Functional Effects of Tendon Neuroplastic Training in Wrestlers

May 10, 2026 updated by: Recep Baloglu, Hacettepe University

Functional Effects of Tendon Neuroplastic Training in Wrestlers With Shoulder Tendinopathy: a Randomized Controlled Trial

ABSTRACT AIM: The term tendinopathy describes multifaceted pathologies occurring in the tendon, characterized by pain, functional impairment, and decreased exercise tolerance. The aim of this study is to use Tendon Neuroplastic Training (TNT) in Wrestlers with shoulder tendinopathy between the ages of 14-25; To investigate its effects on balance, coordination, mental performance and shoulder functionality.

METHOD: After determining the sample size of the study with the G Power (Software 3.1.9.2) program, 26 athletes were randomly divided into two groups; the study group received a 4-week TNT training protocol, while the control group received 4 weeks of standard eccentric training. Both groups were given exercises for the Supraspinatus, Infraspinatus, Subscapularis and Biceps muscles. The athletes' balance with "Upper Quarter Y Balance", coordination with "Alternate Hand Wall Toss", and mental performance with Stroop Color-Word tests were evaluated. "Kerlan-Jobe" and "Western Ontario Rotator Cuff" scales were used to evaluate shoulder functionality and pain. All assessments were administered before and after exercise training. The data were analyzed statistically with the "IBM SPSS 25" package program.

Key Words: Athlete, Mental Test, Shoulder, Tendinopathy

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

26

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Kayseri
      • Kayseri, Kayseri, Turkey (Türkiye), 38100
        • Kayseri Youth and Sports Provincial Directorate

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Being a licensed athlete for at least one year
  • Having a diagnosis of tendinopathy based on clinical and radiological examination
  • To positive least three of the following diagnostic tests: Neer Test, Hawkins-Kennedy Test, Jobe-Supraspinatus Test, Painful arc at 60-120 degrees of shoulder abduction
  • Pain level is below 2 out of 10 at rest and below 3 out of 10 during active movement according to the visual pain scale,
  • No limitation in joint range of motion (at least 85% of the healthy side).

Exclusion Criteria:

  • • Having any vision or hearing problems

    • Previous surgery at last 6 month
    • Having diagnose complete tendon rupture

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Tendon Neuroplastic Training Group
The Group that Perceived Tendon Neuroplastic Training
Other: Tendon Neuroplastic Training
Tendon Neuroplastic Training can be adapted to isometric and isotonic exercises with a digital metronome program. Tendon Neuroplastic Training has been reported to improve functionality and strength, reduce pain and cortical inhibition in athletes by generating 'adaptation' in central nervous system. Resistance training planned with visual or auditory stimuli (externally paced), can induce changes on motor control. the exercises paced to an external audio/visual cue on the participant's smartphone
Other Names:
  • External Paced Training
Other: Control Group
The Group that Perceived Standard Eccentric Training
Other: Tendon Neuroplastic Training
Tendon Neuroplastic Training can be adapted to isometric and isotonic exercises with a digital metronome program. Tendon Neuroplastic Training has been reported to improve functionality and strength, reduce pain and cortical inhibition in athletes by generating 'adaptation' in central nervous system. Resistance training planned with visual or auditory stimuli (externally paced), can induce changes on motor control. the exercises paced to an external audio/visual cue on the participant's smartphone
Other Names:
  • External Paced Training

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cognitive function
Time Frame: "Baseline" and "week 4"
Cognitive function was assessed with the Stroop Test TBAG (Temel Bilimler Araştırma Grubu) Form. The Stroop Test also referred to as the Color- Word Task, was used to assess executive abilities, selective attention, and the ability to inhibit a habitual response. In sports psychology research, the Stroop test and its derivations are commonly used to investigate the benefits of exercise on cognitive function. Stroop Test TBAG Form consists of five cards. For each section, the time taken by participants during the application was measured using a 0.01-second precision smartphone chronometer. The completion time of reading the card, the number of errors and the number of corrections (if any) for each section were recorded on an evaluation form for each participant. There are no minimum or maximum score values for this test. A lower score means a better result.
"Baseline" and "week 4"

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hacettepe University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • 1. Singh A, Sharan L, Shankhapal VR, Shenoy S. From shoulder to ankle: A cross-sectional study of tendinopathy prevalence across the athletic population. J Sport Rehabil Sci. 2026;3(1):1-10. 2. McCausland C, Sawyer E, Eovaldi BJ, Varacallo MA. Anatomy, Shoulder and Upper Limb, Shoulder Muscles. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 8, 2023. 3. Maunder DJ, Nelson BC, Murthi AM, Hoffman RA. The Burden of Shoulder and Elbow Injuries in Wrestling: A Systematic Review of Incidence, Injury Types, and Competition-Level Comparisons. Sports Health: A Multidisciplinary Approach. 2025;0(0). 4. Goodman AD, Twomey-Kozak J, DeFroda SF, Owens BD. Epidemiology of shoulder and elbow injuries in National Collegiate Athletic Association wrestlers, 2009-2010 through 2013-2014. The Physician and Sportsmedicine. 2018;46 (3):361-366. 5. Noh, Ji-Woong & Park, Byoung-Sun & Kim, Meeyoung & Lee, Lim-Kyu & Yang, Seung-Min & Lee, Won-Deok & Shin, Yong-Sub & Kim, Ju-Hyun & Lee, Jeong-Uk & Kwak, Taek-Yong & Lee, Tae-Hyun & Kim, Ju-Young & Park, Jaehong & Kim, Junghwan. (2015). Analysis of combat sports players' injuries according to playing style for sports physiotherapy research. Journal of physical therapy science. 27. 2425-30 6. Thomas RE, Zamanpour K. Injuries in wrestling: systematic review. The Physician and Sportsmedicine. 2018;46(2):168-196 7. Millar N, Silbernagel K, Thorborg K et al. Tendinopathy. Nature Reviews Disease Primers. 2021;7(1):1 8. Reinking M. Tendinopathy in athletes. Phys Ther Sport. 2012; 13: 3-10 9. Taik, F. Z., Karkouri, S., Tahiri, L., Aachari, I., Moulay Berkchi, J., Hmamouchi, I., Abouqal, R., Rkain, H., & Allali, F. (2022). Effects of kinesiotaping on disability and pain in patients with rotator cuff tendinopathy: double-blind randomized clinical trial. BMC musculoskeletal disorders, 23(1), 90 10. Aydeniz B, Ersoy S, Çinicioğlu M, Vural M. Evaluation of Kinesiophobia, Pain and Functional Status in Adhesive Capsulitis and Rotator Cu

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 15, 2024

Primary Completion (Actual)

March 8, 2025

Study Completion (Actual)

October 22, 2025

Study Registration Dates

First Submitted

April 28, 2026

First Submitted That Met QC Criteria

May 10, 2026

First Posted (Actual)

May 14, 2026

Study Record Updates

Last Update Posted (Actual)

May 14, 2026

Last Update Submitted That Met QC Criteria

May 10, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2022/10123

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

We respect the privacy of participants' 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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Shoulder Tendinopathy

Clinical Trials on Tendon Neuroplastic Training

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Dominican Republic

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe