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

Not Applicable

• Conditions: Scapular Dyskinesis; Handball Players; Female Athlete

• Registration Number: NCT06875596
• Lead Sponsor: Medical University of Gdansk

Brief Summary

The primary objective of this study is to investigate the effectiveness of a shoulder girdle exercise program in improving stability, range of motion, and motor control in female handball players.

Detailed Description

The aim of this study is to investigate the effects of a structured shoulder girdle exercise programme on stability, range of motion (ROM) and motor control in female handball players. The study will be conducted over a period of 8 weeks and will involve 60 participants aged 17-30 years recruited from professional handball clubs. Participants will be randomly assigned to either the experimental group, which will follow a modified version of the Watson programme, or the control group, which will continue with their standard training programme. Aims: - To compare the effects of the upper scapular rotation-oriented exercise intervention with a standardised upper extremity exercise programme. - Scapulohumeral rhythm assessment: To assess scapulohumeral rhythm at different angles of shoulder flexion (30°, 60°, 90° and 120°) in young female handball players, with a focus on identifying potential asymmetries between the dominant and non-dominant limbs. - Analysis of scapular kinematics: To measure scapular upward rotation, anterior/posterior tilt and medial/lateral translation at different degrees of shoulder flexion to identify movement patterns associated with scapular dyskinesis. - Functional stability analysis: To assess upper extremity functional stability using the Y-Balance Upper Quarter Test (YBT-UQ) and the Closed Kinetic Chain Upper Extremity Stability Test pre- and post-exercise to identify potential correlations between stability improvements and changes in scapular rhythm and muscle activation. - Isometric strength measurement: To evaluate isometric strength in shoulder abduction, internal rotation and external rotation using the Lafayette HHD handheld dynamometer to assess the impact of the intervention on shoulder muscle performance.

Study Timeline

• Status Verified: 2025-03
• Study Start: 2025-03-08
• Study First Submitted: 2025-03-08
• Study First Submitted QC: 2025-03-08
• Study First Posted: 2025-03-13
• Last Update Submitted: 2025-03-13
• Last Update Posted: 2025-03-18
• Primary Completion: 2025-09-10
• Study Completion: 2028-02-10

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: Female
• Target Recruitment: 60

Inclusion Criteria

• 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

Exclusion criteria:

• 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

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Scapulohumeral rhythm	through study completion, an average of 2 years	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.
ISOMETRIC STRENGTH TEST - Internal and External Rotation	through study completion, an average of 2 years	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).
Y-Balance Upper Quarter Test (YBT-UQ)	through study completion, an average of 2 years	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).

Secondary Outcome Measures

Name	Time	Method
Closed Kinetic Chain Upper Extremity Stability Test	through study completion, an average of 2 years	Two strips of tape will be placed on the floor 90 cm apart. Participants will be instructed to assume a push-up position and perform as many hand touches as possible on each strip within 15 seconds. The examiner will count the number of touches.; Three trials will be conducted, and the final score will be calculated as the average number of touches across all three trials. A 45-second rest period will be provided between each trial.; The CKCUEST score and CKCUEST power will be calculated using the following formulas: * Score = Average number of touches on CKCUEST / height (m); * Power = 68% of body weight (kg) × Average number of touches on CKCUEST
RANGE OF MOTION (Shoulder Internal and External Rotation)	through study completion, an average of 2 years	Range of motion is measured for internal and external rotation of the shoulder. The participant is positioned in the prone position with the shoulder abducted to 90 degrees and the elbow flexed to 90 degrees, allowing the forearm to hang freely over the edge of the examination table. The starting position (0 degrees) is defined as the forearm being vertically aligned. Results are presented in degre

Trial Locations

Locations (1)

Department of Immunobiology and Environment Microbiology, Medical University of Gdańsk; 🇵🇱 Gdańsk, Pomorskie, Poland