The Effects of Upper-Extremity Plyometric Combined Strength Training in Overhead Athletes With Shoulder Instability

NCT05857540 | Active Not Recruiting

• 1 other identifier: YM111161F
• Study Type: interventional
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this randomized controlled trial is to investigate the additional effects of upper extremity plyometric training versus strength training alone in recreational overhead athletes with shoulder instability. The investigators hypothesis that compared to strengthening training alone, plyometric training combined with strengthening training will significantly improve shoulder isokinetic strength, proprioception, scapular kinematics, symptoms of shoulder instability, and shoulder function.

Conditions

Glenohumeral Subluxation; Shoulder Subluxation; Shoulder Instability Subluxation Bilateral

Keywords

Plyometric; Strengthening; Overhead athlete; Shoulder instability

Outcome Measures

Primary Outcomes (4)

• Shoulder isokinetic muscle strength

  Shoulder isokinetic muscle strength will be measured by dynamometer in 3 modes (concentric/concentric, concentric/eccentric, eccentric/concentric) at 3 angular velocities (90°/s, 180°/s, \& 240°/s), 1 set of 5 repetitions for each angular velocities. Shoulder isokinetic muscle strength will be normalized by body weight (BW) and described with peak torque/BW (N·m·kg-1).

  Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks

• Shoulder acceleration time, deceleration time, and amortization time

  Shoulder acceleration time, deceleration time, and amortization time will be measured by dynamometer in concentric/concentric mode at 3 angular velocities (90°/s, 180°/s, \& 240°/s) and will be described with millisecond (ms).

  Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks

• Shoulder proprioception

  Shoulder proprioception will be measured by dynamometer in 90° shoulder abduction and 90° elbow flexion position, including active joint position sense and passive joint position sense. The proprioception will be described with degree of error from target position.

  Change from baseline shoulder external rotation joint position sense through completion of 12-session intervention, an average of 6 weeks

• Seated medicine ball throw distance

  Subjects will throw a 2kg soft weighted ball as far forward as possible with dominant arms while sitting with back against a wall and legs bending with feet flat on the floor. Outcomes include average throwing distance and maximal throwing distance (cm). The distances are measured with measure tape.

  Change from baseline seated medicine ball throw distance through completion of 12-session intervention, an average of 6 weeks

Secondary Outcomes (3)

• Shoulder function

  Change from baseline DASH questionnaire through completion of 12-session intervention, an average of 6 weeks

• Visual analogue scale (VAS) of shoulder pain and instability

  Change from baseline VAS of shoulder pain and instability through completion of 12-session intervention, an average of 6 weeks

• Global rating of change (GRC)

  through completion of 12-session intervention, an average of 6 weeks

Study Arms (2)

Plyometric training group

EXPERIMENTAL

Participants in this group will receive upper extremity plyometric training in body weight or with weight ball and strengthening exercises with band, dumbbell and barbell. The difficulty and intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.

Procedure: Plyometric and strengthening exercises

Strengthening training group

ACTIVE COMPARATOR

Participants in this group will receive upper extremity strengthening exercises with band, dumbbell and barbell. The intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.

Procedure: Strengthening exercise

Interventions

Plyometric and strengthening exercises PROCEDURE

Each session includes 2 upper-extremity plyometric exercises in bodyweight or with weight ball for 15-20 minutes and 4-5 strengthening exercises with band, dumbbell or barbell for 30-35 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.

Plyometric training group

Strengthening exercise PROCEDURE

Each session includes 5 upper-extremity strengthening exercises with band, dumbbell or barbell for 50 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.

Strengthening training group

Eligibility Criteria

• Age: 20 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Have experience of at least 1 of the following symptoms of shoulder instability during upper extremity movement: (a) pain, clicking, a sense of the shoulder coming apart, (b) dead-arm syndrome, or (c) subluxation of the joint.
• Self-reported decreased performance or feeling fear to perform shoulder movements during sports or daily activities
• Positive findings on ≥ 1 of the following 5 tests: load and shift test, apprehension, relocation, \& surprise tests, Gagey hyperabduction test, sulcus sign, Feagin test
• Recreational overhead athletes who keep practicing ≥ 4 hours/week in the recent 1 month and with ≥ 1 year overhead sports experience

You may not qualify if:

• Full contact sport athletes
• Severe shoulder instability with \> 5 shoulder dislocations history
• Obvious shoulder bony/labrum lesion in the dominant side warranted for surgery first as decided by the orthopedic surgeon
• Previous surgery or fracture in the shoulder area on the dominant side within 1 year
• Voluntary instability (the ability to deliberately dislocate one's shoulder)
• During acute phase after shoulder dislocation event
• Not suitable to start plyometric training yet: Shoulder muscle weakness (manual muscle test \<3) or range of motion limitation (\<90 abduction, \<70 external rotation) in the dominant side
• Pregnancy
• Cancer, neck pain, brain \& neurological impairment
• Ehlers-Danlos syndrome or Marfan syndrome
• Unable to attend 6 weeks supervised training

Sponsors & Collaborators

• National Yang Ming Chiao Tung University: lead

Study Sites (1)

National Yang Ming Chiao Tung University

Taipei, Taipei, 112, Taiwan

Location

MeSH Terms

Conditions

Shoulder Dislocation

Condition Hierarchy (Ancestors)

Joint Dislocations; Joint Diseases; Musculoskeletal Diseases; Wounds and Injuries; Shoulder Injuries

Study Officials

• Yin-Liang Lin, PhD

  National Yang Ming Chiao Tung University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: April 11, 2023
• First Posted: May 12, 2023
• Study Start: May 20, 2023
• Primary Completion: April 1, 2025
• Study Completion: June 30, 2025
• Last Updated: May 22, 2025

Record last verified: 2025-05

Locations

TW (1)