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3D Shoulder Kinematics During Throwing-related Movement Patterns Tasks in Upper Extremity Low-to-moderate/Moderate-to-high Loading Conditions

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ClinicalTrials.gov Identifier: NCT02852785
Recruitment Status : Enrolling by invitation
First Posted : August 2, 2016
Last Update Posted : March 25, 2020
Sponsor:
Collaborators:
University of Lisbon
Instituto Politécnico de Leiria
Information provided by (Responsible Party):
Nuno Morais, Universidade do Porto

Brief Summary:
The main purpose of this study is to characterize and compare the 3D shoulder kinematics bilaterally while performing functional movement patterns tests that hypothetically replicate the 5 main phases of the throwing cycle. The tests are based on diagonal D2 for flexion (early and late cocking of the arm) and D2 for extension (acceleration, deceleration and follow-through of the arm) of the upper extremity of proprioceptive neuromuscular facilitation techniques.

Condition or disease Intervention/treatment
Shoulder Pain Behavioral: PNF D2 for flexion; low-to-moderate loading condition Behavioral: PNF D2 for flexion; moderate-to-high loading condition Behavioral: PNF D2 for extension; low-to-moderate loading condition Behavioral: PNF D2 for extension; moderate-to-high loading condition

Detailed Description:

The 3D shoulder kinematics (thorax, scapula and humerus) will be collected in different groups of subjects with specific characteristics. To load the upper extremity during PNF D2 for flexion and extension directions, elastic tubing (Thera-Band) will be used as resistance. Selection of the two resistances will be according to a self-perceived ability of the subjects to consistently move a maximal amount of resistance (color) during PNF D2 flexion and extension tests for 15s and 30s, respectively. Each subject will be permitted to sample various resistances in order to assist in selecting the most appropriate load, with no more than three practice repetitions permitted per each resistance sampled.

To perform the tests, subjects will be sited in a standard chair without armrests, with their feet and lower legs placed on another standard chair, positioned just in front of their chair and the non-testing arm placed across the thoracic wall, to minimize the participation of the legs and trunk to upper extremity performance during testing. Elastic tubing will be anchored to a stable base to perform the diagonals (Thera-Band door anchor accessory or the opposite foot). Five repetitions of each test on both sides will be performed, in two different moments (5-10 minutes apart). A rate of 2 seconds per repetition will be employed during recordings using a metronome. A rest period will be given between trials to avoid fatigue. To perform the tests, subjects will begin/end with their hand on the contralateral hip and end/begin at head height and shoulder width. A marker will be placed in the latter position to standardize the start and end of hand position. The order of the tests (PNF D2 flexion and extension) and side (symptomatic/dominant and asymptomatic/non-dominant) will be randomized.

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Study Type : Observational
Estimated Enrollment : 150 participants
Observational Model: Case-Control
Time Perspective: Cross-Sectional
Official Title: 3D Shoulder Kinematics During Throwing-related Movement Patterns Tasks in Upper Extremity Low-to-moderate/Moderate-to-high Loading Conditions
Actual Study Start Date : July 24, 2018
Estimated Primary Completion Date : October 2020
Estimated Study Completion Date : December 2020

Group/Cohort Intervention/treatment
Asymptomatic volleyball attackers
Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant
Behavioral: PNF D2 for flexion; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for flexion during low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for flexion during moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for extension during low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for extension during moderate-to-high loading condition

Asymptomatic bilateral overhead athletes
Asymptomatic swimmers involved in competitive events ≥ 2 years and no signs of postural and movement impairments of the upper body quadrant
Behavioral: PNF D2 for flexion; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for flexion during low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for flexion during moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for extension during low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for extension during moderate-to-high loading condition

Asymptomatic non-athletes
Asymptomatic persons not regularly involved in sports activities or occupational overhead tasks (e.g. construction workers),
Behavioral: PNF D2 for flexion; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for flexion during low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for flexion during moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for extension during low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for extension during moderate-to-high loading condition

