Throwing Velocity and Patient Reported Outcomes in Elite Level Handball Players After Completion of Shoulder-Pacemaker Strength Training

Sportorthopädie Zentrum in Wien Hietzing

Status: Completed

Conditions: Shoulder Dislocation

Treatments: Other: Non-Motion-triggered NMES training protocol; Other: Motion-triggered NMES training protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT06459258

EK22-201-1022 (Other Identifier)

Details and patient eligibility

About

The successful application of treatment protocols using motion-triggered neuromuscular electrical stimulation (NMES) for treatment-resistant functional posterior shoulder instability was recently demonstrated. The purpose of this study is to evaluate the concept of a motion-triggered NMES training protocol through objective clinical outcome parameters and its impact on external rotational (ER) shoulder strength and throwing velocity in healthy, elite-level handball players.

Full description

The aim of this study is to evaluate the concept of a motion-triggered NMES training protocol through objective clinical outcome parameters and its impact on external rotational (ER) shoulder strength and throwing velocity in healthy, elite-level handball players. It is hypothesized that a 6-week motion-triggered NMES shoulder strengthening training protocol in elite-level handball players would lead to an increase in throwing velocity due to an improved motor ability and ER shoulder strength.

Enrollment: 14 patients

Sex: Male

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Elite level handball players healthy and actively competing at the time of the study
• Patients must be at least 18 years at the time of signing the informed consent
• Pregnancy must be ruled out in the case of female participants (e.g., pregnancy test)
• Patient must be available for all specified assessments throughout the study duration
• All patients are required to give written informed consent before enrollment

Exclusion criteria

• age <18,
• history of type I or II shoulder instability according to the Stanmore classification12,
• existing pain syndrome (defined by pain at rest or during motion that is not caused by dislocation and impedes training),
• recent shoulder surgery (<1 year).
• Contraindication to SPM treatment (e.g., cardiac pacemaker)
• Neurological disorders or nerve injuries causing the instability
• Uncontrolled alcohol or substance abuse

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

14 participants in 2 patient groups

Non-NMES control group

Active Comparator group

Description:

Subjects of the control group undergo a conventional standardized strength training program (3x/week, 30 minutes for 6 weeks) with concentric, eccentric, and functional training exercises.

Treatment:

Other: Non-Motion-triggered NMES training protocol

NMES group

Experimental group

Description:

Experimental group subjects undergo a motion-triggered NMES shoulder strengthening training program (3x/week, 30 minutes for 6 weeks) using the Shoulder Pacemaker (NCS Lab Srl, Modena, Italy), a motion activated stimulation device to strengthen muscular disbalances. This is accomplished through varying neuromuscular electrical stimulation intensity based on the angle of motion of the arm producing subtetanic contraction and provoking supraspinal neural adaptations. Electrode placement: electrode 1, inferior to the scapular spine (infraspinatus, teres minor, + posterior deltoid); electrode 2, medial to the medial scapula border (lower trapezius + rhomboids) . Sets x repetitions: 3x20; Levels: Level 1-3; Exercise 1: L1: Supported row, L2: Front raises in 45°, L3 Front raises (thumbs up); Exercise 2: L1: Resisted front raises, L2: Crossbody resisted raises, L3: Crossbody 'forehand swing'; Exercise 3: L1: Rear dealt fly, L2: Single arm resisted row, L3: Underhand serve

Treatment:

Other: Motion-triggered NMES training protocol