Game-Based Rehab for Scapular Dyskinesia

NCT07504653 | Recruiting

• 1 other identifier: INTI/CPS/2025/001
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Scapular dyskinesia (SD) is a disorder defined by aberrant scapular placement and movement, which can have a substantial impact on athletes' performance, particularly those who participate in throwing sports like Frisbee. This study aims to investigate the prevalence of SD among Frisbee players in Malaysia, assess its effects on various aspects of athletic performance, and evaluate the effectiveness of gamified scapular rehabilitation exercises delivered via a mobile application. This study's approach is divided into three unique phases, where phase one consists of a prevalence and impact assessment using a cross-sectional study design, which will be carried out among several Frisbee clubs in Malaysia. This phase will use several outcome measures to evaluate SD and its impact along with respiratory muscle strength assessments to analyze the potential respiratory outcomes. Phase Two focuses on the creation of a mobile application that would gamify scapular rehabilitation exercises while embracing agile development approaches. The development process will include comprehensive testing procedures to ensure functionality and usability, such as functional testing to verify the application's features, usability testing to assess user experience, data validation to ensure accurate information processing, and regression testing to confirm stability after updates, and user acceptance testing to evaluate performance in real-world scenarios. Phase Three consists of intervention and evaluation by a randomized controlled trial (RCT) to determine the efficacy of the gamified rehabilitation intervention. The intervention, which consists of gamified scapular rehabilitation exercises given via a mobile application, will last eight weeks. Subjects will be followed up after 6 months of the intervention to determine their level of adherence to the rehabilitation.The expected outcomes of this study aim to significantly contribute to the field of sports medicine and rehabilitation by introducing and validating gamified rehabilitation techniques specifically designed for athletes with scapular dyskinesia. The study results are expected to promote the well-being of athletes by improving their sports performance and reducing the risk of injuries. In conclusion, this study not only advances our understanding of SD in athletes but also paves the way for innovative rehabilitation solutions that can be adopted across various sports and settings.

Conditions

Scapular Dyskinesis

Keywords

Overhead Athletes; Mobile Game; Adherence to Therapy; Digital Health Solutions; Tele-Rehabilitation; Scapular Stabilization

Outcome Measures

Primary Outcomes (4)

• Seated Medicine Ball Throw Test (SMBT)

  The Seated Medicine Ball Throw Test (SMBT) evaluates unilateral upper-extremity power by measuring the distance an individual can throw a 6-pound medicine ball from a seated position. The test assesses shoulder kinematics, movement patterns, and trunk engagement, with performance differences between dominant and non-dominant sides typically ranging from 5% to 10% (3). The test is considered a cost-effective and reliable method for assessing upper-body power.

  From enrollment to the end of treatment at 8 weeks

• Lateral Scapular Slide Test (LSST)

  The Lateral Scapular Slide Test (LSST) assesses scapular position and dyskinesis. The test involves measuring the bilateral distance between the inferior angle of the scapula and the nearest vertebral spinous process in three distinct positions: with the arms relaxed at the side (0° humeral elevation), with the shoulder abducted to 40-45° with hands on hips, and with the shoulder abducted to 90° with arms in full internal rotation. A difference of more than 1.5 cm between the sides indicates scapular dyskinesis (1). While the LSST provides more objective measures compared to mere observation, it is not entirely reliable in assessing scapular asymmetry. Test-retest reliability ranges from 0.84 to 0.88, and intertester reliability varies between 0.77 and 0.85.,

  From enrollment to the end of treatment at 8 weeks

• Functional Throwing Performance Index (FTPI)

  The Functional Throwing Performance Index (FTPI) measures the accuracy of overhand throws. It is calculated by dividing the number of accurate throws by the total number of throws. Athletes stand 15 feet from a target and throw a ball at it as many times as possible within 30 seconds. Accuracy is determined by whether any part of the ball contacts the target

  From enrollment to the end of treatment at 8 weeks

• Measurement of Throwing Velocity

  Throwing velocity is calculated by measuring the time it takes for a Frisbee to travel a fixed distance (60.5 feet) and using a stopwatch. The speed is calculated using the formula S=D/TS = D / TS=D/T, where SSS is speed, DDD is distance, and TTT is time. This speed is then converted to miles per hour (mph) for analysis

  From enrollment to the end of treatment at 8 weeks

Secondary Outcomes (2)

