The Effectiveness of Neuromuscular Training-Based Exercise Program Among Overhead Athletes With Shoulder Pain
Overview
- Phase
- Not Applicable
- Intervention
- Neuromuscular Training-based Exercise Program
- Conditions
- Pain, Shoulder
- Sponsor
- Yeditepe University
- Enrollment
- 28
- Locations
- 1
- Primary Endpoint
- Pain Assessment
- Status
- Completed
- Last Updated
- 2 months ago
Overview
Brief Summary
This randomised controlled study aimed to investigate the effectiveness of a neuromuscular training-based exercise program on pain, function, risk factors specific to shoulder injuries and performance in overhead athletes with shoulder pain.
The main hypothesis is;
H0: There is no difference between the "Thrower's Ten" exercise program and the neuromuscular training-based exercise program applied to overhead athletes with shoulder pain, on pain, function, risk factors specific to shoulder injuries, and performance.
H1: The effects of a neuromuscular training-based exercise program on pain, function, risk factors specific to shoulder injuries and performance in overhead athletes with shoulder pain are superior to the effects of "Thrower's Ten" exercise program
Detailed Description
Overhead athletes with shoulder pain who met the inclusion criteria applied to Yeditepe University Hospital Orthopedics and Traumatology Clinic for a randomized controlled study will be included to demonstrate the effectiveness of a neuromuscular training-based exercise program in overhead athletes with shoulder pain. Athletes will be included in two different exercise programs (Thrower's Ten and Neuromuscular Training Based groups) by simple randomization. Athletes evaluated by the orthopaedic surgeon will be included in the study if willing to participate in the rehabilitation program. The treatment program to be applied, hands-off treatment, was determined as exercise therapy. In our study, the athletes participating in the Neuromuscular Training-Based Exercise Program (Group 1) and the ''Thrower's Ten'' Exercise Program (Group 2) will participate in 24 physiotherapy sessions, three days a week, for eight weeks. Before starting the treatment program, the participants' sociodemographic characteristics, comorbidities, dominant sides, sports histories, training routine (frequency/week, duration, etc.), and previous injury histories will be questioned with a structured evaluation form. Before randomization, a clinical examination for shoulder pain will be done by the orthopaedic surgeon. Pain intensity, pressure pain threshold, muscle tone, shoulder functional status, risk factors specific to shoulder injuries, sportive performance and kinesiophobia will be evaluated before treatment, at the end of the eight-week exercise program,
Investigators
Asli Yeral
Physiotherapist, MSc. (principal Investigator)
Yeditepe University
Eligibility Criteria
Inclusion Criteria
- •Giving consent to be a volunteer for participating
- •18-35 years of age
- •Athletes playing overhead sports like volleyball, water polo, tennis, baseball, cricket, swimming, badminton, and basketball for at least 2 days a week (Unilateral sports).
- •Patients with unilateral shoulder pain lasting \>6 weeks.
- •Suitable and referred for conservative treatment by an orthopedist (non-surgical patients)
- •Having one positive sign in the following 3 categories; the painful arc of movement, Neer or Hawkins-Kennedy impingement signs and pain during resisted external rotation, abduction, or empty can test performed by the orthopedist.
- •Participating in regular training with the team for at least 3 years of experience in overhead sports
Exclusion Criteria
- •Bilateral shoulder pain
- •Having an acute shoulder pain
- •Having a non-specific shoulder pain
- •Reflected pain
- •Having some severe shoulder patholojies such as adhesive capsulitis, osteoarthritis, rheumatoid arthritis, fracture, dislocation and instability
- •Shoulder pain originating from non-musculoskeletal system
- •Having the shoulder and neck surgery and non-traumatic injuries within the last six months
- •Having severe pathologies during the rehabilitation program (cardiac, diabetes mellitus and neuropsychiatric problems)
- •Presence of diagnosed significant comorbidity (neurological and systemic disorders)
- •Current and past carcinoma
Arms & Interventions
Neuromuscular Training-based Exercise Program Group
Patient Education: Both groups will be given patient education on pain mechanism, posture/posture, exercise training, the role of the shoulder joint in shooting mechanics, situations, and positions to be avoided. Neuromuscular Training-based Exercise Program: This group will be given a neuromuscular training-based exercise program in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks. In addition to shoulder strength, stabilization and kinetic chain exercises, this program includes internal and external focus (sound, touch, light, dual task, etc.), sport-specific exercises and plyometric exercises (speed, agility).
Intervention: Neuromuscular Training-based Exercise Program
Thrower's Ten Exercise Program Group
Patient Education: Both groups will be given patient education on pain mechanism, posture/posture, exercise training, the role of the shoulder joint in shooting mechanics, situations, and positions to be avoided. Thrower's Ten Exercise Program: This group will be given include Thrower's Ten Exercise Program in a total of 24 physiotherapy sessions, 3 days a week, for eight weeks. This program includes 10 different shoulder strengthening and shoulder stabilization exercises in a diagonal pattern. "Advanced Thrower's Ten" exercises that include kinetic chain exercises (covering more than one joint) in addition to shoulder exercises planned to be used in the late stages of rehabilitation into the program, progression is considered after the 3rd week will be added.
Intervention: ''Thrower's Ten'' Exercise Program
Outcomes
Primary Outcomes
Pain Assessment
Time Frame: 8 weeks
Visual Analogue Scale will be used to evaluate the severity of pain felt around the shoulder joint. The location of the pain and the severity of the pain will be questioned. Participants will be asked to indicate pain severiy they felt (rest, activity and night) on a 10 cm horizontal line, ranging from 0 to 10. Zero shows no pain and 0 is intolerable pain. Pain intensity will be recorded by measuring the value of the marked place in cm. Higher values indicate more severe pain.
Disabilities of the Arm, Shoulder and Hand (DASH)
Time Frame: 8 weeks
The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to evaluate status of shoulder function. It is a questionnaire that evaluates all upper extremity functions and consists of a total of thirty questions. 21 of the questions of the questionnaire question the ability to perform functional activities, 5 of them about pain and 4 of them about the psychosocial effects of the disease. Each question is scored using a 5-point Likert scale with a range of 1-5. The total score of the questionnaire varies between 0-100 points, higher scores indicate better functional status. DASH, which has a short completion time and moderate scoring ease, is a questionnaire that can be used in patients between the ages of 18-64.
Secondary Outcomes
- Tampa Kinesiophobia Scale(8 weeks)
- Closed Kinetic Chain Extremity Stability Test(8 weeks)
- Single Arm Seated Shot Put Test(8 weeks)
- Hylyght Injury Prevention and Return to the Sports Screening Program ((8 weeks)
- Y Balance Test- Upper Quarter(8 weeks)