Shoulder InjuriesDNSGyroSHOANCT07572682
Effects of Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic Training on Shoulder Function in Overhead Athletes
A study testing Dynamic Neuromuscular Stabilization (DNS), Gyrotonic Training and Usual Training in people with Shoulder Injuries, run by Sport University of Tirana at 1 site in Albania.
Trial summary
The goal of this randomized control trial is to evaluate the effect of the Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic training compared to a control group on pain level, functional performance, and shoulder stability in overhead athletes aged 18 to 25 years. Read more about this study
- Who is it for?
- Ages 18 to 25 years
- Conditions the study is for
- Shoulder Injuries
- What is being tested?
- Dynamic Neuromuscular Stabilization (DNS), Gyrotonic Training and Usual Training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 90 participants
- Where
- 1 siteAlbania
- Study dates
- 17 Feb 2025to 20 Jun 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 18 to 25 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Male and female participants
- Had a minimum of two years of sports experience
- Presence of shoulder region injury or pain
- Active participation in sports
Who cannot join
- Shoulder surgery
- Neurological disorders that can affect the upper limb
- Shoulder dislocation
- Orthopedic condition such as upper or lower limb fractures
- Athletes with less than two years of sports experience
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluation of Effects of Dynamic Neuromuscular Stabilization Treatments and Other Innovative Methods on Shoulder Problems in Athletes
The goal of this randomized control trial is to evaluate the effect of the Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic training compared to a control group on pain level, functional performance, and shoulder stability in overhead athletes aged 18 to 25 years. The main question is whether these interventions are more effective than usual training in improving clinical and performance related outcomes.
Participants will take part in a supervised rehabilitation program based on these methods three times per week for six weeks.
Read more
Assessments were performed at baseline and after 6 weeks of intervention. Outcome measures included pain level, functional performance, and dynamic shoulder stability. Also, core endurance, shoulder mobility, and shoulder muscle strength will be evaluated as a secondary outcomes.
These outcomes will be assessed using Visual Analog Scale (VAS), Kerlan-Jobe Orthopedic Clinic score (KJOC), the Y-Balance Upper Quarter Stability Test (UQYBT), McGill Endurance Test Battery, goniometer and digital dynamometer.
The study was approved by the Ethics Committee of the Sports University of Tirana. All participants involved in this study provided written informed consent.
Read the detailed description
One of the most challenging aspects of orthopedic sports medicine is the rehabilitation of the overhead athletes. Overhead athletes place a lot of load on the shoulder joint, because of the volume of throws, mechanical stress and repetitive movements above shoulder level. During the game these athletes require high levels of mobility and stability at the same time, and neuromuscular control. Rapid motion, poor biomechanics, and weak links in the kinetic chain put this area in high risk of injury in glenohumeral joint and surrounding soft tissues. As a result, those athletes are exposed of developing shoulder pain, functional impairments, overuse injuries, and deficits in strength and mobility.
Recent rehabilitation programs for shoulder injuries in overhead athletes incorporate exercise-based interventions that integrate core activation, coordinated movement, and sport-specific function.
The purpose of this randomized controlled trial was to investigate the effect of structured neuromuscular rehabilitation program based on the Dynamic Neuromuscular Stabilization (DNS) method and Gyrotonic training on shoulder pain, functional performance, and dynamic stability in overhead athletes with shoulder injuries. The study looked for to determine whether these interventions could lead to significant improvements in the variables at baseline and after the interventions.
Participants meeting the inclusion criteria were recruited and were randomly allocated into one of three study groups. The intervention consisted of a supervised rehabilitation program focused on key components of shoulder function, such as neuromuscular control, strength, mobility, and coordination. The DNS program was focused on exercise based on developmental kinesiology, aimed to improve core stability, breathing patterns, and shoulder stabilization in various functional positions. The Gyrotonic program incorporated three-dimensional, spiral movement patterns aimed to improve mobility, coordination, and integrated upper limb function. The athletes involved in the DNS and Gyrotonic group continued also with their usual sports training. Exercise sessions were performed regularly in both intervention groups for a period of six-weeks. Participants in the control group continued with the usual training regime and did not receive any specific rehabilitation intervention.
Outcome assessments were conducted at baseline and after six weeks of intervention. Pain intensity, functional performance, dynamic stability were the main outcomes that were evaluated before and after the intervention period.
In addition, core endurance, mobility and muscle strength of glenohumeral joint was evaluated as a secondary outcome before and after the rehabilitation program. This study design allows the comparison of changes over time within and between groups in order to identify the most effective approach for improving pain, functional performance and stability in overhead athletes with shoulder injuries.
The findings of this study aim to provide clinically relevant evidence for the rehabilitation of overhead athletes with shoulder injuries.
