Augmented Feedback Effects on Shoulder Rotator Performance

Immediate and Retention Effects of Augmented Feedback on Isometric Peak Force and Rate of Force Development of Shoulder Rotators

The existing literature demonstrates that motor learning strategies are effective in enhancing sports performance. One of these strategies, augmented feedback, is widely used in athletic training to help athletes achieve their goals more effectively, support the learning process, and motivate improvements in performance. Although studies in the literature have demonstrated the positive effects of augmented feedback provided during training on performance, no study has been found that examines the acute effects of such feedback on peak force and rate of force development during isometric training of the shoulder internal and external rotator muscles. The aim of this study is to investigate the acute effects of outcome feedback on isometric peak force and rate of force development during isometric training of the shoulder internal and external rotator muscles, as well as the short-term retention of these effects. It is expected that augmented feedback on isometric peak force and rate of force development, provided during isometric training of the shoulder internal and external rotator muscles, will have both acute and short-term retention effects on strength parameters. Healthy and physically active individuals will participate in isometric strength training targeting the dominant side shoulder internal and external rotator muscles across two separate sessions. Within a randomized crossover design, all participants will perform the isometric training program under two different conditions: with augmented feedback and without augmented feedback. The order of the conditions will be determined using a computer-based randomization program.To minimize potential learning effects, a washout period of 5-7 days will be provided between the two training conditions. Testing and training protocols will be conducted using an isometric dynamometer (ForceFrame, VALD Performance, Australia). The reported intraclass correlation coefficients (ICC) of the ForceFrame dynamometer for shoulder strength measurements range between 0.85 and 0.91, indicating good to excellent test-retest reliability. All testing and training procedures will be performed in accordance with the standard testing positions recommended by the manufacturer.

Study Overview

• Status: Recruiting
• Conditions: Shoulder; Athlete; Performance Enhancement
• Intervention / Treatment: Other: Augmented Feedback

Detailed Description

All participants will complete a standardized warm-up protocol of approximately 10 minutes prior to the testing sessions. The warm-up will begin with arm circles to promote active mobilization of the shoulder joint. This will be followed by one set of 10 repetitions of shoulder internal and external rotation exercises performed at 90° of shoulder abduction and 90° of elbow flexion using a resistance band providing submaximal resistance. Following the warm-up, a familiarization session will be conducted to increase participants' familiarity with the ForceFrame device used in the testing and training sessions. During this session, participants will perform five repetitions of isometric contractions, each lasting 5 seconds, at a self-selected submaximal effort level. The familiarization session is intended to ensure participants' adaptation to the testing procedure, learning of the correct movement sequence, and execution of the exercise with proper technique. Following completion of the warm-up protocol, isometric muscle strength and rate of force development of the dominant shoulder internal and external rotator muscles will be assessed. All measurements will be performed using an isometric dynamometer (ForceFrame). During testing, participants will be positioned in a supine position with the knees flexed and feet flat on the ground, while the non-tested arm will be placed across the chest.

The tested shoulder will be positioned at 90° of abduction and the elbow at 90° of flexion, with the hand placed at a comfortable height appropriate for pushing against the sensors. The testing protocol will consist of three repetitions of maximal isometric contractions, each lasting 5 seconds, with 20 seconds of rest between repetitions. Maximum force and rate of force development values will be recorded during each trial. Throughout testing, participants will be instructed to maintain the standardized position and keep their arms stable. Prior to each test, standardized verbal instructions will be provided, instructing participants to perform the contractions "by producing maximal force as quickly as possible." The test protocol will be administered at three time points: before the isometric training (pre-test), immediately after the training protocol (post-test), and 15 minutes after training to assess immediate retention (immediate retention test).

Following the pre-test, participants will perform the isometric training protocol targeting the shoulder internal and external rotator muscles. The training protocol will also be conducted using the ForceFrame device. During training, participants will be positioned identically to the testing protocol, in a supine position with the knees flexed and feet flat on the ground, while the non-tested arm will be placed across the chest. The tested shoulder will be positioned at 90° of abduction and the elbow at 90° of flexion. The training protocol will consist of one set of three repetitions, each involving a 5-second isometric contraction, with 20 seconds of rest between repetitions. Throughout the training, participants will be instructed to maintain the standardized position and keep their arms stable. Standardized verbal instructions will be provided to all participants, instructing them to perform the isometric contractions "by producing maximal force as quickly as possible."

