Glenohumeral SubluxationNCT05857540
The Effects of Upper-Extremity Plyometric Combined Strength Training in Overhead Athletes With Shoulder Instability
A study testing Plyometric and strengthening exercises and Strengthening exercise in people with Glenohumeral Subluxation and Shoulder Subluxation, run by National Yang Ming Chiao Tung University at 1 site in Taiwan.
Trial summary
The purpose of this randomized controlled trial is to investigate the additional effects of upper extremity plyometric training versus strength training alone in recreational overhead athletes with shoulder instability. Read more about this study
- Who is it for?
- Ages 20 to 40 years
- Conditions the study is for
- Glenohumeral Subluxation, Shoulder Subluxation, Shoulder Instability Subluxation Bilateral
- What is being tested?
- Plyometric and strengthening exercises and Strengthening exercise
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 64 participants
- Where
- 1 siteTaiwan
- Study dates
- 20 May 2023to 30 Jun 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Have experience of at least 1 of the following symptoms of shoulder instability during upper extremity movement: (a) pain, clicking, a sense of the shoulder coming apart, (b) dead-arm syndrome, or (c) subluxation of the joint.
- Self-reported decreased performance or feeling fear to perform shoulder movements during sports or daily activities
- Positive findings on ≥ 1 of the following 5 tests: load and shift test, apprehension, relocation, \& surprise tests, Gagey hyperabduction test, sulcus sign, Feagin test
- Recreational overhead athletes who keep practicing ≥ 4 hours/week in the recent 1 month and with ≥ 1 year overhead sports experience
Who cannot join
- Full contact sport athletes
- Severe shoulder instability with > 5 shoulder dislocations history
- Obvious shoulder bony/labrum lesion in the dominant side warranted for surgery first as decided by the orthopedic surgeon
- Previous surgery or fracture in the shoulder area on the dominant side within 1 year
- Voluntary instability (the ability to deliberately dislocate one's shoulder)
- During acute phase after shoulder dislocation event
Show all 11Show fewer
- Not suitable to start plyometric training yet: Shoulder muscle weakness (manual muscle test <3) or range of motion limitation (<90 abduction, <70 external rotation) in the dominant side
- Pregnancy
- Cancer, neck pain, brain \& neurological impairment
- Ehlers-Danlos syndrome or Marfan syndrome
- Unable to attend 6 weeks supervised training
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of this randomized controlled trial is to investigate the additional effects of upper extremity plyometric training versus strength training alone in recreational overhead athletes with shoulder instability. The investigators hypothesis that compared to strengthening training alone, plyometric training combined with strengthening training will significantly improve shoulder isokinetic strength, proprioception, scapular kinematics, symptoms of shoulder instability, and shoulder function.
Read the detailed description
Background: Shoulder instability is a common problem in active young adults with a wide spectrum ranging from microinstability, subluxation to dislocation. In patients with instability of Stanmore polar type 2 or 3, recurrent shoulder instability may be related to abnormal movement patterns but not result from trauma. Non-operative management is suggested to this subgroup as the first-line treatment. Previous rehabilitation protocols including progressive shoulder muscles strengthening and neuromuscular control training have shown positive effects on functional outcomes in individuals with shoulder instability. Recent protocols for shoulder instability usually include various types of plyometric training to prepare injured athletes to return to sports. Plyometric training in lower extremity has been wildly used for knee injury prevention. In upper extremity, plyometrics also has been shown to improve isokinetic strength, throwing performance, and proprioception in healthy subjects and healthy overhead athletes. However, it is still not well-understood that whether a strengthening training combined with plyometrics would be more effective to improve shoulder neuromuscular control and shoulder function in subjects with instability. The purpose of this study is to investigate the additional effects of upper extremity plyometric training in recreational overhead athletes with anterior shoulder instability. The investigators hypothesis that compared to strengthening training alone, plyometric training combined with strengthening training will significantly improve strength, proprioception, shoulder kinematic and muscle activity, shoulder pain and shoulder function.