- Conditions
- Shoulder Injuries
- Being tested
- Dynamic Neuromuscular Stabilization (DNS), Gyrotonic Training, Usual Training
- Keywords
- DNS (Dynamic Neuromuscular Stabilization), Gyrotonic training, Shoulder injury, Overhead athletes, Shoulder Stability, Neuromuscular Training, Functional Performance
- Medical subject headings
- Shoulder Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dynamic Neuromuscular Stabilization (DNS)Other
Dynamic Neuromuscular Stabilization (DNS) The exercise program based on the DNS method was focused on core activation, diaphragmatic breathing, and shoulder stabilization in various positions based on development kinesiology. Sessions were supervised by certificated therapist and were performed three times per week over a period of 6 weeks.
Gyrotonic TrainingOther
A structured rehabilitation program based on the Gyrotonic method were conducted in the second intervention group. Sessions were supervised by certificated therapist and were conducted three times per week for 6 weeks. The program based on this method was focused on shoulder mobility and stability.
Usual TrainingOther
Participants continued their usual sports training without any additional protocol exercise. The inclusion of the control group allows for the assessment of the additional effect of the interventions beyond usual training.
| Study group | Role | What they receive |
|---|---|---|
| DNS Group | Experimental | Participants involved in DNS group underwent a structured exercise-based intervention aimed to improve mobility, strength, and neuromuscular control. Also, the participants in this group followed the usual training program. Receives: Other: Dynamic Neuromuscular Stabilization (DNS) |
| Gyrotonic Training Group | Experimental | Participants in the Gyrotonic group followed an exercise program based on three-dimensional, flowing movement aimed to improve mobility, strength, and neuromuscular control. Also, the participants continued the usual training program. Receives: Other: Gyrotonic Training |
| Control Group | Active comparator | Participants included in control group continued their usual sports training routines without additional intervention during the study period. Receives: Other: Usual Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from baseline in Shoulder Functional Performance (Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score)
Shoulder functional performance was assessed using the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score Questionnaire (KJOC), a validated 0-100 scale, where higher scores indicate better function. Changes from baseline to post-intervention will be evaluated.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention
Change from baseline in Shoulder Pain (Visual Analog Scale)
Shoulder pain was assessed by Visual Analog Scale (VAS), a 0-10 scale, where higher scores indicate greater pain intensity. Changes from baseline to post-intervention will be evaluated.
Measured: Baseline (pre-intervention) and 6 weeks after of intervention.
Secondary outcomes (9)
Changes from baseline in Upper Limb Dynamic Stability (Upper Quarter Y Balance Test)
Upper limb dynamic stability was assessed by Upper Quarter Y Balance Test (UQYBT), which evaluates reach distance in multiple directions to assess functional shoulder stability. Results were recorded in centimeters and normalized as a percentage of limb length. Higher scores indicates better dynamic stability.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Trunk Flexor Endurance
Trunk flexor endurance was assessed using the McGill Endurance Battery Test and was recorded in seconds (s). Higher values indicate greater endurance
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Trunk Extensor Endurance
Trunk extensor endurance was assessed by McGill Endurance Battery Test, a validated clinical assessment of trunk muscle endurance. Performance is recorded in seconds. Higher values indicate greater muscular endurance.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Abduction Range of Motion
Glenohumeral abduction range of motion (ROM) was assessed in both upper limbs, the dominant and non-dominant using a universal goniometer in degrees (◦). Goniometer is a validated instrument for joint angle measurement. Higher values indicate greater joint mobility. Changes from baseline to post intervention will be analyzed.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Internal Rotation Range of Motion
Glenohumeral internal rotation range of motion (ROM) was assessed in both upper limbs, the dominant and non-dominant using a universal goniometer in degrees (◦). Goniometer is a validated instrument for joint angle measurement. Higher values indicate greater joint mobility. Changes from baseline to post intervention will be analyzed.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder External Rotation Range of Motion
Glenohumeral external rotation range of motion (ROM) was assessed in both upper limbs, the dominant and non-dominant using a universal goniometer in degrees (◦). Goniometer is a validated instrument for joint angle measurement. Higher values indicate greater joint mobility. Changes from baseline to post intervention will be analyzed.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Internal Rotation Muscle Strength
Shoulder internal rotation muscle strength was assessed using a digital dynamometer, a valid and reliable instrument for isometric muscle strength, and expressed in Newton (N). Higher values indicate greater muscle strength.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder External Rotation Muscle Strength
Shoulder external rotation muscle strength was assessed using a digital dynamometer, a valid and reliable instrument for isometric muscle strength, and expressed in Newton (N). Higher values indicate greater muscle strength.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Abduction Muscle Strength
Shoulder abduction muscle strength was assessed using a digital dynamometer, a valid and reliable instrument for isometric muscle strength, and expressed in Newton (N). Higher values indicate greater muscle strength.
