The Effectiveness of Neuromuscular Training-Based Exercise Program

NCT06385743 | Completed

• 1 other identifier: yeditepe15
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

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

Conditions

Pain, Shoulder; Sports Physical Therapy

Keywords

Overhead Athletes; Neuromuscular training; Shoulder funtions; Shoulder pain; performance

Outcome Measures

Primary Outcomes (2)

• Pain Assessment

  Visual Analogue Scale will be used to evaluate the severity of pain felt around the shoulder joint. The location of the pain and the severity of the pain will be questioned. Participants will be asked to indicate pain severiy they felt (rest, activity and night) on a 10 cm horizontal line, ranging from 0 to 10. Zero shows no pain and 0 is intolerable pain. Pain intensity will be recorded by measuring the value of the marked place in cm. Higher values indicate more severe pain.

  8 weeks

• Disabilities of the Arm, Shoulder and Hand (DASH)

  The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate status of shoulder function. It is a questionnaire that evaluates all upper extremity functions and consists of a total of thirty questions. 21 of the questions of the questionnaire question the ability to perform functional activities, 5 of them about pain and 4 of them about the psychosocial effects of the disease. Each question is scored using a 5-point Likert scale with a range of 1-5. The total score of the questionnaire varies between 0-100 points, higher scores indicate better functional status. DASH, which has a short completion time and moderate scoring ease, is a questionnaire that can be used in patients between the ages of 18-64.

  8 weeks

Secondary Outcomes (5)

• Tampa Kinesiophobia Scale

  8 weeks

• Hylyght Injury Prevention and Return to the Sports Screening Program (

  8 weeks

• Y Balance Test- Upper Quarter

  8 weeks

• Closed Kinetic Chain Extremity Stability Test

  8 weeks

• Single Arm Seated Shot Put Test

  8 weeks

Study Arms (2)

Neuromuscular Training-based Exercise Program Group

EXPERIMENTAL

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).

Other: Neuromuscular Training-based Exercise Program

Thrower's Ten Exercise Program Group

ACTIVE COMPARATOR

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.

Other: ''Thrower's Ten'' Exercise Program

Interventions

Neuromuscular Training-based Exercise Program 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.

Neuromuscular Training-based Exercise Program Group

''Thrower's Ten'' Exercise Program 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.

Thrower's Ten Exercise Program Group

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Giving consent to be a volunteer for participating
• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Yeditepe University: lead

Study Sites (1)

Yeditepe University

Istanbul, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Shoulder Pain

Condition Hierarchy (Ancestors)

Arthralgia; Joint Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Aslı Yeral, MSc

  Yeditepe University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist, MSc. (principal Investigator)

Study Record Dates

• First Submitted: April 10, 2023
• First Posted: April 26, 2024
• Study Start: April 17, 2023
• Primary Completion: April 15, 2025
• Study Completion: May 31, 2025
• Last Updated: February 4, 2026

Record last verified: 2026-01

Locations

TU (1)