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Contralateral Resistance Training During Immobilization in Patients With Acromioclavicular Joint Injury (CROSS-ACD)

2026年6月4日 更新者：Omar Esteban Valdés Tapia、Universidad Nacional Andres Bello

Effects of Contralateral Eccentric and Concentric Resistance Training During Immobilization on Neuromuscular Function, Functional Recovery, and Quality of Life in Patients With Acromioclavicular Joint Injury: A Randomized Controlled Trial

This randomized controlled trial aims to compare the effects of contralateral eccentric and concentric resistance training performed during the immobilization period following acromioclavicular joint injury. Immobilization is commonly prescribed after injury but may lead to reductions in muscle mass, neuromuscular function, force production, and upper-limb functionality.

Contralateral resistance training, also known as cross-education training, involves exercising the non-injured limb to induce beneficial adaptations in the immobilized limb through neural mechanisms. While both eccentric and concentric exercise may produce contralateral effects, their relative effectiveness in a clinical population remains unclear.

Participants with acute acromioclavicular joint injury requiring sling immobilization will be randomly assigned to either a contralateral eccentric training group or a contralateral concentric training group. During immobilization, participants will perform supervised resistance training with the non-injured upper limb. Following immobilization, all participants will receive the same standardized rehabilitation program.

Neuromuscular function, muscle morphology, force production, upper-limb function, and quality of life will be assessed before immobilization, after immobilization, and following rehabilitation. The findings may contribute to the development of more effective rehabilitation strategies for patients recovering from upper-limb injuries requiring temporary immobilization.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

Acromioclavicular joint injury is one of the most common shoulder injuries in physically active individuals. Temporary immobilization using a sling is frequently prescribed during the acute phase of recovery; however, immobilization can result in rapid declines in muscle strength, muscle mass, neuromuscular function, and upper-limb performance.

Cross-education is a neurophysiological phenomenon whereby unilateral resistance training induces adaptations in the contralateral untrained limb. Previous experimental studies have demonstrated that resistance exercise performed with the non-immobilized limb may attenuate strength loss and neuromuscular impairments in an immobilized limb. However, the relative effectiveness of different muscle contraction modes during cross-education training in clinical populations remains poorly understood.

The purpose of this randomized controlled trial is to compare the effectiveness of contralateral eccentric versus contralateral concentric resistance training performed during the immobilization period in patients with acromioclavicular joint injury. Participants will be randomly allocated to one of two intervention groups: (1) contralateral eccentric resistance training or (2) contralateral concentric resistance training. Both interventions will be performed using the non-injured upper limb during the period of prescribed sling immobilization.

Participants will undergo comprehensive assessments before immobilization, immediately after immobilization, and after completion of a standardized rehabilitation program. Outcomes will include measures of neuromuscular function obtained through peripheral nerve stimulation, transcranial magnetic stimulation, electromyography, and voluntary force assessments. Muscle morphology will be evaluated using ultrasound imaging, while upper-limb function and quality of life will be assessed using validated clinical questionnaires.

Following immobilization, all participants will receive the same rehabilitation program focused on restoring shoulder stability, muscle strength, and functional capacity. The primary objective is to determine whether eccentric or concentric contralateral resistance training more effectively preserves neuromuscular function and facilitates recovery following immobilization.

The results of this study may provide evidence to optimize rehabilitation strategies for patients with acromioclavicular joint injuries and other musculoskeletal conditions requiring temporary upper-limb immobilization.

研究类型

介入性

注册 (估计的)

16

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

学习地点

  • 智利
    • Providencia
      • Santiago、Providencia、智利
        • 招聘中
        • Clínica Indisa
        • 接触：

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人

接受健康志愿者

不

描述

Inclusion Criteria:

  • Men and women aged 18 to 36 years.
  • Diagnosis of acute acromioclavicular joint injury confirmed by an orthopedic surgeon.
  • Physician-prescribed upper-limb immobilization using a sling for approximately 2 to 4 weeks, with or without surgical repair.
  • Ability to understand study procedures and provide written informed consent.
  • Medical clearance to participate in the rehabilitation and resistance training program.

Exclusion Criteria:

  • Previous surgery or severe musculoskeletal injury affecting either upper limb within the previous 12 months.
  • Neurological disorders affecting motor function or neuromuscular performance.
  • Contraindications to transcranial magnetic stimulation according to established safety guidelines.
  • Current participation in another clinical trial or structured upper-limb rehabilitation program.
  • Cognitive impairment or inability to comply with study procedures.
  • Pregnancy.
  • Any medical condition that, in the opinion of the investigators, may compromise participant safety or study participation.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：单身的