Asympt. athletes / scapula dyskinesis
Asymptomatic volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis
Behavioral: PNF D2 for flexion; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for flexion during low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for flexion during moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for extension during low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for extension during moderate-to-high loading condition

Symptom. athletes / scapula dyskinesis
Volleyball attackers involved in competitive events ≥ 2 years and with clinical evidence of scapula dyskinesis and complaints of shoulder pain and disability
Behavioral: PNF D2 for flexion; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for flexion during low-to-moderate loading condition

Behavioral: PNF D2 for flexion; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for flexion during moderate-to-high loading condition

Behavioral: PNF D2 for extension; low-to-moderate loading condition
Exposure to upper extremity PNF D2 for extension during low-to-moderate loading condition

Behavioral: PNF D2 for extension; moderate-to-high loading condition
Exposure to upper extremity PNF D2 for extension during moderate-to-high loading condition




Primary Outcome Measures :
  1. Side-to-side differences in 3-dimensional scapular angular displacement (in degrees) [ Time Frame: Through study completion, an average of 1 year ]
    The angular position and displacement of the scapula in the 3 planes of [lateral/medial (upward/downward) rotation, protraction/retraction (internal/external rotation), anterior/posterior tilting] at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)

  2. Side-to-side differences in 3-dimensional humerus angular displacement (in degrees) [ Time Frame: Through study completion, an average of 1 year ]
    The angular position and displacement of the humerus in the 3 planes of (plane of elevation, elevation/depression, axial rotation) at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)

  3. Side-to-side differences in 3-dimensional thoracic angular displacement (in degrees) [ Time Frame: Through study completion, an average of 1 year ]
    The angular position and displacement of the thorax in the 3 planes of [flexion/extension, lateral rotation (inclination), axial rotation] at 4 key events of the simulated throwing motion during the two loading conditions (1, initiation of humeral motion; 2, maximum humeral horizontal abduction relative to the trunk; 3, maximum humeral external rotation; 4, maximum humeral internal rotation)


Secondary Outcome Measures :
  1. Borg's Rate of Perceived Exertion scale [ Time Frame: Through study completion, an average of 1 year ]
    Rate of Perceived Exertion (RPE) scale varies from 6 (no exertion) to 20 (very, very hard)

  2. Visual Numeric Rating Scale score (0-10) [ Time Frame: Through study completion, an average of 1 year ]
    A 11-point scale to rate pain intensity



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 40 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Athletes from sports organizations involved in competitive events with pain and disability in the shoulder region
Criteria

Inclusion Criteria:

  • subjects who can perform at least 150 degrees of arm elevation

Exclusion Criteria:

  • subjects rating pain ≥8/10
  • score 5 on any of the items of the Disabilities of Arm, Shoulder and Hand (DASH)
  • pain elicited by provocation maneuvers of the neighboring regions (e.g., cervical spine).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02852785


Locations
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Portugal
Faculdade de Motricidade Humana, Universidade de Lisboa
Oeiras, Cruz-Quebrada, Portugal, 1499-002
Escola Superior de Saúde, Instituto Politécnico de Leiria
Leiria, Portugal, 2411-901
Faculdade de Desporto, Universidade do Porto
Porto, Portugal, 4200-450
Sponsors and Collaborators
Universidade do Porto
University of Lisbon
Instituto Politécnico de Leiria
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Responsible Party: Nuno Morais, PhD student, Universidade do Porto
ClinicalTrials.gov Identifier: NCT02852785    
Other Study ID Numbers: FADEUP_PhDPT_NunoMorais_std#3
First Posted: August 2, 2016    Key Record Dates
Last Update Posted: March 25, 2020
Last Verified: March 2020
Additional relevant MeSH terms:
Layout table for MeSH terms
Shoulder Pain
Arthralgia
Joint Diseases
Musculoskeletal Diseases
Pain
Neurologic Manifestations
Signs and Symptoms