Are Alterations in Shoulder Rotations and Core Stability Effective for Water Polo Shoulder Problems?

NCT04202744 | Unknown

• 1 other identifier: Yeditepe
• Study Type: observational
• Target: 82
• Locations: 1 country
• Sites: 1

Brief Summary

Hypothesis of the clinical study: There are differences between the Water Polo Group and the Non-Water Polo Group in terms of shoulder parameters and core (lumbopelvic) parameters and there are differences between the throwing and non-throwing sides in terms of shoulder parameters in Water Polo Group.

Conditions

Shoulder Injuries; Sport Injury; Sports Physical Therapy

Outcome Measures

Primary Outcomes (4)

• Shoulder Internal and External Rotation Range of Motion Measurement

  Glenohumeral rotations were assessed with the subject lying supine with their shoulder in 90° abduction, 90° elbow flexion and the forearm pronated. Shoulder and elbow alignment were provided with the help of the towel. For external rotation, the goniometer's axis was placed on olecranon process of ulna, the stationary arm was placed perpendicular to the floor and moving arm was placed on ulnar border of forearm toward ulnar styloid process. For internal rotation, the goniometer's axis was positioned on the same area. Then, its stationary arm was positioned perpendicular to the floor and the moving arm was placed on ulnar border of forearm toward ulnar styloid process. The angle was recorded in degrees, three trials were performed and the average taken. Subjects were evaluated by the same physiotherapist to control measurement error.

  5 minutes

• Posterior Shoulder Capsule Tightness

  Goniometer measurement of horizontal adduction (Add) angle was used for Posterior shoulder tightness (PST). Shoulder was 90° of abduction (Abd) and elbow was flexed 90° of flexion in supine position. The scapula was stabilized using the thenar part of hand on the lateral edge of the scapula and the other hand was used to move the arm in horizontal Add. The goniometer's axis was placed on Acromioclavicular joint (ACJ), the stationary arm was directed parallel to the ground and the goniometer's mobile arm was placed on lateral epicondyle of the humerus. No scapular protraction and elevation were allowed. Shoulders with a smaller horizontal abduction angle showed a stiffness of posterior capsule.

  5 minutes

• Shoulder Strength Assessment

  Maximum isometric shoulder rotation strengths were evaluated using a hand-held dynamometer (HHD) with all measurements recorded in newton meter. The arm was positioned at 45° of abduction, elbow was flexed to 90° and shoulder was at 30° of horizontal adduction. For evaluation of internal rotation strength, the HHD was located on the volar side of the wrist 2 cm proximal to the radial styloid and on the dorsal aspect for testing of external rotation strength. To evaluate external rotation strength, the subject was instructed to externally rotate the examining shoulder against HHD while the humerus was stabilized; under same circumstances to measure internal rotation strength the subject was instructed to internally rotated. Subjects were instructed to perform isometric contraction for 5 seconds during the test. Between maximal isometric contractions, 30 seconds of resting intervals were given. The average values of the three trials were taken.

  10 minutes

• Trunk Muscles Endurance Test - (McGill Trunk Endurance Test)

  For endurance of the trunk extensors, subjects were positioned in prone lying with spina iliaca anterior superior level over the edge of the treatment table and their body were stabilized by straps. The upper body was supported by hands before initiation of the test. With the initiation of the test, hands were crossed across their chest and start to keep their upper body parallel to the ground. During the test, participants were instructed to maintain the horizontal position as long as possible. For trunk lateral flexors, subjects were side-lying position on the exercise mat with extended legs and arm must be in full contact with the body. As soon as the participants lift the hips, the test was initiated. Subjects were instructed to maintain a straight line along with the vertebrae by controlling lateral flexor muscles of the trunk as long as possible. The lateral flexors were assessed on both sides.

  15 minutes

Secondary Outcomes (2)

• Shoulder Pectoralis Minor Muscle Length

  5 minutes

• Sahrmann Core Stability Test

  10 minutes

Study Arms (2)

Water Polo Group

Participants were active water polo players who train regularly with ages in between 10-30 years. Five main parameters of the shoulder were assessed: the flexibility of pectoralis minor muscle, tightness of the posterior shoulder capsule, glenohumeral range of motion of internal and external rotation (sum of internal and external rotation: total range of motion), the strength of rotator cuff muscles and scapula position. As core parameters, trunk muscle endurance (flexor, extensor, and laterals) and core stability were evaluated.

