Strengthening Exercises for Humeral Head Depressor Muscles

NCT ID: NCT07309796

Last Updated: 2025-12-30

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 27 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-02
• Study Completion Date: 2026-12-02

Brief Summary

Postoperative rehabilitation after reverse shoulder arthroplasty aims to improve pain control, range of motion, and functional capacity. However, studies examining the effects of strengthening exercises targeting the humeral head depressor muscles are limited. This randomized controlled trial will evaluate the effects of adding a specific strengthening program to standard rehabilitation on pain, range of motion, quality of life, and functional outcomes.

Detailed Description

Reverse shoulder arthroplasty (RSA) is an effective surgical method, particularly in cases of massive rotator cuff tears that lead to irreversible loss of shoulder function. The primary goals of postoperative rehabilitation are to reduce pain, improve shoulder joint functions, optimize scapulothoracic rhythm, and safely restore functional use. However, studies examining the effects of specific strengthening exercises targeting the humeral head depressor muscle group (latissimus dorsi, teres major, infraspinatus, etc.) on clinical outcomes are quite limited. This study aims to evaluate the effects of a specific strengthening protocol designed for the humeral head depressor muscles following reverse shoulder arthroplasty on pain, range of motion (ROM), quality of life, functional status, and psychological well-being. Planned as a randomized controlled trial, the research will apply an additional humeral head depressor muscle strengthening program to the standard conventional rehabilitation protocol in the experimental group, while the control group will receive only the standard rehabilitation program.

Conditions

Reverse Shoulder Arthroplasty; Depressor Muscle Training; Shoulder Rehabilitation

Keywords

Reverse shoulder arthroplasty; Depressor muscle training. Shoulder; Arthroplasty

Study Design

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

Study Groups

Conventional Rehabilitation Group

Participants undergoing reverse shoulder arthroplasty will receive a standard conventional rehabilitation program starting at postoperative 6 th week . The patient will receive treatment 5 days a week for 6 weeks, for a total of 30 sessions. The program consists of passive, active-assisted, and active/resisted exercises.

Exercises Included:

Passive / Assisted

• Scapular mobilization
• Scapular clock
• Passive external rotation with a stick Passive → Active-Assisted
• Active-assisted flexion and abduction with a stick
• Glenohumeral joint mobilization Active / Light Resistance
• Scapular retraction
• Light-resistance strengthening of biceps, triceps, and serratus anterior using a theraband Active / Resistance
• Theraband-based resisted biceps, triceps, and serratus anterior strengthening
• Continuation of glenohumeral mobilization
• Flexion and abduction above 90°
• Posterior capsule stretching

Group Type: ACTIVE_COMPARATOR

Conventional Rehabilitation Group

Intervention Type: OTHER

After randomization and baseline assessments, participants will undergo a standard 6-week postoperative shoulder rehabilitation program, consisting of range-of-motion exercises, scapular stabilization training, and progressive strengthening. No additional depressor muscle-specific exercises will be applied.

Depressor Muscle Strengthening Program

Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period.

Additional Exercises:

Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise

Group Type: EXPERIMENTAL

Conventional Rehabilitation Group

Intervention Type: OTHER

After randomization and baseline assessments, participants will undergo a standard 6-week postoperative shoulder rehabilitation program, consisting of range-of-motion exercises, scapular stabilization training, and progressive strengthening. No additional depressor muscle-specific exercises will be applied.

Depressor Muscle Strengthening Group

Intervention Type: OTHER

After randomization and baseline assessments, participants will receive a 6-week rehabilitation program consisting of conventional postoperative shoulder rehabilitation combined with a specific strengthening protocol targeting the shoulder depressor muscles.

Interventions

Conventional Rehabilitation Group

After randomization and baseline assessments, participants will undergo a standard 6-week postoperative shoulder rehabilitation program, consisting of range-of-motion exercises, scapular stabilization training, and progressive strengthening. No additional depressor muscle-specific exercises will be applied.

Intervention Type: OTHER

Depressor Muscle Strengthening Group

After randomization and baseline assessments, participants will receive a 6-week rehabilitation program consisting of conventional postoperative shoulder rehabilitation combined with a specific strengthening protocol targeting the shoulder depressor muscles.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients scheduled for primary reverse total shoulder arthroplasty Intact teres minor confirmed by physical examination (Hornblower's test) and intraoperative assessment Ability to participate in physiotherapy or a home exercise program

Exclusion Criteria

• Active infection Deltoid muscle insufficiency Inability or unwillingness to comply with randomization Prior shoulder arthroplasty on the same side Unwillingness to participate Inability to read or understand written instructions

• Minimum Eligible Age: 65 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Hacettepe University

OTHER

Sponsor Role: lead

Responsible Party

Caner Karartı

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Caner KARARTI, Assoc. Prof.

Role: CONTACT

Phone: 903862805362

Email: fzt.caner.92@gmail.com

Other Identifiers

20251224

Identifier Type: -

Identifier Source: org_study_id