Internal Rotation Contracture-shoulder Clinical Trial
Official title:
Restoration of Glenohumeral Internal Rotation Deficit (GIRD) After Throwing: A Randomized Clinical Trail Comparing the Sleeper Stretch to the 90/90 Hip Lift With Balloon Blow Exercise
The primary purpose of this study is to determine if the loss of internal rotation following
a throwing session is best restored through soft tissue stretching with the sleeper stretch
or with scapular repositioning with the 90/90 hip lift with balloon blow exercise. This study
will progress the body of research related to internal rotation deficits with regards to
baseball throwers. The research will be relevant to clinicians who treat patients with
baseball players with internal rotation loss.
High school baseball players will be the targeted subjects for this study. They will perform
two exercises (one per week) designed to increase shoulder internal rotation over the course
of three weeks with one week of rest between intervention weeks. The primary outcome will be
shoulder internal rotation range of motion improvements over the course of one week's time.
There are no known adverse risks to either intervention.
Purpose of the Study: The primary purpose of this study is to determine if the loss of
internal rotation following a throwing session is best restored through soft tissue
stretching with the sleeper stretch or with scapular repositioning with the 90/90 hip lift
with balloon blow exercise. This study will progress the body of research related to internal
rotation deficits with regards to baseball throwers. The research will be relevant to
clinicians who treat patients with baseball players with internal rotation loss.
Specific Aim: To determine if the glenohumeral internal rotation deficit (GIRD) is more
effectively restored following a throwing session by performing the sleeper stretch (SS) or
the 90/90 hip lift with balloon blow exercise (BBE).
Hypothesis: BBE will improve GIRD more effectively and quickly than the SS.
This is a prospective randomized trial comparing the efficacy of two exercises designed to
improve shoulder internal rotation. Subjects meeting study criteria will be randomly
allocated to each group as shown in the following CONSORT allocation diagram. Randomization
will be performed via random number generator.
Each subject will participate in two week-long interventions with at least one week
separating the two intervention weeks. During the week of intervention, the subject will have
his baseline IR measured. He will then be instructed in how to perform a single exercise
designed to improve internal rotation range of motion. Approximately half of the subjects
will perform the Sleeper Stretch the first week, then the Balloon Blow Exercise the second
week. The remaining group of subjects will perform the Balloon Blow Exercise during the first
week, then the Sleeper Stretch the second week. Both exercises will be instructed by a
physical therapist who commonly prescribes the exercises in the clinical setting. A written
handout detailing the exercise instructions, frequency, and duration of the stretch will be
provided for the subjects' reference (submitted with IRB application). The subject will
perform this exercise throughout the week as directed by study personnel. Baseline measures
of glenohumeral internal rotation (IR) with the shoulder positioned at 90 degrees of
abduction in the scapular plane will be obtained using a goniometer, as described by Manske.
These measurements will be repeated after the initiation of the intervention exercise at the
following intervals: 2 hours, 1 day, 2 days, 3 days and 4 days. All measures of IR will be
taken 3 times and the average of the three measures used in data analysis. The investigator
performing the measures will be blinded to participant group assignment. When the subject
completes both intervention weeks, he will be asked if he had a personal preference for
either exercise.
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