Glenohumeral Internal Rotation DeficitNCT06704529
Cortical Processing of Proprioception Related to Pitching Performance in Baseball Players With Glenohumeral Internal Rotation Deficit
An observational study of Glenohumeral Internal Rotation Deficit, run by National Taiwan University Hospital at 1 site in Taiwan.
Trial summary
The current study aims to characterize the cortical activity and proprioceptive acuity in baseball players with glenohumeral internal rotation deficit (GIRD). Additionally, the correlations between cortical activity, proprioceptive acuity, and pitching performance will be examined. Read more about this study
- Who is it for?
- Ages 15 to 40 yearsHealthy volunteers can take part
- Conditions the study is for
- Glenohumeral Internal Rotation Deficit
- What is being tested?
- pitching motion
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 98 participants
- Where
- 1 siteTaiwan
- Study dates
- 20 Aug 2024to 30 Jul 2025
- Phase
- Observational
- 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 15 to 40 years
- All sexes
- Healthy volunteers accepted
- Child, Adult
Study population: GIRD is defined as 20° less GH IR ROM in the dominant shoulder compared to the non-dominant shoulder. Players without GIRD will be recruited to match the characteristics and sports involvement data (age ±3 years, right-handed or left-handed, pitcher or fielder, practice time >10 hours/week or <10 hours/week, baseball experience >3 years or <3 years) of the GIRD players.
Who may be able to join
- playing baseball for at least one year
- still active in training or competition
- frequency of training or games should be at least 3 hours per week
Who cannot join
- current dominant upper extremities pain
- a history of upper extremities surgical interventions or fractures or dislocation or degenerative joint disease
- cervical radiculopathy within 6 months
- lower extremities injury or surgery within the current 6 months
- Visual analog scale (VAS) > 5 during movement in the experiment
Trial locations and contacts
1 site in 1 country.
Taiwan1 site
Institute of Physical Therapy, National Taiwan University
Taipei, Taiwan, 100
About this study
The current study aims to characterize the cortical activity and proprioceptive acuity in baseball players with glenohumeral internal rotation deficit (GIRD). Additionally, the correlations between cortical activity, proprioceptive acuity, and pitching performance will be examined. The evaluation of proprioception will be conducted using the active joint reposition sense of the shoulder. Simultaneously, the investigators will record cortical activity by electroencephalography (EEG). To represent pitching performance, the investigators will collect ball velocity and pitching accuracy. This will help the investigators understand the process of proprioception in the central nervous system, as well as factors associated with pitching performance in baseball players with GIRD.
- Conditions
- Glenohumeral Internal Rotation Deficit
- Being tested
- pitching motion
- Keywords
- proprioception, baseball, pitching performance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
pitching motionBehavioural
participants pitch fastball to the strike zone
| Study group | Role | What they receive |
|---|---|---|
| baseball players with GIRD | Not described Receives: Behavioral: pitching motion | |
| baseball players without GIRD | Not described Receives: Behavioral: pitching motion |
What is being measured
The primary outcome is the main question the study is designed to answer.
Active joint reposition test
Participants will mimic the pitching motion with reducing the influence from the lower limb by kneeling the knee and hip of the nondominant side 90° and their foot are flat on the ground. They will be blindfolded, with their non-throwing hand resting on the thigh. The reproducing arm-cocking and ball-release positions will be tested at random sequences for six trials, respectively. Results or feedback regarding the accuracy of individual trials will not be provided at any time. The acuity of active joint reposition will be calculated by 3-dimensional variable error scores for scapulothoracic (internal-external rotation, upward-downward rotation, posterior-anterior tilt) and glenohumeral (internal-external rotation, horizontal abduction-adduction, abduction-adduction) joint 55. Three-dimensional variable error scores (3DVE) reflect acuity (measured in degrees) in all planes of motion measured for individual joints.
Measured: baseline
Pitching performance
Pitching performance will be collected by radar gun (JUGS company, Tualatin, OR, USA) and digital camera (JVC GC-PX100B, Yokohama, Japan) for ball velocity and pitching location, respectively. Participants will pitch on a mound 18.44 m away from the home plate. The target will be aligned with the theoretical line extending from the right edge of the home plate at a height of approximately 30 cm above the ground.
After warming up at their own pace, each participant throws 30 game-like effort pitches in three 10-pitch sessions without specific instruction on focusing their attention. The fastest velocity of 10 pitches will be collected for analysis.
Measured: baseline
Secondary outcomes (7)
Shoulder range of motion
The tester grasps the subject's forearm in a supine position to measure the shoulder horizontal adduction/abduction. The humerus will be moved until the movement ceases (firm end-feel), indicating the end of shoulder tissue flexibility. The recorder places the digital inclinometer parallel to the humerus. Each measurement will be performed 3 times, and the average data will be analyzed.
GH internal/external (IR/ER) ranges will be measured accordingly following the method in a previous study. Participants lay down supine with 90° shoulder abduction and elbow flexion. Then GH IR/ER will be measured by the main assessor using a digital inclinometer by stabilizing the scapula by grasping the coracoid process and the spine of the scapula posteriorly, then moving the forearm to reach the end range. Each measurement will be performed 3 times, and the average data will be used for analysis.