Measured: Baseline (pre-intervention) and after 6 weeks of intervention.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2026
- Study start17 Feb 2025
- Primary completion17 Mar 2025
- Study completion20 Jun 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Shoulder InjuriesStudies of the same condition, open and under way.
- 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
- Model description
- Participants will be allocated into three parallel groups: DNS intervention group, Gyrotonic intervention group, and control group continued their regular sports training program and did not receive any additional intervention during the study period.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 90 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sport University of Tirana
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jonida Drizaj, Sport University of Tirana
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07572682
- Sponsor's protocol ID
- DNS-Gyro-Study-2025
- Acronym
- DNSGyroSHOA
- Status last verified
- Apr 2026
- First submitted
- 23 Apr 2026
- Last updated
- 7 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The individual participant data (IPD) will not be shared in order to protect participant confidentiality and privacy. In accordance with institutional regulations and informed consent obtained from participants, only overall results will be reported in publications.
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of Effects of Dynamic Neuromuscular Stabilization Treatments and Other Innovative Methods on Shoulder Problems in Athletes
- ClinicalTrials.gov ID
- NCT07572682
- Acronym / sponsor ID
- DNSGyroSHOA / DNS-Gyro-Study-2025
- Conditions
- Shoulder Injuries
- Keywords
- DNS (Dynamic Neuromuscular Stabilization), Gyrotonic training, Shoulder injury, Overhead athletes, Shoulder Stability, Neuromuscular Training, Functional Performance
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 90 participants (actual)
- Lead sponsor
- Sport University of TiranaUniversity, hospital or other
- Study start
- 17 Feb 2025 (actual)
- Primary completion
- 17 Mar 2025 (actual)
- Study completion
- 20 Jun 2025 (actual)
- First posted
- 7 May 2026 (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 goal of this randomized control trial is to evaluate the effect of the Dynamic Neuromuscular Stabilization (DNS) and Gyrotonic training compared to a control group on pain level, functional performance, and shoulder stability in overhead athletes aged 18 to 25 years. The main question is whether these interventions are more effective than usual training in improving clinical and performance related outcomes.
Participants will take part in a supervised rehabilitation program based on these methods three times per week for six weeks.
Assessments were performed at baseline and after 6 weeks of intervention. Outcome measures included pain level, functional performance, and dynamic shoulder stability. Also, core endurance, shoulder mobility, and shoulder muscle strength will be evaluated as a secondary outcomes.
These outcomes will be assessed using Visual Analog Scale (VAS), Kerlan-Jobe Orthopedic Clinic score (KJOC), the Y-Balance Upper Quarter Stability Test (UQYBT), McGill Endurance Test Battery, goniometer and digital dynamometer.
The study was approved by the Ethics Committee of the Sports University of Tirana. All participants involved in this study provided written informed consent.
Detailed description
One of the most challenging aspects of orthopedic sports medicine is the rehabilitation of the overhead athletes. Overhead athletes place a lot of load on the shoulder joint, because of the volume of throws, mechanical stress and repetitive movements above shoulder level. During the game these athletes require high levels of mobility and stability at the same time, and neuromuscular control. Rapid motion, poor biomechanics, and weak links in the kinetic chain put this area in high risk of injury in glenohumeral joint and surrounding soft tissues. As a result, those athletes are exposed of developing shoulder pain, functional impairments, overuse injuries, and deficits in strength and mobility.
Recent rehabilitation programs for shoulder injuries in overhead athletes incorporate exercise-based interventions that integrate core activation, coordinated movement, and sport-specific function.
The purpose of this randomized controlled trial was to investigate the effect of structured neuromuscular rehabilitation program based on the Dynamic Neuromuscular Stabilization (DNS) method and Gyrotonic training on shoulder pain, functional performance, and dynamic stability in overhead athletes with shoulder injuries. The study looked for to determine whether these interventions could lead to significant improvements in the variables at baseline and after the interventions.
Participants meeting the inclusion criteria were recruited and were randomly allocated into one of three study groups. The intervention consisted of a supervised rehabilitation program focused on key components of shoulder function, such as neuromuscular control, strength, mobility, and coordination. The DNS program was focused on exercise based on developmental kinesiology, aimed to improve core stability, breathing patterns, and shoulder stabilization in various functional positions. The Gyrotonic program incorporated three-dimensional, spiral movement patterns aimed to improve mobility, coordination, and integrated upper limb function. The athletes involved in the DNS and Gyrotonic group continued also with their usual sports training. Exercise sessions were performed regularly in both intervention groups for a period of six-weeks. Participants in the control group continued with the usual training regime and did not receive any specific rehabilitation intervention.
