Effects of Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic Training on Shoulder Function in Overhead Athletes

NCT07572682 | Completed

• 1 other identifier: DNS-Gyro-Study-2025
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized control trial is to evaluate the effect of the Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic training compared to a control group on pain level, functional performance, and shoulder stability in overhead athletes aged 18 to 25 years. The main question is whether these interventions are more effective than usual training in improving clinical and performance related outcomes. Participants will take part in a supervised rehabilitation program based on these methods three times per week for six weeks. Assessments were performed at baseline and after 6 weeks of intervention. Outcome measures included pain level, functional performance, and dynamic shoulder stability. Also, core endurance, shoulder mobility, and shoulder muscle strength will be evaluated as a secondary outcomes. These outcomes will be assessed using Visual Analog Scale (VAS), Kerlan-Jobe Orthopedic Clinic score (KJOC), the Y-Balance Upper Quarter Stability Test (UQYBT), McGill Endurance Test Battery, goniometer and digital dynamometer. The study was approved by the Ethics Committee of the Sports University of Tirana. All participants involved in this study provided written informed consent.

Conditions

Shoulder Injuries

Keywords

DNS (Dynamic Neuromuscular Stabilization); Gyrotonic training; Shoulder injury; Overhead athletes; Shoulder Stability; Neuromuscular Training; Functional Performance

Outcome Measures

Primary Outcomes (2)

• Change from baseline in Shoulder Functional Performance (Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score)

  Shoulder functional performance was assessed using the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score Questionnaire (KJOC), a validated 0-100 scale, where higher scores indicate better function. Changes from baseline to post-intervention will be evaluated.

  Baseline (pre-intervention) and after 6 weeks of intervention

• Change from baseline in Shoulder Pain (Visual Analog Scale)

  Shoulder pain was assessed by Visual Analog Scale (VAS), a 0-10 scale, where higher scores indicate greater pain intensity. Changes from baseline to post-intervention will be evaluated.

  Baseline (pre-intervention) and 6 weeks after of intervention.

Secondary Outcomes (9)

• Changes from baseline in Upper Limb Dynamic Stability (Upper Quarter Y Balance Test)

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Change from baseline in Trunk Flexor Endurance

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Change from baseline in Trunk Extensor Endurance

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Change from baseline in Shoulder Abduction Range of Motion

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Change from baseline in Shoulder Internal Rotation Range of Motion

  Baseline (pre-intervention) and after 6 weeks of intervention.

Other Outcomes (4)

• Change from baseline in Limb Symmetry Index

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Changes from baseline in Glenohumeral Internal Rotation Deficit (GIRD)

  Baseline (pre-intervention) and after 6 weeks of intervention.

• Change from baseline in shoulder External to Internal Rotation Strength Ratio

  Baseline (pre-intervention) and after 6 weeks of intervention.

Study Arms (3)

DNS Group

EXPERIMENTAL

Participants involved in DNS group underwent a structured exercise-based intervention aimed to improve mobility, strength, and neuromuscular control. Also, the participants in this group followed the usual training program.

Other: Dynamic Neuromuscular Stabilization (DNS)

Gyrotonic Training Group

EXPERIMENTAL

Participants in the Gyrotonic group followed an exercise program based on three-dimensional, flowing movement aimed to improve mobility, strength, and neuromuscular control. Also, the participants continued the usual training program.

Other: Gyrotonic Training

Control Group

ACTIVE COMPARATOR

Participants included in control group continued their usual sports training routines without additional intervention during the study period.

Other: Usual Training

Interventions

Dynamic Neuromuscular Stabilization (DNS) OTHER

Dynamic Neuromuscular Stabilization (DNS) The exercise program based on the DNS method was focused on core activation, diaphragmatic breathing, and shoulder stabilization in various positions based on development kinesiology. Sessions were supervised by certificated therapist and were performed three times per week over a period of 6 weeks.

DNS Group

Gyrotonic Training OTHER

A structured rehabilitation program based on the Gyrotonic method were conducted in the second intervention group. Sessions were supervised by certificated therapist and were conducted three times per week for 6 weeks. The program based on this method was focused on shoulder mobility and stability.

Gyrotonic Training Group

Usual Training OTHER

Participants continued their usual sports training without any additional protocol exercise. The inclusion of the control group allows for the assessment of the additional effect of the interventions beyond usual training.

Control Group

Eligibility Criteria

• Age: 18 Years - 25 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female participants
• Had a minimum of two years of sports experience
• Presence of shoulder region injury or pain
• Active participation in sports

You may not qualify if:

• Shoulder surgery
• Neurological disorders that can affect the upper limb
• Shoulder dislocation
• Orthopedic condition such as upper or lower limb fractures
• Athletes with less than two years of sports experience

Sponsors & Collaborators

• Sport University of Tirana: lead

Study Sites (1)

Sport University of Tirana

Tirana, Tirana, 1001, Albania

Location

MeSH Terms

Conditions

Shoulder Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessors will be blinded to group allocation. The assessors performing questionnaires and functional tests will not be informed about whether participants are assigned to DNS group, Gyrotonic training group, or control group. Participants and therapists will be aware of the assigned interventions due to the nature of the rehabilitation methods.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist, Assistant Lecturer, PhD Candidate

Model Details: Participants will be allocated into three parallel groups: DNS intervention group, Gyrotonic intervention group, and control group continued their regular sports training program and did not receive any additional intervention during the study period.

Study Record Dates

• First Submitted: April 23, 2026
• First Posted: May 7, 2026
• Study Start: February 17, 2025
• Primary Completion: March 17, 2025
• Study Completion: June 20, 2025
• Last Updated: May 7, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

AL (1)