Sensorimotor Training Exercises for Shoulder Position Sense

Effect of Sensorimotor Training Exercises on Shoulder Joint Position Sense Post Mastectomy

Forty-six female patients aged 35-55 years who were suffering from shoulder dysfunction following mastectomy surgeries participated in this study. The participants were recruited from the outpatient clinic of the Faculty of Physical Therapy, Cairo University, and were randomly assigned into two equal groups.

Group A: consisted of 23 patients who received sensorimotor training exercises in addition to a traditional physical therapy program which included shoulder range of motion exercises, capsular stretching exercises, scapular muscle strengthening exercises, shoulder Maitland mobilization, and scapular mobilization.

Group B: consisted of 23 patients who received only the traditional physical therapy program, which included shoulder range of motion exercises, capsular stretching exercises, scapular muscle strengthening exercises, shoulder Maitland mobilization, and scapular mobilization.

Both groups received treatment three sessions per week for a duration of eight weeks.

Study Overview

• Status: Completed
• Conditions: Post Mastectomy
• Intervention / Treatment: Behavioral: Sensorimotor Training Exercises; Behavioral: Traditional Physical Therapy Program

Detailed Description

1. Subjects Forty-six female patients aged 35-55 years who were suffering from shoulder dysfunction following mastectomy surgeries participated in this study. The participants were recruited from the outpatient clinic of the Faculty of Physical Therapy, Cairo University, and were randomly assigned into two equal groups.

   Group A consisted of 23 patients who received sensorimotor training exercises in addition to a traditional physical therapy program, which included shoulder range of motion exercises, capsular stretching exercises, scapular strengthening exercises, scapular mobilization, and shoulder Maitland mobilization. The treatment was administered three sessions per week for eight weeks.

   Group B consisted of 23 patients who received only the traditional physical therapy program, which included shoulder range of motion exercises, capsular stretching exercises, scapular strengthening exercises, scapular mobilization, and shoulder Maitland mobilization. The treatment was administered three sessions per week for eight weeks.

2. Equipment Therapeutic equipment

Sensorimotor training exercises:

Patients performed sensorimotor training exercises that included tracking a diagram fixed on the wall using a laser pointer, throwing and catching a medicine ball, performing upper-limb weight-bearing exercises on a Swiss ball, and executing wall exercises using a ball. The exercises were applied with a dosage of three sets of ten repetitions, with one minute of rest between sets, three times per week for eight weeks.

Traditional physical therapy program:

The traditional physical therapy program was conducted three sessions per week for eight weeks and included scapular retraction exercises with moderate resistance from standing, shoulder range of motion exercises using a shoulder wheel and ladder in flexion and abduction, scapular mobilization from sitting, shoulder Maitland mobilization as inferior, anterior, and posterior glides, and posterior capsule stretching from sitting with approximately two sets of fifteen repetitions.

Measurement equipment

Digital inclinometer:

A digital inclinometer was used as a precise, gravity-based instrument to measure joint angles and range of motion (ROM) with high accuracy. It provided real-time digital readings, making it a reliable and efficient alternative to traditional goniometers. Clinically, it was commonly used to assess joint mobility of the spine, shoulders, hips, and knees, aiding in the evaluation of conditions such as arthritis, ligament injuries, and postoperative stiffness. In addition to ROM assessment, the digital inclinometer was considered a validated tool for evaluating joint position sense (JPS), a key component of proprioception. It was used to measure patients' ability to replicate joint angles, helping to identify neuromuscular control deficits frequently observed in musculoskeletal injuries and post-surgical cases. The objective data obtained supported individualized rehabilitation planning, progress monitoring, and functional recovery. Its portability, ease of use, and high reproducibility made it a valuable instrument in both clinical and research settings.

