Strengthening Exercises for Humeral Head Depressor Muscles

Hacettepe University

Status: Not yet enrolling

Conditions: Shoulder Rehabilitation; Depressor Muscle Training; Reverse Shoulder Arthroplasty

Treatments: Other: Conventional Rehabilitation Group; Other: Depressor Muscle Strengthening Group

Study type: Interventional

Funder types: Other

Identifiers

NCT07309796

20251224

Details and patient eligibility

About

Postoperative rehabilitation after reverse shoulder arthroplasty aims to improve pain control, range of motion, and functional capacity. However, studies examining the effects of strengthening exercises targeting the humeral head depressor muscles are limited. This randomized controlled trial will evaluate the effects of adding a specific strengthening program to standard rehabilitation on pain, range of motion, quality of life, and functional outcomes.

Full description

Reverse shoulder arthroplasty (RSA) is an effective surgical method, particularly in cases of massive rotator cuff tears that lead to irreversible loss of shoulder function. The primary goals of postoperative rehabilitation are to reduce pain, improve shoulder joint functions, optimize scapulothoracic rhythm, and safely restore functional use. However, studies examining the effects of specific strengthening exercises targeting the humeral head depressor muscle group (latissimus dorsi, teres major, infraspinatus, etc.) on clinical outcomes are quite limited. This study aims to evaluate the effects of a specific strengthening protocol designed for the humeral head depressor muscles following reverse shoulder arthroplasty on pain, range of motion (ROM), quality of life, functional status, and psychological well-being. Planned as a randomized controlled trial, the research will apply an additional humeral head depressor muscle strengthening program to the standard conventional rehabilitation protocol in the experimental group, while the control group will receive only the standard rehabilitation program.

Enrollment: 27 estimated patients

Sex: All

Ages: 65 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients scheduled for primary reverse total shoulder arthroplasty Intact teres minor confirmed by physical examination (Hornblower's test) and intraoperative assessment Ability to participate in physiotherapy or a home exercise program

Exclusion criteria

• Active infection Deltoid muscle insufficiency Inability or unwillingness to comply with randomization Prior shoulder arthroplasty on the same side Unwillingness to participate Inability to read or understand written instructions

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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27 participants in 2 patient groups

Conventional Rehabilitation Group

Active Comparator group

Description:

Participants undergoing reverse shoulder arthroplasty will receive a standard conventional rehabilitation program starting at postoperative 6 th week . The patient will receive treatment 5 days a week for 6 weeks, for a total of 30 sessions. The program consists of passive, active-assisted, and active/resisted exercises. Exercises Included: Passive / Assisted * Scapular mobilization * Scapular clock * Passive external rotation with a stick Passive → Active-Assisted * Active-assisted flexion and abduction with a stick * Glenohumeral joint mobilization Active / Light Resistance * Scapular retraction * Light-resistance strengthening of biceps, triceps, and serratus anterior using a theraband Active / Resistance * Theraband-based resisted biceps, triceps, and serratus anterior strengthening * Continuation of glenohumeral mobilization * Flexion and abduction above 90° * Posterior capsule stretching

Treatment:

Other: Conventional Rehabilitation Group

Depressor Muscle Strengthening Program

Experimental group

Description:

Participants will receive specific strengthening exercises targeting the shoulder depressor muscles in addition to the conventional rehabilitation program. These exercises will be performed throughout the 6-week intervention period. Additional Exercises: Latissimus dorsi: Seated rowing exercise - 3 sets × 10 repetitions Pectoralis major: Supine fly exercise - 3 sets × 10 repetitions Teres major: Prone shoulder adduction, extension, and internal rotation exercise

Treatment:

Other: Depressor Muscle Strengthening Group

Other: Conventional Rehabilitation Group