武器和干预

参与者组/臂
干预/治疗
实验性的：Contralateral Eccentric Training
Participants will perform supervised contralateral eccentric resistance training with the non-injured upper limb during the period of physician-prescribed sling immobilization following acute acromioclavicular joint injury, with or without surgical repair. The immobilization period is expected to last approximately 2 to 4 weeks depending on clinical management. Following immobilization, participants will complete a standardized 4-week rehabilitation program.
行为的：Contralateral Eccentric Resistance Training
Supervised unilateral eccentric elbow flexor training performed with the non-injured limb during sling immobilization (2-4 weeks). Training is performed 3 times/week, 5 sets of 8-12 repetitions at 60-90% 1RM, with 4-second contractions and 3-minute rest intervals between sets.
有源比较器：Contralateral Concentric Training
Participants will perform supervised contralateral concentric resistance training with the non-injured upper limb during the period of physician-prescribed sling immobilization following acute acromioclavicular joint injury, with or without surgical repair. The immobilization period is expected to last approximately 2 to 4 weeks depending on clinical management. Following immobilization, participants will complete the same standardized 4-week rehabilitation program.
行为的：Contralateral Concentric Resistance Training
Supervised unilateral concentric elbow flexor training performed with the non-injured limb during sling immobilization (2-4 weeks). Training is performed 3 times/week, 5 sets of 8-12 repetitions at 60-90% 1RM, with 4-second contractions and 3-minute rest intervals between sets.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Maximal Voluntary Isometric Contraction
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Maximal voluntary isometric force of the injured upper limb assessed using a calibrated dynamometer. Force values will be recorded during standardized maximal isometric contractions and used to evaluate changes in muscle performance throughout immobilization and rehabilitation. Unit: Newtons (N)
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Rate of Force Development
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Rate of force development (RFD) of the injured upper limb assessed during maximal voluntary isometric contractions using a calibrated dynamometer. RFD will be calculated from the force-time curve and used as an indicator of explosive force production and neuromuscular performance. Unit: N·s-¹ (N/s)
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

次要结果测量

结果测量
措施说明
大体时间
Elbow Flexors Voluntary Activation
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Voluntary activation of the elbow flexors assessed using the interpolated twitch technique during maximal voluntary isometric contractions. Values will be expressed as a percentage of voluntary neural drive to the muscle. Unit: %
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Motor Supramaximal Response Amplitude
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Peak-to-peak amplitude of the motor supramaximal response (MSUP) evoked by peripheral nerve stimulation during submaximal contractions as an indicator of motor pathway excitability. Unit: mV
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Motor Evoked Potential Amplitude
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation and normalized to peripheral responses to assess corticospinal excitability. Unit: mV
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Silent Period Duration
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Duration of the electromyographic silent period following transcranial magnetic stimulation during voluntary contractions as an indicator of cortical inhibition. Unit: ms
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Short-Interval Intracortical Inhibition
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Short-interval intracortical inhibition assessed using paired-pulse transcranial magnetic stimulation as an index of intracortical inhibitory function. Unit: mV
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Cervicomedullary Motor Evoked Potential Amplitude
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Motor unit discharge characteristics assessed using high-density surface electromyography, including discharge rate, recruitment thresholds, and estimates of intrinsic motoneuron properties. Unit: mV
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Motor Unit Behavior
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Motor unit discharge characteristics assessed using high-density surface electromyography, including discharge rate, recruitment thresholds, and estimates of intrinsic motoneuron properties. Unit: pulses/s (pps)
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii MMAX Amplitude
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Peak-to-peak amplitude of the maximal compound muscle action potential (MMAX) evoked by peripheral nerve stimulation as an indicator of peripheral excitability. Unit: mV
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Peripheral Contractile Properties
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Evoked twitch and doublet force responses obtained using peripheral nerve stimulation to assess muscle contractile function. Unit: N
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Biceps Brachii Muscle Thickness
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Muscle thickness assessed by B-mode ultrasonography as an indicator of muscle morphology and preservation during immobilization and rehabilitation. Unit: mm
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Upper Limb Function (QuickDASH)
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Upper-limb disability and functional status assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Unit: 0-100 points
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Health-Related Quality of Life (SF-36)
大体时间：Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)
Health-related quality of life assessed using the 36-Item Short Form Health Survey (SF-36). Unit: 0-100 points
Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Universidad Nacional Andres Bello

调查人员

  • 研究主任：Claudio Chamorro Lange, PhD、Universidad Nacional Andres Bello
  • 研究主任：Luis Peñailillo Escaráte, PhD、Universidad Nacional Andres Bello

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2026年1月1日

初级完成 (估计的)

2027年7月1日

研究完成 (估计的)

2027年7月1日

研究注册日期

首次提交

2026年5月29日

首先提交符合 QC 标准的

2026年5月29日

首次发布 (实际的)

2026年6月5日

研究记录更新

最后更新发布 (实际的)

2026年6月8日

上次提交的符合 QC 标准的更新

2026年6月4日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

关键字

其他研究编号

  • DI-03-CBC/22
  • 21261279 (其他赠款/资助编号：ANID/Beca de Doctorado Nacional 2026.Chile)
  • DI-07-25/INI (其他赠款/资助编号：Concurso de Iniciación a la Investigación UNAB 2025,Chile)
  • 24 010884 01 (其他赠款/资助编号：Programme Ambition International 2024, La Région Auvergne Rhône Alpes,France)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

是的

IPD 计划说明

De-identified individual participant data underlying the results reported in publications arising from this study will be made available to qualified researchers upon reasonable request. Shared data may include demographic characteristics, clinical outcomes, force production measurements, neuromuscular assessments, electromyographic recordings, transcranial magnetic stimulation outcomes, peripheral nerve stimulation outcomes, and questionnaire-derived scores. Data will be provided in a de-identified format to protect participant confidentiality.

IPD 共享时间框架

Data will become available beginning 6 months following publication of the primary study results and will remain available for a period of 5 years.

IPD 共享访问标准

Researchers who provide a methodologically sound proposal and whose intended use of the data has been approved by the study investigators may access the data. Requests should be directed to the Principal Investigator. Data will be shared through a secure institutional repository or encrypted electronic transfer following execution of an appropriate data-sharing agreement.

IPD 共享支持信息类型

  • 研究方案
  • 树液
  • 分析代码

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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