• Study Type: Interventional
• Enrollment (Actual): 46
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt, 12613
    • Faculty of Physical Therapy

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Female patients
• Aged between 35 and 55 years
• Underwent unilateral mastectomy
• Underwent wide local excision
• Underwent axillary dissection
• Presence of shoulder joint dysfunction
• Conscious and able to communicate orally or in writing
• No obvious abnormal spinal morphology or postural abnormalities visible to the naked eye

Exclusion Criteria:

• History of fracture or upper limb surgery within the last 3 months
• History of previous shoulder dislocation or chronic shoulder instability
• Uncontrolled diabetes mellitus
• Inability to communicate effectively or write
• Presence of cognitive, visual, or hearing impairments
• Neurological conditions affecting the upper extremity
• Moderate to severe upper limb lymphedema
• Prior permanent shoulder injury before mastectomy
• Poor physical conditioning or acute pain due to any cause or comorbidity
• Participation in another clinical trial or study that could interfere with the results

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Sensorimotor Training Exercises Plus Traditional Physical Therapy Program.; Sensorimotor training exercises in addition to the traditional physical therapy program (shoulder ROM exercises, capsular stretching exercises, scapular muscle strengthening exercises, and scapular mobilization) were applied three sessions per week for eight weeks. Patients tracked a diagram fixed on the wall using a laser pointer, threw and caught a medicine ball, performed upper-limb weight-bearing exercises on a Swiss ball, and executed wall exercises using a ball. The exercises were performed in three sets of ten repetitions, with one minute of rest between sets, three times per week for eight weeks. Traditional physical therapy program included scapular retraction exercises with moderate resistance from standing, shoulder ROM exercises using a shoulder wheel and ladder in flexion and abduction, scapular mobilization from sitting, shoulder Maitland mobilization (inferior, anterior, and posterior glides), and posterior capsule stretching from sitting with two sets of 15 repetitions	Behavioral: Sensorimotor Training Exercises; Sensorimotor training exercises, in addition to the traditional physical therapy program which included shoulder ROM exercises, capsular stretching exercises, scapular muscle strengthening exercises, and scapular mobilization were applied three sessions per week for eight weeks. Patients tracked a diagram fixed on the wall using a laser pointer, threw and caught a medicine ball, performed upper-limb weight-bearing exercises on a Swiss ball, and executed wall exercises using a ball. Each exercise was performed in three sets of ten repetitions, with one minute of rest between sets. The traditional physical therapy program also included scapular retraction exercises with moderate resistance from standing, shoulder ROM exercises using a shoulder wheel and ladder in flexion and abduction, scapular mobilization from sitting, shoulder Maitland mobilization (inferior, anterior, and posterior glides), and posterior capsule stretching from sitting with two sets of fifteen repetitions.; Behavioral: Traditional Physical Therapy Program; The traditional physical therapy program consisted of scapular retraction exercises with moderate resistance from standing, shoulder range of motion exercises using a shoulder wheel and ladder in flexion and abduction, scapular mobilization from a seated position, shoulder Maitland mobilization including inferior, anterior, and posterior glides, and posterior capsule stretching from a seated position, performed in approximately two sets of fifteen repetitions.
Experimental: Traditional Physical Therapy Program; Traditional physical therapy program 3 sessions per week for 8 weeks included scapular retraction exercises with moderate resistance from standing, shoulder ROM ex on shoulder wheel and ladder in flexion and abduction, scapular mobilization from sitting, shoulder Mitland mobilization as inferior glide, anterior glide and posterior glide, and posterior capsule stretching from sitting with approximately two sets of 15 repetitions.	Behavioral: Traditional Physical Therapy Program; The traditional physical therapy program consisted of scapular retraction exercises with moderate resistance from standing, shoulder range of motion exercises using a shoulder wheel and ladder in flexion and abduction, scapular mobilization from a seated position, shoulder Maitland mobilization including inferior, anterior, and posterior glides, and posterior capsule stretching from a seated position, performed in approximately two sets of fifteen repetitions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ShoulderJoint Position Sense	A digital inclinometer was used as a validated and reliable tool to assess joint position sense (JPS). It measured the participants' ability to accurately reproduce specific joint angles, providing objective data on proprioceptive accuracy.	8 weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: Huda Tarek Abuassi, Cairo university

Study record dates

Study Major Dates

• Study Start (Actual): September 16, 2025
• Primary Completion (Actual): November 16, 2025
• Study Completion (Actual): December 16, 2025

Study Registration Dates

• First Submitted: December 17, 2025
• First Submitted That Met QC Criteria: December 30, 2025
• First Posted (Actual): January 5, 2026

Study Record Updates

• Last Update Posted (Actual): January 5, 2026
• Last Update Submitted That Met QC Criteria: December 30, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Post mastectomy; Sensorimotor training exercises; Shoulder position sense
• Other Study ID Numbers: 25698547123654

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No