End-range Maitland Mobilization on Glenohumeral Internal Rotation Deficit and Proprioception

The Effect of End-range Maitland Mobilization on Glenohumeral Internal Rotation Deficit and Proprioception in Volleyball Players

Glenohumeral internal rotation deficit (GIRD) is one of the main reasons for glenohumeral pain in athletes with over-head activity. As GIRD increases, the ratio between internal and external rotation changes resulting in decreased joint stability.

Joint mobilization is a possible option for the decrease of GIRD and contribution to improvement of proprioception in addition to physical therapy. The aim of this trial is to investigate the effect of end-range Maitland mobilization in addition to physical therapy on GIRD, other joint movements and proprioception.

Study Overview

• Status: Completed
• Conditions: Sports Physical Therapy
• Intervention / Treatment: Procedure: End-range Maitland mobilization + proprioception training; Procedure: Non end-range Maitland mobilization + proprioception training; Procedure: Sham manual therapy technique + proprioception training

Detailed Description

Glenohumeral internal rotation deficit (GIRD) is one of the main reasons for glenohumeral pain in athletes with over-head activity. As GIRD increases, the ratio between internal and external rotation changes resulting in decreased joint stability. The occurence of GIRD and decreased joint proprioception may lead to different shoulder pathologies (e.g. Impingement syndrome).

Joint mobilization is a possible option for the decrease of GIRD and contribution to improvement of proprioception in addition to physical therapy. Several joint mobilization techniques exists, which can be applied for stretching of periarticular tissues. Maitland mobilization is a well applied mobilization type. The effectiveness of both end-range and not end-range Maitland mobilization in lengthening of periarticular tissues and improvement of joint proprioception has been previously confirmed amongst several diseases. However, the effect of end-range Maitland mobilization on decrease of GIRD and proprioception in addition to physical therapy has not been investigated in volleyball players so far.

The aim of this trial is to investigate the effect of end-range Maitland mobilization in addition to physical therapy on GIRD, other joint movements and proprioception.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hungary
  • Please Select
    • Harkány, Please Select, Hungary, 7815
      • Harkány Thermal Rehabilitation Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 30 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• National Championship players in I. or II. level
• at least, 10 degree deficit of glenohumeral internal rotation in the dominant shoulder compared to the non-dominant hand

Exclusion Criteria:

• previous trauma or surgery on the dominant shoulder
• participation in any kind of treatment during the intervention period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: End-range mobilization + proprioception training; End-range Maitland mobilization performed in end-range internal rotation of the shoulder accompanied with 8--week long proprioception training	Procedure: End-range Maitland mobilization + proprioception training; End-range Maitland mobilization performed in end position of internal rotation of the shoulder accompanied with 8--week long proprioception training
Active Comparator: Non end-range mobilization+ proprioception training; Non end-range Maitland mobilization performed in loose position of the shoulder accompanied with 8--week long proprioception training	Procedure: Non end-range Maitland mobilization + proprioception training; Non end-range Maitland mobilization performed in loose position of the shoulder accompanied with 8--week long proprioception training
Sham Comparator: Sham manual therapy technique + proprioception training; Placebo performed in loose position of the shoulder accompanied with 8--week long proprioception training	Procedure: Sham manual therapy technique + proprioception training; Placebo performed in loose position of the shoulder accompanied with 8--week long proprioception training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Internal rotation of the dominant glenohumeral joint	Measurement of active internal rotation of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Flexion of the dominant glenohumeral joint	Measurement of active flexion of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks
Extension of the dominant glenohumeral joint	Measurement of active extension of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks
Abduction of the dominant glenohumeral joint	Measurement of active abduction of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks
Adduction of the dominant glenohumeral joint	Measurement of active adduction of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks
External rotation of the dominant glenohumeral joint	Measurement of active external rotation of the dominant glenohumeral joint with goniometer expressed in degree	after 8 weeks
Western Ontario Shoulder Instability Index	Western Ontario Shoulder Instability Index of the dominant shoulder	after 8 weeks
Posterior Shoulder Endurance Test	Muscle strength test of the dominant shoulder expressed in Newton	after 8 weeks
Proprioception of the shoulder	Proprioception of the shoulder measured with plurimeter expressed in degree	after 8 weeks
Davies test	Measurement of proprioception and muscle strength test by the Davies test expressed in amount of success touch	after 8 weeks
Sportspecific proprioception test	Measurement of the precision of serving expressed in centimeter	after 8 weeks

Collaborators and Investigators

• Sponsor: University of Pecs
• Investigators: Principal Investigator: Miklós Pozsgai, Harkány Thermal Rehabilitation Centre

Publications and helpful links

General Publications

• Miura K, Tsuda E, Ishibashi Y. Glenohumeral Rotational Deficit and Suprascapular Neuropathy in the Hitting Shoulder in Male Collegiate Volleyball Players. Prog Rehabil Med. 2019 Jan 12;4:20190002. doi: 10.2490/prm.20190002. eCollection 2019.
• Wilk KE, Reinold MM, Macrina LC, Porterfield R, Devine KM, Suarez K, Andrews JR. Glenohumeral internal rotation measurements differ depending on stabilization techniques. Sports Health. 2009 Mar;1(2):131-6.

Study record dates

Study Major Dates

• Study Start (Actual): September 28, 2021
• Primary Completion (Actual): October 10, 2021
• Study Completion (Actual): October 10, 2021

Study Registration Dates

• First Submitted: April 22, 2021
• First Submitted That Met QC Criteria: April 27, 2021
• First Posted (Actual): April 30, 2021

Study Record Updates

• Last Update Posted (Actual): September 8, 2022
• Last Update Submitted That Met QC Criteria: September 4, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: Proprioception; Volleyball; Musculoskeletal Manipulations; Range Of Motion, Articular
• Other Study ID Numbers: Maitland_GIRD

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