• Pulmonary Function Tests (PFTs)

  From enrollment to the end of treatment at 8 weeks

• Respiratory Muscle Strength

  From enrollment to the end of treatment at 8 weeks

Study Arms (3)

Gaming Group

EXPERIMENTAL

The experimental group will use a mobile application featuring gamified scapular stabilization and postural correction exercises

Other: game based mobile application scapular stabilisation exercises; Other: Postural correction exercises

Control group A

ACTIVE COMPARATOR

Control Group A will only perform postural correction exercises

Other: Postural correction exercises

Control Group B

NO INTERVENTION

Control Group B will continue regular training without interventions

Interventions

game based mobile application scapular stabilisation exercises OTHER

novel game base exercise that mimics scapular stabilisation exercises.

Gaming Group

Postural correction exercises OTHER

upper thorax postural correction exercises

Control group A; Gaming Group

Eligibility Criteria

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

You may qualify if:

• must be competitive Frisbee players .
• should engage in regular training sessions lasting 1.5 to 2 hours per session, with a minimum of one session per week.
• required to have a full range of motion in the Glenohumeral joint.
• Diagnosed to have Scapular dyskinesia thr0ugh LSST.

You may not qualify if:

• recreational Frisbee players.
• any recent head or neck injuries within the past three months or any upper body surgery in the past year.
• Acute fractures in the shoulder girdle, spine, or thoracic cage.
• history of Chronic Obstructive Pulmonary Disease (COPD), uncontrolled asthma, pulmonary infectious diseases, or respiratory tract infectious diseases.

Sponsors & Collaborators

• INTI International University: lead

Study Sites (1)

Inti International University

Seremban, Negeri Sembilan, 71800, Malaysia

RECRUITING

Related Publications (3)

• U. G. Longo et al., "Scapular Dyskinesis: From Basic Science to Ultimate Treatment," International journal of environmental research and public health, vol. 17, no. 8. NLM (Medline), Apr. 24, 2020. doi: 10.3390/ijerph17082974.

  BACKGROUND

• A. M. Hulsman et al., "Individual differences in costly fearful avoidance and the relation to psychophysiology," Behav. Res. Ther., vol. 137, p. 103788, 2021, doi: https://doi.org/10.1016/j.brat.2020.103788.

  BACKGROUND

• C. Hogan, J. A. Corbett, S. Ashton, L. Perraton, R. Frame, and J. Dakic, "Scapular Dyskinesis Is Not an Isolated Risk Factor for Shoulder Injury in Athletes: A Systematic Review and Meta-analysis," Am. J. Sports Med., vol. 49, no. 10, pp. 2843-2853, Aug. 2021, doi: 10.1177/0363546520968508.

  BACKGROUND

Study Officials

• Prof. Ts. Dr.Siti Sarah Maidin, PHD

  INTI International University

  STUDY DIRECTOR

Central Study Contacts

NITHIYAH MARUTHEY, Master of Physiotherapy

CONTACT

+60162015371; nithiyah.maruthey@newinti.edu.my

Rajermani Thinakaran Thinakaran, Phd In IT

CONTACT

0163128595; rajermani.thina@newinti.edu.my

Study Design

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

Model Details: For this study, the inclusion criteria specify that participants must be competitive Frisbee players aged between 18 and 40 years. These individuals should engage in regular training sessions lasting 1.5 to 2 hours per session, with a minimum of one session per week. Additionally, participants are required to have a full range of motion in the Glenohumeral joint, as highlighted by (27). Participants will be excluded if they are recreational Frisbee players, as they may not have the same level of athletic conditioning or skill as competitive players. Further exclusion criteria include any recent head or neck injuries within the past three months or any upper body surgery in the past year. Acute fractures in the shoulder girdle, spine, or thoracic cage, as well as any history of Chronic Obstructive Pulmonary Disease (COPD), uncontrolled asthma, pulmonary infectious diseases, or respiratory tract infectious diseases, also disqualify potential participants.

Study Record Dates

• First Submitted: March 26, 2026
• First Posted: April 1, 2026
• Study Start: March 1, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): September 1, 2026
• Last Updated: April 1, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, CSR
• Time Frame: ending 3 years after the publication of results
• Access Criteria: proposal that describes planned analyses must be submitted

Locations

MY (1)