The Effects of Thrower's Ten Exercises Performed With an External Focus (The Effects of)

The Effects of Thrower's Ten Exercises Performed With an External Focus on Functional Performance, Balance, and Shooting Performance in Adolescent Basketball Players

The aim of this study is to comprehensively investigate the effects of the Thrower's Ten exercise program-commonly recommended to enhance shoulder stability and strength in athletes-when applied using an external focus of attention approach (i.e., directing attention toward an object or movement outside the body), on functional performance, shoulder stability, balance, and throwing performance in adolescent basketball players.

This study has been designed to examine the effects of performing the Thrower's Ten exercises with an external focus of attention on functional performance, shoulder stability, balance, and throwing performance in adolescent basketball players. Athletes will be randomly assigned to two groups: the experimental group will perform the exercises using an external focus of attention, whereas the control group will perform the same exercises without any specific attentional focus.

The methods employed in this study are expected to effectively address the research objectives. The data collection tools and analytical techniques to be used are based on validated and widely accepted tests in the literature. Functional performance will be assessed using the Closed Kinetic Chain Upper Extremity Stability Test, balance will be evaluated using the Upper Extremity Y Balance Test, and throwing performance will be measured using the Medicine Ball Throw Test.

Study Overview

• Status: Not yet recruiting
• Conditions: Adolescent; Exercise Training; External Focus (e.g., Performing the Exercise by Directing the Individual's Attention to a Laser Beam)
• Intervention / Treatment: Other: Exercise; Other: Exercise with neutral attentional focus

Detailed Description

The aim of this study is to comprehensively investigate the effects of the Thrower's Ten exercise program-commonly recommended to enhance shoulder stability and strength in athletes-when applied using an external focus of attention approach (i.e., directing attention toward an object or movement outside the body), on functional performance, shoulder stability, balance, and throwing performance in adolescent basketball players.

This study has been designed to examine the effects of performing the Thrower's Ten exercises with an external focus of attention on functional performance, shoulder stability, balance, and throwing performance in adolescent basketball players. Athletes will be randomly assigned to two groups: the experimental group will perform the exercises using an external focus of attention, whereas the control group will perform the same exercises without any specific attentional focus.

The methods employed in this study are expected to effectively address the research objectives. The data collection tools and analytical techniques to be used are based on validated and widely accepted tests in the literature. Functional performance will be assessed using the Closed Kinetic Chain Upper Extremity Stability Test, balance will be evaluated using the Upper Extremity Y Balance Test, and throwing performance will be measured using the Medicine Ball Throw Test.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Birgül Dıngırdan; Phone Number: +905444694932; Email: birguldingirdan@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Adolescent male basketball players aged 10-18 years
• With at least one year of continuous participation in basketball
• Basketball players who participate in regular training at least two days per week

Exclusion Criteria:

• Participants will be excluded if they have a history of upper or lower extremity surgery within the past six months
• do not regularly attend training sessions
• do not consent to participate