Methods: A total of 64 participants with anterior shoulder instability will be randomized to either an experimental group (plyometric and strengthening training) or a control group (strengthening training). Both groups will receive a 50-minute supervised training protocol twice a week for 6 weeks. The primary outcomes include (1) isokinetic assessment of internal and external rotation (peak torque, time to peak torque, and amortization time); (2) proprioception (active and passive joint position sense); (3) seated medicine ball throw test (distance in cm). The secondary outcomes include (1) shoulder pain and instability with 10-cm visual analogue scale (VAS); (2) shoulder function assessed with the Disability of Arm, Shoulder and Hand (DASH) questionnaire; (3) Global rating of change (GRC). GRC will be measured after the end of 12 session of intervention, and all the other outcomes will be measured at baseline and following 12 sessions of exercise training. The two-way repeated measures ANOVAs will be used to compare primary and secondary outcome variables between groups. The significant level was set at 0.05.
- Conditions
- Glenohumeral Subluxation, Shoulder Subluxation, Shoulder Instability Subluxation Bilateral
- Being tested
- Plyometric and strengthening exercises, Strengthening exercise
- Keywords
- Plyometric, Strengthening, Overhead athlete, Shoulder instability
- Medical subject headings
- Shoulder Dislocation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Plyometric and strengthening exercisesProcedure or surgery
Each session includes 2 upper-extremity plyometric exercises in bodyweight or with weight ball for 15-20 minutes and 4-5 strengthening exercises with band, dumbbell or barbell for 30-35 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.
Strengthening exerciseProcedure or surgery
Each session includes 5 upper-extremity strengthening exercises with band, dumbbell or barbell for 50 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session.
| Study group | Role | What they receive |
|---|---|---|
| Plyometric training group | Experimental | Participants in this group will receive upper extremity plyometric training in body weight or with weight ball and strengthening exercises with band, dumbbell and barbell. The difficulty and intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. Receives: Procedure: Plyometric and strengthening exercises |
| Strengthening training group | Active comparator | Participants in this group will receive upper extremity strengthening exercises with band, dumbbell and barbell. The intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. Receives: Procedure: Strengthening exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Shoulder isokinetic muscle strength
Shoulder isokinetic muscle strength will be measured by dynamometer in 3 modes (concentric/concentric, concentric/eccentric, eccentric/concentric) at 3 angular velocities (90°/s, 180°/s, \& 240°/s), 1 set of 5 repetitions for each angular velocities. Shoulder isokinetic muscle strength will be normalized by body weight (BW) and described with peak torque/BW (N·m·kg-1).
Measured: Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks
Shoulder acceleration time, deceleration time, and amortization time
Shoulder acceleration time, deceleration time, and amortization time will be measured by dynamometer in concentric/concentric mode at 3 angular velocities (90°/s, 180°/s, \& 240°/s) and will be described with millisecond (ms).
Measured: Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks
Shoulder proprioception
Shoulder proprioception will be measured by dynamometer in 90° shoulder abduction and 90° elbow flexion position, including active joint position sense and passive joint position sense. The proprioception will be described with degree of error from target position.
Measured: Change from baseline shoulder external rotation joint position sense through completion of 12-session intervention, an average of 6 weeks
Seated medicine ball throw distance
Subjects will throw a 2kg soft weighted ball as far forward as possible with dominant arms while sitting with back against a wall and legs bending with feet flat on the floor. Outcomes include average throwing distance and maximal throwing distance (cm). The distances are measured with measure tape.
Measured: Change from baseline seated medicine ball throw distance through completion of 12-session intervention, an average of 6 weeks
Secondary outcomes (3)
Shoulder function
Shoulder function will be measured by the disabilities of the arm, shoulder and hand (DASH) questionnaire, including the disability/symptom section (30 items, scored 1-5) and the optional high performance Sport/Music or Work section (4 items, scored 1-5). A higher score indicates greater disability.
Measured: Change from baseline DASH questionnaire through completion of 12-session intervention, an average of 6 weeks
Visual analogue scale (VAS) of shoulder pain and instability
Shoulder pain and instability will be measured by visual analogue scale (VAS). Subjects need to mark the point that they feel represent their perception of their current state on a 10-cm line. Scores range from 0 (no symptom) to 100 (maximum symptom).
Measured: Change from baseline VAS of shoulder pain and instability through completion of 12-session intervention, an average of 6 weeks
Global rating of change (GRC)
The improvements in a patient's condition will be measured with 15-point self-report GRC scale. Score ranges from -7 (lack of progress) to 7 (maximum of progress).
