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Acromioclavicular Joint InjuryCROSS-ACDNCT07628361

Contralateral Resistance Training During Immobilization in Patients With Acromioclavicular Joint Injury

A study testing Contralateral Eccentric Resistance Training and Contralateral Concentric Resistance Training in people with Acromioclavicular Joint Injury and Acromioclavicular Joint Dislocation, run by Universidad Nacional Andres Bello at 1 site in Chile.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 18 to 36 years
What is being tested?
Contralateral Eccentric Resistance Training and Contralateral Concentric Resistance Training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
1 siteChile
Study dates
1 Jan 2026to 1 Jul 2027
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 18 to 36 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • 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.

Who cannot join

  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Omar E Valdés Tapia, PT, MSc, PhD(c) contact

+569 74082822

o.valdestapia@uandresbello.edu

Chile1 site, 1 recruiting
  • Clínica Indisa

    Santiago, Providencia

    Claudio Chamorro Lange, PhD, +569 94398014, claudio.chamorro@unab.cl

    Recruiting

Other trials in Chile

About this study

Official title: 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.

Read more

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.

Read the detailed description

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.

Being tested
Contralateral Eccentric Resistance Training, Contralateral Concentric Resistance Training
Keywords
Cross-Education, Contralateral Training, Eccentric Exercise, Concentric Exercise, Resistance Training, Immobilization, Shoulder Rehabilitation, Acromioclavicular Joint Injury, Neuromuscular Function, Muscle Strength, Transcranial Magnetic Stimulation, Electromyography, Upper Limb Function, Physical Therapy, Rehabilitation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Contralateral Eccentric Resistance TrainingBehavioural

    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.

  • Contralateral Concentric Resistance TrainingBehavioural

    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.

Study groups in NCT07628361
Study groupRoleWhat they receive
Contralateral Eccentric TrainingExperimentalParticipants 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.
Receives: Behavioral: Contralateral Eccentric Resistance Training
Contralateral Concentric TrainingActive comparatorParticipants 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.
Receives: Behavioral: Contralateral Concentric Resistance Training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Maximal Voluntary Isometric Contraction

    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)

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  2. Rate of Force Development

    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)

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

Secondary outcomes (12)
  1. Elbow Flexors Voluntary Activation

    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: %

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  2. Biceps Brachii Motor Supramaximal Response Amplitude

    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

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  3. Biceps Brachii Motor Evoked Potential Amplitude

    Motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation and normalized to peripheral responses to assess corticospinal excitability. Unit: mV

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  4. Biceps Brachii Silent Period Duration

    Duration of the electromyographic silent period following transcranial magnetic stimulation during voluntary contractions as an indicator of cortical inhibition. Unit: ms

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  5. Biceps Brachii Short-Interval Intracortical Inhibition

    Short-interval intracortical inhibition assessed using paired-pulse transcranial magnetic stimulation as an index of intracortical inhibitory function. Unit: mV

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  6. Biceps Brachii Cervicomedullary Motor Evoked Potential Amplitude

    Motor unit discharge characteristics assessed using high-density surface electromyography, including discharge rate, recruitment thresholds, and estimates of intrinsic motoneuron properties. Unit: mV

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  7. Biceps Brachii Motor Unit Behavior

    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)

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  8. Biceps Brachii MMAX Amplitude

    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

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  9. Biceps Brachii Peripheral Contractile Properties

    Evoked twitch and doublet force responses obtained using peripheral nerve stimulation to assess muscle contractile function. Unit: N

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  10. Biceps Brachii Muscle Thickness

    Muscle thickness assessed by B-mode ultrasonography as an indicator of muscle morphology and preservation during immobilization and rehabilitation. Unit: mm

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  11. Upper Limb Function (QuickDASH)

    Upper-limb disability and functional status assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Unit: 0-100 points

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

  12. Health-Related Quality of Life (SF-36)

    Health-related quality of life assessed using the 36-Item Short Form Health Survey (SF-36). Unit: 0-100 points

    Measured: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jun 2026
  2. Study start1 Jan 2026
  3. Primary completion1 Jul 2027 (estimated)
  4. Study completion1 Jul 2027 (estimated)

Resources

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 with acute acromioclavicular joint injury requiring a period of upper-limb immobilization with a sling, either following conservative management or surgical repair, will be randomly assigned to one of two parallel intervention groups: contralateral concentric resistance training or contralateral eccentric resistance training. Both interventions will be performed with the non-injured upper limb during the immobilization period. Following immobilization, all participants will receive the same standardized rehabilitation program. Outcomes will be assessed at baseline, after immobilization, and after completion of rehabilitation.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
16 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07628361
Sponsor's protocol ID
DI-03-CBC/22
Other IDs
21261279, DI-07-25/INI, 24 010884 01
Acronym
CROSS-ACD
Status last verified
Jun 2026
First submitted
29 May 2026
Last updated
8 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: 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.

Questions about this trial

What is this clinical trial studying?

A study testing Contralateral Eccentric Resistance Training and Contralateral Concentric Resistance Training in people with Acromioclavicular Joint Injury and Acromioclavicular Joint Dislocation, run by Universidad Nacional Andres Bello at 1 site in Chile.

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 5 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 8 Jun 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 Chile. 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?

Contact Omar E Valdés Tapia, PT, MSc, PhD(c) (+569 74082822, o.valdestapia@uandresbello.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Maximal Voluntary Isometric Contraction (time frame: Baseline, post-immobilization (2-4 weeks), and post-rehabilitation (6-8 weeks)). 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 8 Jun 2026; AzTrials last refreshed its copy on 6 Nov 2026.

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