Measured: baseline
Humeral retrotorsion
Humeral retrotorsion will be measured with the T3300 ultrasound system (BenQ, Taipei, Taiwan). Participants lay supine with 90° shoulder abduction and elbow flexion. The main assessor places the transducer on the participant's anterior shoulder for a short-axis view of the lesser and greater tubercles. The two-person technique is adopted. The first assessor adjusts the probe perpendicular to the floor and rotates the participant's humerus with a line connecting the greater and lesser tubercles parallel to the horizontal plane. Then, the second assessor places a digital inclinometer on the ulnar side of the forearm to record the rotation angle, which is defined as the humeral retroversion.23 The ICC3,k of intra-rater reliability is 0.995. Each measurement will be performed 3 times, and averaged data will be used for analysis.
Measured: baseline
Acromiohumeral distance
Acromiohumeral distance will be measured with the ultrasound transducer placed on the lateral aspect of the acromion in line with the longitudinal axis of the humerus to visualize the shortest distance between the humerus and the acromion.58 Three consecutive ultrasound images of the acromiohumeral distance are captured. The investigator captures 3 more consecutive ultrasound images at rest while the participant sit with the shoulder in the neutral position. The shortest distance will be measured with built-in calipers. The ICC3,k for intra-rater reliability is 0.963. Each measurement will be performed 3 times and averaged data will be used for analysis.
Measured: baseline
Rotator cuff thickness
The probe will be positioned on the bicipital grove horizontally to measure subscapularis tendon thickness in a short axis of view. The participant's forearm is placed with the elbow flexed to 90° in slight internal rotation, with the palm facing upward and medially. This position allows the bicipital groove to be brought to an anterior position, allowing clear visualization of the tendon within the grove. .
Measured: baseline
Posterior capsule thickness
For measurement of the posterior capsule thickness, the participants sit upright in a chair with both forearms resting on the thighs and upper arms by the participant's sides. The examiner positions a transducer on the posterior shoulder and visualizes the glenoid labrum, humeral head, rotator cuff, and posterior capsule. The posterior capsule is defined as the tissue immediately lateral to the tip of the labrum between the humeral head and rotator cuff. When the capsule is identified in the image, posterior capsule thickness will be measured with built-in calipers. The ICC3,k for intra-rater reliability is 0.951. Each measurement will be performed 3 times, and averaged data will be used for analysis.
Measured: baseline
Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC)
The KJOC is the most common questionnaire for overhead athletes, and it was conducted in several studies.66 Recently, the Major League Baseball (MLB) organization adopted this evaluation tool as the standard for recovering injuries in MLB players.67 The questionnaire is commonly used to assess shoulder function and performance. It is valid, reliable in its pilot form, and responsive to the tested population of adult overhead athletes.66 KJOC questionnaire ranges from 0 to 100, and the lower score represents a limited function.
Measured: baseline
Posterior capsule elasticity
To measure the posterior capsule elasticity, the participants sit upright in a chair with both forearms resting on the thighs and upper arms by the participant's sides. The examiner positions a transducer on the posterior shoulder and visualizes the glenoid labrum, humeral head, rotator cuff, and posterior capsule. The posterior capsule is defined as the tissue immediately lateral to the tip of the labrum between the humeral head and rotator cuff. When the capsule is identified in the image, posterior capsule elasticity will be recorded. Each measurement will be performed 3 times and averaged data will be used for analysis.
Measured: baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Nov 2024
- Study start20 Aug 2024
- Primary completion30 May 2025
- Study completion30 Jul 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Glenohumeral Internal Rotation DeficitStudies of the same condition, open and under way.
- More trials run by National Taiwan University HospitalThe 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
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 98 participants (actual)
Sponsor and investigators
- Lead sponsor
- National Taiwan University Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- Ministry of Science and Technology, Taiwan
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06704529
- Sponsor's protocol ID
- 202407026RINB
- Status last verified
- Dec 2025
- First submitted
- 21 Aug 2024
- Last updated
- 17 Dec 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000 Mar;80(3):276-91.
PubMed 10696154Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2017 Jul;26(4):294-305. doi: 10.1123/jsr.2015-0172. Epub 2016 Aug 24.
PubMed 27632891Aldridge R, Stephen Guffey J, Whitehead MT, Head P. The effects of a daily stretching protocol on passive glenohumeral internal rotation in overhead throwing collegiate athletes. Int J Sports Phys Ther. 2012 Aug;7(4):365-71.
PubMed 22893856Johnson JE, Fullmer JA, Nielsen CM, Johnson JK, Moorman CT 3rd. Glenohumeral Internal Rotation Deficit and Injuries: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2018 May 22;6(5):2325967118773322. doi: 10.1177/2325967118773322. eCollection 2018 May.