Outcome assessments were conducted at baseline and after six weeks of intervention. Pain intensity, functional performance, dynamic stability were the main outcomes that were evaluated before and after the intervention period.
In addition, core endurance, mobility and muscle strength of glenohumeral joint was evaluated as a secondary outcome before and after the rehabilitation program. This study design allows the comparison of changes over time within and between groups in order to identify the most effective approach for improving pain, functional performance and stability in overhead athletes with shoulder injuries.
The findings of this study aim to provide clinically relevant evidence for the rehabilitation of overhead athletes with shoulder injuries.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- Participants will be allocated into three parallel groups: DNS intervention group, Gyrotonic intervention group, and control group continued their regular sports training program and did not receive any additional intervention during the study period.
| Arm | Type | Receives |
|---|---|---|
| DNS Group | Experimental | Other: Dynamic Neuromuscular Stabilization (DNS)Participants involved in DNS group underwent a structured exercise-based intervention aimed to improve mobility, strength, and neuromuscular control. Also, the participants in this group followed the usual training program. |
| Gyrotonic Training Group | Experimental | Other: Gyrotonic TrainingParticipants in the Gyrotonic group followed an exercise program based on three-dimensional, flowing movement aimed to improve mobility, strength, and neuromuscular control. Also, the participants continued the usual training program. |
| Control Group | Active comparator | Other: Usual TrainingParticipants included in control group continued their usual sports training routines without additional intervention during the study period. |
Who may qualify
- Ages
- 18 to 25 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Male and female participants
- Had a minimum of two years of sports experience
- Presence of shoulder region injury or pain
- Active participation in sports
Key exclusion criteria (5 listed)
- Shoulder surgery
- Neurological disorders that can affect the upper limb
- Shoulder dislocation
- Orthopedic condition such as upper or lower limb fractures
- Athletes with less than two years of sports experience
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 |
|---|---|---|
| Dynamic Neuromuscular Stabilization (DNS)Dynamic Neuromuscular Stabilization (DNS) The exercise program based on the DNS method was focused on core activation, diaphragmatic breathing, and shoulder stabilization in various positions based on development kinesiology. Sessions were supervised by certificated therapist and were performed three times per week over a period of 6 weeks. | Other | DNS Group |
| Gyrotonic TrainingA structured rehabilitation program based on the Gyrotonic method were conducted in the second intervention group. Sessions were supervised by certificated therapist and were conducted three times per week for 6 weeks. The program based on this method was focused on shoulder mobility and stability. | Other | Gyrotonic Training Group |
| Usual TrainingParticipants continued their usual sports training without any additional protocol exercise. The inclusion of the control group allows for the assessment of the additional effect of the interventions beyond usual training. | Other | Control Group |
Primary outcome
Change from baseline in Shoulder Functional Performance (Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score)
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention
Shoulder functional performance was assessed using the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow Score Questionnaire (KJOC), a validated 0-100 scale, where higher scores indicate better function. Changes from baseline to post-intervention will be evaluated.
Change from baseline in Shoulder Pain (Visual Analog Scale)
Time frame: Baseline (pre-intervention) and 6 weeks after of intervention.
Shoulder pain was assessed by Visual Analog Scale (VAS), a 0-10 scale, where higher scores indicate greater pain intensity. Changes from baseline to post-intervention will be evaluated.
9 secondary outcomes
Changes from baseline in Upper Limb Dynamic Stability (Upper Quarter Y Balance Test)
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Trunk Flexor Endurance
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Trunk Extensor Endurance
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Abduction Range of Motion
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Internal Rotation Range of Motion
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder External Rotation Range of Motion
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Internal Rotation Muscle Strength
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder External Rotation Muscle Strength
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Change from baseline in Shoulder Abduction Muscle Strength
Time frame: Baseline (pre-intervention) and after 6 weeks of intervention.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2026.
- Individual participant dataSharing planned: No. The individual participant data (IPD) will not be shared in order to protect participant confidentiality and privacy. In accordance with institutional regulations and informed consent obtained from participants, only overall results will be reported in publications.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Dynamic Neuromuscular Stabilization (DNS), Gyrotonic Training and Usual Training in people with Shoulder Injuries, run by Sport University of Tirana at 1 site in Albania.
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 5 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: finished, as of the sponsor's last update on 7 May 2026. 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 Albania. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Change from baseline in Shoulder Functional Performance (Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score) (time frame: Baseline (pre-intervention) and after 6 weeks of intervention). The study lists 2 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 7 May 2026.