The Effectiveness of an Exercise Program on Scapulohumeral Rhythm, Range of Motion, and Stability in Young Female Handball Players

NCT06875596 | Active Not Recruiting

• 1 other identifier: KB/42/2025
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This record describes a planned randomized parallel-group trial of a modified Watson-based shoulder exercise program in female handball players. An internal pilot phase was conducted first to evaluate feasibility and obtain preliminary estimates to inform the definitive trial.

Conditions

Handball Players; Female Athlete; Scapular Dyskinesis

Keywords

Handball; Sports Performance Assessment; Muscle Strength assessment; Scapular; Scapular dyskinesis

Outcome Measures

Primary Outcomes (3)

• Scapulohumeral rhythm

  Scapular upward rotation is assessed with the Digital Inclinometer (BASELINE 12-1057) in a seated position to minimize compensatory movements of the trunk and lower extremities. The first measurement is taken at baseline (0° of shoulder flexion), followed by additional measurements at 30°, 60°, 90°, and 120° of shoulder flexion. Each position is held for 10-15 seconds to ensure stable measurement conditions. Measurements are repeated three times and the average is used for analysis. The assessment will be performed on both the dominant and non-dominant upper limb to evaluate movement symmetry. Data will be recorded manually by a research assistant to reduce the risk of reading errors and to ensure measurement accuracy. Statistical analysis will be performed to determine the scapulohumeral rhythm across different ranges of motion and to identify potential movement asymmetries.

  through study completion, an average of 2 years

• ISOMETRIC STRENGTH TEST - Internal and External Rotation

  Isometric strength assessment of the shoulder girdle muscles will be conducted using the Lafayette Hand-Held Dynamometer (HHD). For the rotator muscles, measurements will be performed in the prone position with the shoulder abducted to 90° and the elbow flexed to 90°, with the forearm hanging freely over the edge of the examination table. This setup will be used for both internal and external rotation strength assessments. Results are expressed in Newtons (N) or normalized to body weight as Newtons per kilogram (N/kg).

  through study completion, an average of 2 years

• Y-Balance Upper Quarter Test (YBT-UQ)

  The Y-Balance Upper Quarter Test (YBT-UQ) is used to assess upper extremity stability and reach performance. The test requires the participant to maintain a single-arm support position while the opposite arm performs reaching movements in three directions: anterior (forward), inferolateral (diagonally opposite the supporting hand), and superolateral (diagonally toward the supporting hand). Each reach is measured in centimeters, and the final score for each direction is calculated as the average of three trials. The test will be performed on both upper limbs and arm length will be included in the analysis to ensure standardized results. Results will be reported in centimeters, "cm", and Upper Limb Length % (standardized by upper limb length).

  through study completion, an average of 2 years

Secondary Outcomes (2)

• RANGE OF MOTION (Shoulder Internal and External Rotation)

  through study completion, an average of 2 years

• Closed Kinetic Chain Upper Extremity Stability Test

  through study completion, an average of 2 years

Study Arms (2)

Experimental: Modified Watson-based scapular exercise program

EXPERIMENTAL

Participants undergo baseline and post-intervention assessment including scapulohumeral rhythm, range of motion, isometric shoulder strength, Upper Quarter Y-Balance Test, and Closed Kinetic Chain Upper Extremity Stability Test. The intervention lasts 8 weeks and is divided into four consecutive 2-week phases targeting the dominant upper extremity. Participants receive scapular positioning correction and scapular-specific cueing aimed at improving upward rotation and neuromuscular control during exercise performance. Two elastic resistance bands are used: one to facilitate scapular upward rotation control and one to provide external resistance during the exercises. Participants are instructed to perform the home exercise program daily for approximately 10 minutes.

Other: Modified Watson-based scapular exercise program

Active Comparator: Standard upper-limb exercise program

ACTIVE COMPARATOR

Participants undergo baseline and post-intervention assessment including scapulohumeral rhythm, range of motion, isometric shoulder strength, Upper Quarter Y-Balance Test, and Closed Kinetic Chain Upper Extremity Stability Test. The control intervention lasts 8 weeks and is divided into four consecutive 2-week phases targeting the dominant upper extremity. Participants perform a standardized upper-limb exercise program without scapular positioning correction, without scapular-specific cueing, and without specific upward-rotation facilitation. One elastic resistance band is used to provide external resistance during the exercises. Participants are instructed to perform the home exercise program daily for approximately 10 minutes.

Other: Active Comparator: Standard upper-limb exercise program

Interventions

Active Comparator: Standard upper-limb exercise program OTHER

An 8-week dominant-limb standardized upper-limb exercise program performed with one elastic resistance band and without scapular positioning correction or scapular-specific cueing.

Active Comparator: Standard upper-limb exercise program

Modified Watson-based scapular exercise program OTHER

An 8-week dominant-limb exercise program based on the Watson rehabilitation approach, incorporating scapular positioning correction, scapular-specific cueing, and progressive exercises performed with two elastic resistance bands.

Experimental: Modified Watson-based scapular exercise program

Eligibility Criteria

• Age: 16 Years - 45 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Healthy individuals with no reported health problems
• No history of shoulder or elbow surgery within the past 2 years
• Received information about the study
• Written consent from the participant to participate in the study, including video recording and photography

You may not qualify if:

• Injury or trauma to the upper extremity within the past 3 months
• Illness that prevents participation in the study or tests
• Heavy physical activity of the shoulder girdle within 2 hours prior to the study
• Orthopedic surgery or physiotherapy treatment of the shoulder girdle

Sponsors & Collaborators

• Medical University of Gdansk: lead
• Gdansk Medical Academy of Applied Sciences: collaborator

Study Sites (1)

Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk

Gdansk, Pomeranian Voivodeship, 80-211, Poland

Location

Study Officials

• Bartosz Wilczyński

  Medical University of Gdansk

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants are not informed of the study hypothesis, which is to compare the effects of the upper scapular rotation-based exercise intervention with a standardised upper extremity exercise programme. This will ensure that participants perform to the best of their ability without bias. The internal pilot phase used a pragmatic allocation procedure that differed from the definitive randomization plan.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 8, 2025
• First Posted: March 13, 2025
• Study Start: March 8, 2025
• Primary Completion: September 10, 2025
• Study Completion (Estimated): February 10, 2028
• Last Updated: May 7, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Time Frame: Beginning upon publication and available indefinitely.
• Access Criteria: Available via OSF repository without restriction.

Locations

PL (1)