Knowledge of results will be provided between repetitions during the training session. Following each repetition, participants will receive immediate quantitative feedback regarding their maximum force (peak force) and rate of force development. The feedback will be delivered by the same physiotherapist to all participants, using a clear and emphatic tone, slightly louder than normal conversational volume to ensure it is distinguishable from background noise.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Elif Turgut, PhD, PT; Phone Number: +905442645600; Email: elif.turgut.pt@gmail.com

Study Locations

• Turkey (Türkiye)
  • Sıhhıye
    • Ankara, Sıhhıye, Turkey (Türkiye), 06100
      • Recruiting
      • Hacettepe University, Faculty of Physical Therapy and Rehabilitation,
      • Contact: Elif Turgut, PhD, PT; Phone Number: +905442645600; Email: elif.turgut.pt@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Healthy individuals aged between 18 and 30 years,
• Body Mass Index (BMI) below 30 kg/m²,
• An activity level of 5 or higher according to the Tegner Activity Scale,
• Full active range of motion (ROM) in shoulder flexion, abduction, internal, and external rotation.

Exclusion Criteria:

• Resence of current pain complaints,
• Provocation of symptoms during at least one of the specific shoulder clinical tests (Neer Test, Hawkins-Kennedy Test, Jobe Test, Resisted External Rotation Test, and Apprehension Test),
• History of any upper extremity injury, pain, or surgical intervention within the past 12 months,
• Presence or history of hypertension, cardiovascular diseases, peripheral vascular diseases, deep vein thrombosis, neurological disorders, systemic inflammation, diabetes, cancer, or obesity,
• Unwillingness to participate in the study.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Augmented Feedback; Participants will attend two separate sessions of isometric strength training targeting the dominant shoulder internal and external rotator muscles. All participants will perform the isometric training program under two different conditions-providing augmented feedback and no feedback-within a randomized cross-over design. Augmented feedback will be provided during the training between repetitions. After each repetition, participants will receive immediate quantitative feedback regarding their peak force and rate of force development values.	Other: Augmented Feedback; Augmented feedback is a term used to describe information about the performance of a skill provided from an external source. When this information is presented quantitatively, it is referred to as Knowledge of results (e.g., movement velocity, jump height, or peak force). Knowledge of results, which is a critical component of performance improvement, is delivered to athletes through professional coaching staff as well as advanced technological applications. Accordingly, research in this area has focused on the pivotal role of real-time data flow and feedback in optimizing performance.
No Intervention: Non-Feedback; Participants in the non-feedback condition will perform the standard isometric strength training protocol targeting the dominant shoulder internal and external rotator muscles. During this condition, participants will not receive any quantitative or augmented feedback regarding their peak force or rate of force development values. They will be instructed to perform the exercises with maximal effort based solely on standard verbal instructions, without access to any real-time performance data from the testing device.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Peak Force	Peak force refers to the maximum force generated by the shoulder internal or external rotator muscles during a single maximal isometric contraction.	Within the same intervention day: Baseline, immediately post-intervention, and 15 minutes post-intervention
Rate of Force Development	Rate of Force Development efers to the speed at which force is generated by the shoulder internal or external rotator muscles during a maximal isometric contraction.	Within the same intervention day: Baseline, immediately post-intervention, and 15 minutes post-intervention

Collaborators and Investigators

• Sponsor: Elif Turgut
• Collaborators: Hacettepe University

Publications and helpful links

General Publications

• Chalker WJ,Shield AJ,Opar DA,Rathbone EN,Keogh JWL

Helpful Links

• Effect of acute augmented feedback on between limb asymmetries and eccentric knee flexor strength during the Nordic hamstring exercise

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): November 1, 2026

Study Registration Dates

• First Submitted: March 26, 2026
• First Submitted That Met QC Criteria: March 31, 2026
• First Posted (Actual): April 6, 2026

Study Record Updates

• Last Update Posted (Actual): April 6, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Shoulder; Performance; Motor learning; Muscle strength; Rotator cuff; Knowledge of result
• Other Study ID Numbers: FTREK26/30

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because the informed consent obtained from the participants and the ethics committee approval do not cover the public sharing of raw data.

Drug and device information, study documents

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