Measured: through completion of 12-session intervention, an average of 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 May 2023
- Study start20 May 2023
- Primary completion1 Apr 2025
- Study completion30 Jun 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Glenohumeral SubluxationStudies of the same condition, open and under way.
- More trials run by National Yang Ming Chiao Tung UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 64 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Yang Ming Chiao Tung University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Yin-Liang Lin, National Yang Ming Chiao Tung University
- Investigators
- Yin-Liang Lin, PhD, Principal investigator, National Yang Ming Chiao Tung University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05857540
- Sponsor's protocol ID
- YM111161F
- Status last verified
- May 2025
- First submitted
- 11 Apr 2023
- Last updated
- 22 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 22 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Upper-Extremity Plyometric Combined Strength Training in Overhead Athletes With Shoulder Instability
- ClinicalTrials.gov ID
- NCT05857540
- Acronym / sponsor ID
- YM111161F
- Conditions
- Glenohumeral Subluxation, Shoulder Subluxation, Shoulder Instability Subluxation Bilateral
- Keywords
- Plyometric, Strengthening, Overhead athlete, Shoulder instability
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 64 participants (estimated)
- Lead sponsor
- National Yang Ming Chiao Tung UniversityUniversity, hospital or other
- Study start
- 20 May 2023 (actual)
- Primary completion
- 1 Apr 2025 (actual)
- Study completion
- 30 Jun 2025 (estimated)
- First posted
- 12 May 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this randomized controlled trial is to investigate the additional effects of upper extremity plyometric training versus strength training alone in recreational overhead athletes with shoulder instability. The investigators hypothesis that compared to strengthening training alone, plyometric training combined with strengthening training will significantly improve shoulder isokinetic strength, proprioception, scapular kinematics, symptoms of shoulder instability, and shoulder function.
Detailed description
Background: Shoulder instability is a common problem in active young adults with a wide spectrum ranging from microinstability, subluxation to dislocation. In patients with instability of Stanmore polar type 2 or 3, recurrent shoulder instability may be related to abnormal movement patterns but not result from trauma. Non-operative management is suggested to this subgroup as the first-line treatment. Previous rehabilitation protocols including progressive shoulder muscles strengthening and neuromuscular control training have shown positive effects on functional outcomes in individuals with shoulder instability. Recent protocols for shoulder instability usually include various types of plyometric training to prepare injured athletes to return to sports. Plyometric training in lower extremity has been wildly used for knee injury prevention. In upper extremity, plyometrics also has been shown to improve isokinetic strength, throwing performance, and proprioception in healthy subjects and healthy overhead athletes. However, it is still not well-understood that whether a strengthening training combined with plyometrics would be more effective to improve shoulder neuromuscular control and shoulder function in subjects with instability. The purpose of this study is to investigate the additional effects of upper extremity plyometric training in recreational overhead athletes with anterior shoulder instability. The investigators hypothesis that compared to strengthening training alone, plyometric training combined with strengthening training will significantly improve strength, proprioception, shoulder kinematic and muscle activity, shoulder pain and shoulder function.
Methods: A total of 64 participants with anterior shoulder instability will be randomized to either an experimental group (plyometric and strengthening training) or a control group (strengthening training). Both groups will receive a 50-minute supervised training protocol twice a week for 6 weeks. The primary outcomes include (1) isokinetic assessment of internal and external rotation (peak torque, time to peak torque, and amortization time); (2) proprioception (active and passive joint position sense); (3) seated medicine ball throw test (distance in cm). The secondary outcomes include (1) shoulder pain and instability with 10-cm visual analogue scale (VAS); (2) shoulder function assessed with the Disability of Arm, Shoulder and Hand (DASH) questionnaire; (3) Global rating of change (GRC). GRC will be measured after the end of 12 session of intervention, and all the other outcomes will be measured at baseline and following 12 sessions of exercise training. The two-way repeated measures ANOVAs will be used to compare primary and secondary outcome variables between groups. The significant level was set at 0.05.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Plyometric training group | Experimental | Procedure: Plyometric and strengthening exercisesParticipants in this group will receive upper extremity plyometric training in body weight or with weight ball and strengthening exercises with band, dumbbell and barbell. The difficulty and intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. |
| Strengthening training group | Active comparator | Procedure: Strengthening exerciseParticipants in this group will receive upper extremity strengthening exercises with band, dumbbell and barbell. The intensity of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. |
Who may qualify
- Ages
- 20 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Have experience of at least 1 of the following symptoms of shoulder instability during upper extremity movement: (a) pain, clicking, a sense of the shoulder coming apart, (b) dead-arm syndrome, or (c) subluxation of the joint.