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: external focus group; This program has been designed to improve shoulder stability, muscular strength, and overall performance. The exercise protocol to be implemented consists of the Thrower's Ten Exercise Program. Thrower's Ten Exercise Program: The Thrower's Ten Exercise Program, originally developed by Kevin E. Wilk and colleagues (1993), comprising ten different exercises, will be applied to both the experimental and control groups. The exercises included in this program are as follows: 1.a. Diagonal Pattern D2 Extension; b. Diagonal Pattern D2 Flexion; a. External Rotation at 0° Abduction 2.b. Internal Rotation at 0° Abduction 2.c. External Rotation at 90° Abduction 2.d. Internal Rotation at 90° Abduction 3. Shoulder Abduction at 90° 4. Scaption (Scapular Plane Elevation) with External Rotation 5. Side-Lying External Rotation 6.a. Prone Horizontal Abduction (Neutral) 6.b. Prone Horizontal Abduction (Full Range of Motion, 100° Abduction) 6.c. Prone Rowing 6.d. Prone Rowing with External Rotation 7	Other: Exercise; The exercise protocol to be implemented consists of the Thrower's Ten Exercise Program. Thrower's Ten Exercise Program: The Thrower's Ten Exercise Program, originally developed by Kevin E. Wilk and colleagues (1993), comprising ten different exercises, will be applied to both the experimental and control groups. In the experimental group, an external focus of attention strategy will be employed, directing participants' attention away from their body movements toward external targets (e.g., a target board used in conjunction with a laser pointer) during the execution of the exercises.
Active Comparator: control group; The Thrower's Ten exercises will be performed using a neutral attentional focus approach.	Other: Exercise with neutral attentional focus; The Thrower's Ten exercises will be performed using a neutral attentional focus approach.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Balance	The Upper Extremity Y Balance Test (UEYBT) will be used to assess shoulder stability and dynamic balance. Participants will perform reach movements in three directions (anterior, posterolateral, and posteromedial), and the reach distance will be recorded. Three trials will be performed for each direction, and the maximum reach distance will be used for analysis. The UEYBT will be conducted for both the dominant and non-dominant upper extremities. Participants will begin the test in a push-up (plank) position. In this position, one hand will be placed at the center of the Y Balance Test apparatus, while both feet will remain in contact with the ground, positioned shoulder-width apart. While maintaining this position, participants will reach maximally in three directions (medial, superolateral, and inferolateral) with the contralateral upper extremity (15). After each reach, participants will return to the starting position without compromising the push-up posture.	Assessments will be conducted before the intervention (exercise program) and after the completion of the program. The exercise program will be implemented over a period of 6 weeks. Accordingly, evaluations will be performed at baseline (pre-intervention)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional performance	The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) will be used to assess shoulder stability and functional performance. In this test, participants will assume a push-up position and alternately touch the contralateral hand in a cross-over manner, with the number of touches completed within 15 seconds recorded. For the CKCUEST, participants will be positioned in a push-up stance, with their hands placed 92 cm apart, perpendicular to the body. Participants will be instructed to alternately touch the opposite hand as quickly as possible for 15 seconds. Each participant will perform two trials with a 1-minute rest interval between trials. The number of touches will be recorded by the evaluators. Trials will be considered invalid if the participant fails to reach the predetermined hand position or is unable to maintain the proper support position.	Assessments will be conducted before the intervention (exercise program) and after the completion of the program. The exercise program will be implemented over a period of 6 weeks. Accordingly, evaluations will be performed at baseline (pre-intervention)
Shooting Performance	The Medicine Ball Throw Test will be used to assess upper extremity explosive power and throwing performance. Participants will be instructed to throw a 2-kg medicine ball as far as possible, and the throwing distance will be recorded. For the test, participants will be seated on the floor with their backs firmly supported against a wall and their legs extended straight, with approximately 60 cm between the feet. A measuring tape will be placed on the ground and extended to a length of 10 meters. Participants will hold the 2-kg medicine ball with both hands at chest level, close to the midline of the body, and will be instructed to throw the ball horizontally, parallel to the measuring tape, as far as possible. The distance traveled by the ball will be measured in centimeters using the same measuring tape and recorded. Each participant will be given two trials, with a 1-minute rest interval between attempts.	Assessments will be conducted before the intervention (exercise program) and after the completion of the program. The exercise program will be implemented over a period of 6 weeks. Accordingly, evaluations will be performed at baseline (pre-intervention)

Collaborators and Investigators

• Sponsor: Hacettepe University

Study record dates

Study Major Dates

• Study Start (Estimated): April 25, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): July 20, 2026

Study Registration Dates

• First Submitted: April 13, 2026
• First Submitted That Met QC Criteria: April 20, 2026
• First Posted (Actual): April 23, 2026

Study Record Updates

• Last Update Posted (Actual): April 23, 2026
• Last Update Submitted That Met QC Criteria: April 20, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: functional performance; basketball; throwers ten exercise
• Additional Relevant MeSH Terms: Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise
• Other Study ID Numbers: SUBU 5

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

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