agility).

Group Type: EXPERIMENTAL

Neuromuscular Training-based Exercise Program

Intervention Type: OTHER

Neuromuscular training has been accepted as an effective treatment modality to improve the neurophysiological states of the joints for coordinated work. In addition to shoulder strength, stabilization and kinetic chain exercises, this program includes internal and external focus (sound, touch, light, dual task, etc.), sport-specific exercises and plyometric exercises (speed, agility). All athletes with shoulder pain will include in the baseline evaluation at the beginning of the season and all parameters will be followed throughout the season for 8 weeks. All athletes in this group will participate in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks.

Thrower's Ten Exercise Program Group

Patient Education: Both groups will be given patient education on pain mechanism, posture/posture, exercise training, the role of the shoulder joint in shooting mechanics, situations, and positions to be avoided.

Thrower's Ten Exercise Program: This group will be given include Thrower's Ten Exercise Program in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks. This program includes 10 different shoulder strengthening and shoulder stabilization exercises in a diagonal pattern. "Advanced Thrower's Ten" exercises that include kinetic chain exercises (covering more than one joint) in addition to shoulder exercises planned to be used in the late stages of rehabilitation into the program, progression is considered after the 3rd week will be added.

Group Type: ACTIVE_COMPARATOR

''Thrower's Ten'' Exercise Program

Intervention Type: OTHER

''Thrower's Ten'' Exercise Program includes 10 different shoulder strengthening and shoulder stabilization exercises in a diagonal pattern. "Advanced Thrower's Ten" exercises that include kinetic chain exercises (covering more than one joint) in addition to shoulder exercises planned to be used in the late stages of rehabilitation into the program, progression is considered after the 3rd week will be added. All athletes with shoulder pain will include in the baseline evaluation at the beginning of the season and all parameters will be followed throughout the season for 8 weeks. All athletes in this group will participate in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks.

Interventions

Neuromuscular Training-based Exercise Program

Neuromuscular training has been accepted as an effective treatment modality to improve the neurophysiological states of the joints for coordinated work. In addition to shoulder strength, stabilization and kinetic chain exercises, this program includes internal and external focus (sound, touch, light, dual task, etc.), sport-specific exercises and plyometric exercises (speed, agility). All athletes with shoulder pain will include in the baseline evaluation at the beginning of the season and all parameters will be followed throughout the season for 8 weeks. All athletes in this group will participate in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks.

Intervention Type: OTHER

''Thrower's Ten'' Exercise Program

''Thrower's Ten'' Exercise Program includes 10 different shoulder strengthening and shoulder stabilization exercises in a diagonal pattern. "Advanced Thrower's Ten" exercises that include kinetic chain exercises (covering more than one joint) in addition to shoulder exercises planned to be used in the late stages of rehabilitation into the program, progression is considered after the 3rd week will be added. All athletes with shoulder pain will include in the baseline evaluation at the beginning of the season and all parameters will be followed throughout the season for 8 weeks. All athletes in this group will participate in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Giving consent to be a volunteer for participating
• 18-35 years of age
• Athletes playing overhead sports like volleyball, water polo, tennis, baseball, cricket, swimming, badminton, and basketball for at least 2 days a week (Unilateral sports).
• Patients with unilateral shoulder pain lasting >6 weeks.
• Suitable and referred for conservative treatment by an orthopedist (non-surgical patients)
• Having one positive sign in the following 3 categories; the painful arc of movement, Neer or Hawkins-Kennedy impingement signs and pain during resisted external rotation, abduction, or empty can test performed by the orthopedist.
• Participating in regular training with the team for at least 3 years of experience in overhead sports

Exclusion Criteria

• Bilateral shoulder pain
• Having an acute shoulder pain
• Having a non-specific shoulder pain
• Reflected pain
• Having some severe shoulder patholojies such as adhesive capsulitis, osteoarthritis, rheumatoid arthritis, fracture, dislocation and instability
• Shoulder pain originating from non-musculoskeletal system
• Having the shoulder and neck surgery and non-traumatic injuries within the last six months
• Having severe pathologies during the rehabilitation program (cardiac, diabetes mellitus and neuropsychiatric problems)
• Presence of diagnosed significant comorbidity (neurological and systemic disorders)
• Current and past carcinoma
• Type 3 acromion
• Avulsion fracture
• Non-compliance with treatment
• Symptomatic cervical spine pathology
• Antidepressant usage
• Clinical signs of full-thickness rotator cuff tears (positive lag signs)

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 35 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Yeditepe University

OTHER

Sponsor Role: lead

Responsible Party

Asli Yeral

Physiotherapist, MSc. (principal Investigator)

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Yeditepe University

Istanbul, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

yeditepe15

Identifier Type: -

Identifier Source: org_study_id