Other: Shoulder and core evaluations

Non-Water Polo Group

Participants who do not engage in overhead sports with ages in between 10-30 years. Five main parameters of the shoulder were assessed: the flexibility of pectoralis minor muscle, tightness of the posterior shoulder capsule, glenohumeral range of motion of internal and external rotation (sum of internal and external rotation: total range of motion), the strength of rotator cuff muscles and scapula position. As core parameters, trunk muscle endurance (flexor, extensor, and laterals) and core stability were evaluated.

Other: Shoulder and core evaluations

Interventions

Shoulder and core evaluations OTHER

Five main parameters of the shoulder were assessed: the flexibility of pectoralis minor muscle, tightness of the posterior shoulder capsule, glenohumeral range of motion of internal and external rotation (sum of internal and external rotation: total range of motion), the strength of rotator cuff muscles and scapula position. As core parameters, trunk muscle endurance (flexor, extensor, and laterals) and core stability were evaluated.

Non-Water Polo Group; Water Polo Group

Eligibility Criteria

• Age: 10 Years - 30 Years
• Sex: male
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study is comprised of 82 male participants: 43 of them were Water Polo players and the remaining 39 participants served as controls (non-Water Polo players).

You may qualify if:

• Participating to the study in a voluntary basis.
• Participant in ages between 10-30 years of age.
• Parent permission for participants younger than 18
• Giving consent for older than 18

You may not qualify if:

• Having a history of orthopaedic surgery in the shoulder girdle within the last 6 months
• Having a history of fracture within the shoulder girdle complex
• Having a shoulder problem within the last 6 months continuing more than 3 months
• Having a history of pathology in lumbar area within the last 6 months

Sponsors & Collaborators

• Yeditepe University: lead
• Yeditepe University Hospital: collaborator

Study Sites (1)

Yeditepe University

Istanbul, Turkey (Türkiye)

Location

Related Publications (19)

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  PMID: 27841812 BACKGROUND

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  BACKGROUND

• Webster MJ, Morris ME, Galna B. Shoulder pain in water polo: a systematic review of the literature. J Sci Med Sport. 2009 Jan;12(1):3-11. doi: 10.1016/j.jsams.2007.05.014. Epub 2007 Sep 21.

  PMID: 17889614 BACKGROUND

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  PMID: 10230566 BACKGROUND

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• Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189-98. doi: 10.2165/00007256-200636030-00001.

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  PMID: 24427426 BACKGROUND

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  PMID: 19026017 BACKGROUND

• Marcondes FB, de Jesus JF, Bryk FF, de Vasconcelos RA, Fukuda TY. Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players. Braz J Phys Ther. 2013 Mar-Apr;17(2):185-94. doi: 10.1590/S1413-35552012005000079.

  PMID: 23778770 BACKGROUND

• Werner BC, Holzgrefe RE, Griffin JW, Lyons ML, Cosgrove CT, Hart JM, Brockmeier SF. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. J Shoulder Elbow Surg. 2014 Nov;23(11):e275-82. doi: 10.1016/j.jse.2014.02.030. Epub 2014 Jun 9.

  PMID: 24925699 BACKGROUND

• Shin SH, Ro du H, Lee OS, Oh JH, Kim SH. Within-day reliability of shoulder range of motion measurement with a smartphone. Man Ther. 2012 Aug;17(4):298-304. doi: 10.1016/j.math.2012.02.010. Epub 2012 Mar 13.

  PMID: 22421186 BACKGROUND

• Ortiz A, Val S, Delgado D. Reliability and concurrent validity of the goniometer-pro app vs a universal goniometer in determining passive flexion of knee. Int J Comput Appl. 2017;173; 2017.

  BACKGROUND

• Awan R, Smith J, Boon AJ. Measuring shoulder internal rotation range of motion: a comparison of 3 techniques. Arch Phys Med Rehabil. 2002 Sep;83(9):1229-34. doi: 10.1053/apmr.2002.34815.

  PMID: 12235602 BACKGROUND

MeSH Terms

Conditions

Shoulder Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 15, 2019
• First Posted: December 18, 2019
• Study Start: March 12, 2019
• Primary Completion: July 12, 2019
• Study Completion: January 12, 2020
• Last Updated: December 18, 2019

Record last verified: 2019-12

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)