The Effect of Core Stability Exercises on Pain, Muscle Strength, and Muscle Architecture in Tennis Players With Rotator Cuff Lesions

This study aims to shed light on the supraspinatus and infraspinatus muscles, which play a significant role in rotator sheath tendinopathy and tears. It includes isometric measurements of muscle thickness, fiber length, and pennation angles, as well as muscle strength, using ultrasound to evaluate the muscle architecture of the supraspinatus and infraspinatus muscles in tennis players.

Study Overview

• Status: Completed
• Conditions: Rotator Cuff Injuries; Muscle Weakness; Exercise
• Intervention / Treatment: Other: exercise

Detailed Description

The shoulder joint is prone to injury due to its unique anatomy. Rotator cuff lesions (RCL) are a common cause of shoulder pain, with a prevalence of 81% (1). One effective approach for monitoring muscle function is to visualize the architectural structure of the muscle. Muscle architecture is the examination of the structural arrangement of muscle fibers, muscle thickness, pennation angle, and number of sarcomeres according to the force generation axis (2). Ultrasonographic muscle architecture measurements provide a rapid and objective evaluation to examine the pathology of the muscles associated with subacromial impingement syndrome (3).

Muscle strength measurement is a physical performance measurement used to determine the loss of strength in the muscle and to evaluate the effectiveness of the intervention by resisting the muscle (4). It is worth noting that the strength of the rotator cuff muscles, especially the external and internal force-generating muscles of the shoulder, may be somewhat reduced in athletes with RCL. Strength measurement of these muscles can provide valuable data in shoulder evaluation (5). It is also worth mentioning that shoulder injuries are quite common in tennis. In addition to physiotherapy methods, the success rate in RCL treatment may be enhanced by exercise (6). In shoulder rehabilitation, core exercises are designed to help restore functional movements through the elimination of pain and the dynamic stability of the rotator cuff and scapular muscles. The goal is to strengthen the shoulder girdle muscles and achieve sufficient joint range of motion, especially by providing neuromuscular re-education with therapeutic exercises.

References

1. Dong W, Goost H, Lin XB, et al. Treatments for shoulder impingement syndrome: a systematic review and network meta-analysis. Medicine (Baltimore). 2015;94:e510.
2. Lewis, J., Ginn, K.. Rotator cuff tendinopathy and subacromial pain syndrome.In: Modern Musculoskeletal Physiotherapy, fourth ed. Elsevier, pp. 2015; 563e568.
3. Michener L, Walsworth M, Burnet E. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther, 2004, 17: 152-164.
4. Sauers E. Effectiveness of rehabilitation for patients with subacromial impingement syndrome. J Athl Train, 2005, 40: 221-223
5. Ersever, E. M., Güzel, N. A., Hakan, G. E. N. Ç., & Mülkoğlu, C. (2021). Subakromiyal Sikişma Sendromlu Hastalarda Egzersiz İle Elektrik Stimülasyonunun Etkileri. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi, 54(3), 382-386.
6. Oh, L.S., Luke, S., Brian, R, Michael P., Bruce, A., Marx, Robert G. (2007). Indications for rotator cuff repair: a systematic review. Clinical Orthopaedics and Related Research®, 455: 52-63.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ankara, Turkey
    • Tennis Club

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Acute trauma
• Tendinosis
• Bursitis chronic inflammation degeneration
• Grade 1-2 rupture
• Having unilateral shoulder pain
• At least two specific tests must be positive (Neer-hawkings-Lag sign-drop arm and supraspinatus isolation tests; painful shoulder internal and external rotation against resistance (IR and ER); painful arch during abduction)

Exclusion Criteria:

• An acute trauma
• History of surgery or a fracture in or near the shoulder and shoulder
• A neurological deficit
• intra-articular injections in the last six months
• Rheumatic disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: muscle architecture	Other: exercise; The study will include 40 tennis players diagnosed with rotator cuff lesions who meet the inclusion criteria. The 1st group will be randomly divided into 2 groups as control (n=20) and 2nd group as core exercise (n=20). Unlike the control group, core exercises will be added to the routine exercise program of tennis players once a day, 3 days a week for 8 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
visual pain scale	The primary objective was to see if we could help to decrease the pain intensity of the patients by 4 units in a 10-unit VPS assessment.	8 week

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ultrasonographic examination	increase in supraspinatus muscle thickness = centimeters	8 week

Collaborators and Investigators

• Sponsor: Ankara University

Publications and helpful links

Helpful Links

• Application of core exercises to tennis players
• core exercises to tennis players

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2023
• Primary Completion (Actual): October 1, 2023
• Study Completion (Actual): October 1, 2024

Study Registration Dates

• First Submitted: April 29, 2024
• First Submitted That Met QC Criteria: May 2, 2024
• First Posted (Actual): May 7, 2024

Study Record Updates

• Last Update Posted (Actual): October 15, 2024
• Last Update Submitted That Met QC Criteria: October 11, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: pain; fiber length; pennation angle; muscle thickness
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Pain; Neurologic Manifestations; Wounds and Injuries; Musculoskeletal Diseases; Muscular Diseases; Neuromuscular Diseases; Musculoskeletal Pain; Rupture; Shoulder Injuries; Tendon Injuries; Neuromuscular Manifestations; Myalgia; Rotator Cuff Injuries; Muscle Weakness
• Other Study ID Numbers: 5678525-050.0404/1202308

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