Strengthening Exercises for Humeral Head Depressor Muscles

NCT07309796 | Recruiting

• 1 other identifier: 20251224
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

Postoperative rehabilitation after reverse shoulder arthroplasty aims to improve pain control, range of motion, and functional capacity. However, studies examining the effects of strengthening exercises targeting the humeral head depressor muscles are limited. This randomized controlled trial will evaluate the effects of adding a specific strengthening program to standard rehabilitation on pain, range of motion, quality of life, and functional outcomes.

Conditions

Depressor Muscle Training; Reverse Shoulder Arthroplasty; Shoulder Rehabilitation

Keywords

Reverse shoulder arthroplasty; Depressor muscle training. Shoulder; Arthroplasty

Outcome Measures

Primary Outcomes (3)

• Pain Intensity (Visual Analog Scale - VAS)

  Pain intensity will be assessed using the Visual Analog Scale, a 10-cm line ranging from "no pain" to "worst imaginable pain." The distance from the "no pain" anchor to the participant's mark will be measured in millimeters (0-100 mm), with higher scores indicating higher pain intensity.

  6 weeks

• Upper Extremity Disability (Disabilities of the Arm, Shoulder and Hand Questionnaire - DASH)

  The DASH is a 30-item self-administered questionnaire assessing upper-extremity functional limitations. Items are scored 1-5 and converted to a 0-100 scale, where higher scores indicate greater disability.

  6 weeks

• Shoulder Range of Motion (ROM)

  Active shoulder flexion, abduction, external rotation, and internal rotation will be measured using a standard goniometer. Results will be recorded in degrees (°).

  6 weeks

Secondary Outcomes (6)

• Shoulder Function (American Shoulder and Elbow Surgeons Score - ASES)

  6 weeks

• Thoracic Kyphosis Angle (Spinal Mouse Assessment)

  6 weeks

• Pain Catastrophizing (Pain Catastrophizing Scale - PCS)

  6 weeks

• Anxiety and Depression (Hospital Anxiety and Depression Scale - HADS)

  6 weeks

• Kinesiophobia (Tampa Scale of Kinesiophobia - TSK)

  6 weeks

Study Arms (2)

Conventional Rehabilitation Group

ACTIVE COMPARATOR

Participants undergoing reverse shoulder arthroplasty will receive a standard conventional rehabilitation program starting at postoperative 6 th week . The patient will receive treatment 5 days a week for 6 weeks, for a total of 30 sessions. The program consists of passive, active-assisted, and active/resisted exercises. Exercises Included: Passive / Assisted * Scapular mobilization * Scapular clock * Passive external rotation with a stick Passive → Active-Assisted * Active-assisted flexion and abduction with a stick * Glenohumeral joint mobilization Active / Light Resistance * Scapular retraction * Light-resistance strengthening of biceps, triceps, and serratus anterior using a theraband Active / Resistance * Theraband-based resisted biceps, triceps, and serratus anterior strengthening * Continuation of glenohumeral mobilization * Flexion and abduction above 90° * Posterior capsule stretching

Other: Conventional Rehabilitation Group

Depressor Muscle Strengthening Program

EXPERIMENTAL

Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period. Additional Exercises: Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise

Other: Conventional Rehabilitation Group; Other: Depressor Muscle Strengthening Group

Interventions

Conventional Rehabilitation Group OTHER

After randomization and baseline assessments, participants will undergo a standard 6-week postoperative shoulder rehabilitation program, consisting of range-of-motion exercises, scapular stabilization training, and progressive strengthening. No additional depressor muscle-specific exercises will be applied.

Conventional Rehabilitation Group; Depressor Muscle Strengthening Program

Depressor Muscle Strengthening Group OTHER

After randomization and baseline assessments, participants will receive a 6-week rehabilitation program consisting of conventional postoperative shoulder rehabilitation combined with a specific strengthening protocol targeting the shoulder depressor muscles.

Depressor Muscle Strengthening Program

Eligibility Criteria

• Age: 65 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Patients scheduled for primary reverse total shoulder arthroplasty Intact teres minor confirmed by physical examination (Hornblower's test) and intraoperative assessment Ability to participate in physiotherapy or a home exercise program

You may not qualify if:

• Active infection Deltoid muscle insufficiency Inability or unwillingness to comply with randomization Prior shoulder arthroplasty on the same side Unwillingness to participate Inability to read or understand written instructions

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Kırşehir Ahi Evran University

Kırşehir, 40100, Turkey (Türkiye)

RECRUITING

Central Study Contacts

Caner KARARTI, Assoc. Prof.

CONTACT

903862805362; fzt.caner.92@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Blinded assessor
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Randomized

Study Record Dates

• First Submitted: December 15, 2025
• First Posted: December 30, 2025
• Study Start: January 2, 2026
• Primary Completion (Estimated): September 2, 2026
• Study Completion (Estimated): December 2, 2026
• Last Updated: March 3, 2026

Record last verified: 2026-03

Locations

TU (1)