- Self-reported decreased performance or feeling fear to perform shoulder movements during sports or daily activities
- Positive findings on ≥ 1 of the following 5 tests: load and shift test, apprehension, relocation, \& surprise tests, Gagey hyperabduction test, sulcus sign, Feagin test
- Recreational overhead athletes who keep practicing ≥ 4 hours/week in the recent 1 month and with ≥ 1 year overhead sports experience
Key exclusion criteria (11 listed)
- Full contact sport athletes
- Severe shoulder instability with > 5 shoulder dislocations history
- Obvious shoulder bony/labrum lesion in the dominant side warranted for surgery first as decided by the orthopedic surgeon
- Previous surgery or fracture in the shoulder area on the dominant side within 1 year
- Voluntary instability (the ability to deliberately dislocate one's shoulder)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Plyometric and strengthening exercisesEach session includes 2 upper-extremity plyometric exercises in bodyweight or with weight ball for 15-20 minutes and 4-5 strengthening exercises with band, dumbbell or barbell for 30-35 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. | Procedure or surgery | Plyometric training group |
| Strengthening exerciseEach session includes 5 upper-extremity strengthening exercises with band, dumbbell or barbell for 50 minutes. The difficulty of the movement protocol will increase weekly. They will be trained 2 times per week for 6 weeks with an average duration of 50 min per session. | Procedure or surgery | Strengthening training group |
Primary outcome
Shoulder isokinetic muscle strength
Time frame: Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks
Shoulder isokinetic muscle strength will be measured by dynamometer in 3 modes (concentric/concentric, concentric/eccentric, eccentric/concentric) at 3 angular velocities (90°/s, 180°/s, \& 240°/s), 1 set of 5 repetitions for each angular velocities. Shoulder isokinetic muscle strength will be normalized by body weight (BW) and described with peak torque/BW (N·m·kg-1).
Shoulder acceleration time, deceleration time, and amortization time
Time frame: Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks
Shoulder acceleration time, deceleration time, and amortization time will be measured by dynamometer in concentric/concentric mode at 3 angular velocities (90°/s, 180°/s, \& 240°/s) and will be described with millisecond (ms).
Shoulder proprioception
Time frame: Change from baseline shoulder external rotation joint position sense through completion of 12-session intervention, an average of 6 weeks
Shoulder proprioception will be measured by dynamometer in 90° shoulder abduction and 90° elbow flexion position, including active joint position sense and passive joint position sense. The proprioception will be described with degree of error from target position.
Seated medicine ball throw distance
Time frame: Change from baseline seated medicine ball throw distance through completion of 12-session intervention, an average of 6 weeks
Subjects will throw a 2kg soft weighted ball as far forward as possible with dominant arms while sitting with back against a wall and legs bending with feet flat on the floor. Outcomes include average throwing distance and maximal throwing distance (cm). The distances are measured with measure tape.
3 secondary outcomes
Shoulder function
Time frame: Change from baseline DASH questionnaire through completion of 12-session intervention, an average of 6 weeks
Visual analogue scale (VAS) of shoulder pain and instability
Time frame: Change from baseline VAS of shoulder pain and instability through completion of 12-session intervention, an average of 6 weeks
Global rating of change (GRC)
Time frame: through completion of 12-session intervention, an average of 6 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 May 2025.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Yin-Liang Lin, PhD principal investigator
National Yang Ming Chiao Tung University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Plyometric and strengthening exercises and Strengthening exercise in people with Glenohumeral Subluxation and Shoulder Subluxation, run by National Yang Ming Chiao Tung University at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 22 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Shoulder isokinetic muscle strength (time frame: Change from baseline shoulder isokinetic muscle strength through completion of 12-session intervention, an average of 6 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2025.