Effect of Thrower's Ten Exercise Program on Shoulder Flexibility, Stability and Strength in Water Polo Players

July 6, 2023 updated by: Burak Asal, Baskent University

Context: Studies have shown that the thrower's ten rehabilitation program is effective in the prevention and rehabilitation of injuries in overhead throwing sports. However its effect on water polo sports is still unknown.

Objective: To investigate the effect of thrower's ten (T10) exercise program on shoulder flexibility, stability and strength in water polo athletes.

Design: Randomized controlled clinical trial. Setting: Middle East Technical University swimming pool and training facilities.

Intervention(s): T10 group were given thrower's ten exercises 3 times per week for 10 weeks, each exercise being 2x10 repetitions. Athletes in the control group were not given any additional exercise to their weekly water polo training.

Main Outcome Measure(s): Before and after the exercise, the upper extremity internal and external rotation strength of the athletes was measured with isokinetic dynamometer, the shoulder stability was measured with the closed kinetic chain upper extremity test (CKCUEST), and the shoulder flexibility was measured with the help of the shoulder joint internal and external rotation motion flexibility test.

Key Words: Thrower's Ten, Water Polo, Stability, Flexibility, Strength

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Before starting the study, individuals were informed about the purpose of the study, the test protocols to be applied and the program.

Individuals who met the inclusion criteria were randomly allocated into two groups named T10 (n=24) and Control (n=26) in a single blinded manner using a computer-based online site called "Random Lists". Three separate evaluation tests were administered before and 10 weeks after the start of the study.

Individuals in the T10 group underwent T10 exercise program with a physiotherapist or trainer for 10 weeks with 3 sessions per week and at least 1 day between sessions. Individuals in the control group were followed up for 10 weeks as they continued their weekly team training without being actively subjected to an extra program., After the inital evaluations were completed in the T10 group, exercises were started 1 week before the study and the exercises were taught. Elastic resistance band in the appropriate color to be used in the program were determined based on 70% difficulty according to the OMNI scale.

The athletes participating in the study were evaluated twice in total, at the beginning and at the end of the study. Sociodemographic data including age, weight, height, gender, BMI and dominant side were collected. Shoulder strength of the participants was evaluated with an isokinetic dynamometer in 90° abduction with external and internal rotation force test at angular velocities of 60°/s and 180°/s in two different ways. Upper extremity stability of the participants was evaluated by closed kinetic chain upper extremity stability test (CKCUEST). Shoulder internal and external rotation flexibility of the participants was evaluated with the shoulder joint internal and external rotation flexibility of motion test.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
50

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
    • Çankaya
      • Ankara, Çankaya, Turkey, 06810
        • Baskent University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being a licensed athlete in a professional water polo team and actively participating in competitions
  • Be between the ages of 10-25.
  • Both genders

Exclusion Criteria:

  • Having suffered an injury in the last 6 months
  • Have any orthopedic, neurological, cardiovascular or any other health condition that prevents working in the last 6 months.
  • Have a body mass index of 30 and above.
  • Having undergone orthopedic surgery

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: Control
Experimental: Thrower's Ten
Other: Thrower's Ten Exercise Program
T10 group were given thrower's ten exercises 3 times per week for 10 weeks, each exercise being 2x10 repetitions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Flexibility
Time Frame: two weeks
Shoulder Joint Internal and External Flexibility of Motion Test was used, from a standing position, the participant was asked to reach the lowest possible point of the back, over the shoulder, towards the floor, with the fingers extended and the palm facing the back, with external rotation of the arm. Then, he/she was asked to reach the highest point on his/her back by internal rotation, with the palm facing forward and again with the fingers in extension. The thoracic 5th vertebral process was used as the reference point to assess internal rotation motion and the cervical 7th vertebral process was used as the reference point to assess external rotation motion. If the thumb was not touching the reference point, the distance in cm was recorded as (-), if it was touching the reference point (0) and if it crossed the reference point, the distance in cm was recorded as (+).
two weeks
Stability
Time Frame: two weeks
Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), is a clinical test that measures the neuromuscular control of the upper extremity for shoulder stability. For the test, two bands were placed on the floor approximately 91.4 cm (36 inches) apart and parallel to the body of the subject. The test was performed in the push-up position. First, the subjects were asked for a few trial repetitions. Then, within 15 seconds, they were asked to quickly switch one hand to the other and each switch was recorded. After the test was repeated three times, the average of the recorded values was taken as the basis.
two weeks
Strength
Time Frame: two weeks
Shoulder strength was measured with a Cybex Humac Norm (Cybex, Lumex Inc. Division, Ronkonkoma, NY, USA) isokinetic dynamometer at angular velocities of 60°/s and 180°/s with a concentric/concentric protocol in the 90° abduction and external rotation position with the elbow fixed at 90° flexion. After a warm-up of 5 repetitions after the isokinetic dynamometer measured the end of gravitational correction and range of motion, the participant was asked to perform maximum internal rotation and external rotation, respectively, against the machine at 60°/s angular velocity for a total of 10 repetitions. The same procedure was then repeated for 15 repetitions at 180°/s angular velocity. This procedure was performed on both shoulders, dominant and non-dominant.
two weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Baskent University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 24, 2022

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 27, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 25, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 27, 2023

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 6, 2023

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 14, 2023

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 14, 2023

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 6, 2023

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • BU-ASAL-001

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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