Nordic Throwing Shoulder Project (NTS - Project)

NCT04056078 | Recruiting DMC

• 1 other identifier: NordU
• Study Type: observational
• Target: 60
• Locations: 2 countries
• Sites: 2

Brief Summary

As a part of the Olympic program and with 150 countries in the international Handball Federation team handball has become a worldwide popular sport. Unfortunately, a large number of different types injuries have been reported among team handball players, and shoulder pain has some of the biggest incidence. In handball 44-75% of the athletes had a history of shoulder pain and a weekly prevalence of shoulder problems in 28% of the athletes. Shoulder pain has been reported to have an impact on the athletes' training activities, performance, and daily life. Several studies have established risk factors for shoulder injuries among overhead athletes, with a focus on the range of motion in glenohumeral joint (ROM), shoulder strength and scapula control. Injury occurrence results from a combination of possessing these different risk and the amount of throwing. Thereby training overhead sports must be considered a primary risk factor for shoulder injury. However, several studies have performed kinematics analysis of different throws techniques commonly used in team handball. But no studies havn't investigated kinematics and kinetics of different throwing techniques in relation to team handball players and the development of shoulder pain, and if a throwing technique or a wrong throwing technique stresses the shoulder joint more than other throwing techniques. In baseball it was found that youth pitchers throwing with a curveball was associated with a 52% increased risk of shoulder pain and the slider was associated with an 86% increased risk of elbow pain, and there was a significant association between number of throws and rate of shoulder pain. Two types of wind-ups are used in handball, and those different wind-ups also changed the throwing kinematics and throwing performance. Investigators found that the pelvis rotation was more important in the throw with the circular wind-up than in the whip-like wind up. In addition, the total throwing time was longer with the circular wind up. This could result in less stress and forces on the shoulder joint when compared with the whip like to reach the same performances. The questions arises whether the used throwing techniques of the handball players during training and matches are a risk factor for shoulder pain and if some throwing techniques cause bigger risk than other throwing techniques as the players could put more force on the shoulder and elbow joint.

Conditions

Shoulder Injuries; Shoulder Pain; Injury Prevention; Kinematics; Kinetics; Muscle Weakness; Throwing Performance; Overhead Injuries

Outcome Measures

Primary Outcomes (3)

• The change of joint positions and joint movements in the shoulder during overhead throws

  Kinematic (joint movement) of the upperbody during different styles overhead throws. Ball velocity and throwing kinematics will be measured using a 3D motion capture system (Qualysis, Sävedalen, Sweden, eight cameras, 240-500 Hz) tracking the position of the reflective markers (2.6 cm diameter) during the hole movement.

  Day 1

• Generated joint forcers in the shoulder during overhead throws

  Joint forces (Kinetics) will be measured by using a 3D motion capture system (Qualysis, Sävedalen, Sweden, eight cameras, 240-500 Hz) and calculated by the theory of inverse dynamics of the upperbody during different styles of overhead throws. Kinetics measured by inverse dynamics will be calculated with Visual 3D (C-Motion, Germantown, MD) or Simi motion systems, and the forces in the shoulder will be presented in Newton.

  Day 1

• Upperbody Muscle Activity during different styles overhead throws

  Muscular activity will be measured by electromyography (EMG). Muscles relevant to investigate the throwing technique will be measured with Bipolar surface EMG electrodes.

  Day 1

Secondary Outcomes (6)

• Scapula-humeral Control

  Day 1

• Range of Motion

  Day 1

• Strength

  Day 1

• Shoulder and trunk stability

  Day 1

• Oslo Sports Trauma Reseach Center Overuse Injury Questionnaire

  Day 1

Study Arms (3)

Team Handball Players Playing with Shoulder Pain

Team Elite Handball players playing with shoulder pain i their dominated shoulder for more than 3 months.

Team Handball Players playing without shoulder pain

Team Elite Handball players who never have experience shoulder pain i their dominated shoulder.

Team Handball Players playing with previous shoulder pain

Team Handball players who have had shoulder pain i their dominated shoulder, but currently have been playing without shoulder pain in the previous 6 months.

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Elite Team Handball players playing in the top 3 leauges in Scandinavia will be invited to participate in the study.

You may qualify if:

• Elite handball players in the top three leagues in Denmark, Sweden and Norway
• Players playing without shoulder pain.
• Players playing with previous shoulder.
• Players playing with shoulder pain.
• Participating in both defends- and attack- relating situations.

You may not qualify if:

• Operation in the shoulder
• Not participating in attack related situations.
• Shoulder pain caused by a traumatic event

Sponsors & Collaborators

• Nord University: lead
• Copenhagen University Hospital, Hvidovre: collaborator

Study Sites (2)

Human Movement Laboratory, Hvidovre Hospital

Hvidovre, København, 2650, Denmark

RECRUITING

Nord University

Levanger, 7600, Norway

RECRUITING

MeSH Terms

Conditions

Shoulder Injuries; Shoulder Pain; Muscle Weakness

Condition Hierarchy (Ancestors)

Wounds and Injuries; Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Muscular Diseases; Neuromuscular Manifestations; Nervous System Diseases; Pathologic Processes

Central Study Contacts

Tina P Torabi, PT, MSc.

CONTACT

27209003; Tina.p.torabi@nord.no

Roland Van Den Tillaar, Professor

CONTACT

roland.v.tillaar@nord.no

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PT, MSc. In Physical therapy and Sport Science, PhD. Student

Study Record Dates

• First Submitted: August 7, 2019
• First Posted: August 14, 2019
• Study Start: February 24, 2020
• Primary Completion: December 31, 2024
• Study Completion: January 2, 2025
• Last Updated: April 4, 2024

Record last verified: 2024-04

Locations

NO (1); DK (1)