PubMed 29845083Meister K, Day T, Horodyski M, Kaminski TW, Wasik MP, Tillman S. Rotational motion changes in the glenohumeral joint of the adolescent/Little League baseball player. Am J Sports Med. 2005 May;33(5):693-8. doi: 10.1177/0363546504269936. Epub 2005 Feb 16.
PubMed 15722284Freehill MT, Archer KR, Diffenderfer BW, Ebel BG, Cosgarea AJ, McFarland EG. Changes in collegiate starting pitchers' range of motion after single game and season. Phys Sportsmed. 2014 Feb;42(1):69-74. doi: 10.3810/psm.2014.02.2049.
PubMed 24565823Astolfi MM, Struminger AH, Royer TD, Kaminski TW, Swanik CB. Adaptations of the Shoulder to Overhead Throwing in Youth Athletes. J Athl Train. 2015 Jul;50(7):726-32. doi: 10.4085/1062-6040-50.1.14. Epub 2015 Mar 26.
PubMed 25811844
Study at a glance
From the registry record, last updated by the sponsor on 17 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Cortical Processing of Proprioception Related to Pitching Performance in Baseball Players With Glenohumeral Internal Rotation Deficit
- ClinicalTrials.gov ID
- NCT06704529
- Acronym / sponsor ID
- 202407026RINB
- Conditions
- Glenohumeral Internal Rotation Deficit
- Keywords
- proprioception, baseball, pitching performance
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 98 participants (actual)
- Lead sponsor
- National Taiwan University HospitalUniversity, hospital or other
- Collaborators
- Ministry of Science and Technology, Taiwan
- Study start
- 20 Aug 2024 (actual)
- Primary completion
- 30 May 2025 (actual)
- Study completion
- 30 Jul 2025 (actual)
- First posted
- 26 Nov 2024 (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 current study aims to characterize the cortical activity and proprioceptive acuity in baseball players with glenohumeral internal rotation deficit (GIRD). Additionally, the correlations between cortical activity, proprioceptive acuity, and pitching performance will be examined. The evaluation of proprioception will be conducted using the active joint reposition sense of the shoulder. Simultaneously, the investigators will record cortical activity by electroencephalography (EEG). To represent pitching performance, the investigators will collect ball velocity and pitching accuracy. This will help the investigators understand the process of proprioception in the central nervous system, as well as factors associated with pitching performance in baseball players with GIRD.
Study design
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| baseball players with GIRD | – | Behavioral: pitching motion |
| baseball players without GIRD | – | Behavioral: pitching motion |
Who may qualify
- Ages
- 15 to 40 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult
- Study population
- GIRD is defined as 20° less GH IR ROM in the dominant shoulder compared to the non-dominant shoulder. Players without GIRD will be recruited to match the characteristics and sports involvement data (age ±3 years, right-handed or left-handed, pitcher or fielder, practice time >10 hours/week or <10 hours/week, baseball experience >3 years or <3 years) of the GIRD players.
Key inclusion criteria (3 listed)
- playing baseball for at least one year
- still active in training or competition
- frequency of training or games should be at least 3 hours per week
Key exclusion criteria (5 listed)
- current dominant upper extremities pain
- a history of upper extremities surgical interventions or fractures or dislocation or degenerative joint disease
- cervical radiculopathy within 6 months
- lower extremities injury or surgery within the current 6 months
- Visual analog scale (VAS) > 5 during movement in the experiment
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 |
|---|---|---|
| pitching motionparticipants pitch fastball to the strike zone | Behavioural | baseball players with GIRD, baseball players without GIRD |
Primary outcome
Active joint reposition test
Time frame: baseline
Participants will mimic the pitching motion with reducing the influence from the lower limb by kneeling the knee and hip of the nondominant side 90° and their foot are flat on the ground. They will be blindfolded, with their non-throwing hand resting on the thigh. The reproducing arm-cocking and ball-release positions will be tested at random sequences for six trials, respectively. Results or feedback regarding the accuracy of individual trials will not be provided at any time. The acuity of active joint reposition will be calculated by 3-dimensional variable error scores for scapulothoracic (internal-external rotation, upward-downward rotation, posterior-anterior tilt) and glenohumeral (internal-external rotation, horizontal abduction-adduction, abduction-adduction) joint 55. Three-dimensional variable error scores (3DVE) reflect acuity (measured in degrees) in all planes of motion measured for individual joints.
Pitching performance
Time frame: baseline
Pitching performance will be collected by radar gun (JUGS company, Tualatin, OR, USA) and digital camera (JVC GC-PX100B, Yokohama, Japan) for ball velocity and pitching location, respectively. Participants will pitch on a mound 18.44 m away from the home plate. The target will be aligned with the theoretical line extending from the right edge of the home plate at a height of approximately 30 cm above the ground. After warming up at their own pace, each participant throws 30 game-like effort pitches in three 10-pitch sessions without specific instruction on focusing their attention. The fastest velocity of 10 pitches will be collected for analysis.
7 secondary outcomes
Shoulder range of motion
Time frame: baseline
Humeral retrotorsion
Time frame: baseline
Acromiohumeral distance
Time frame: baseline
Rotator cuff thickness
Time frame: baseline
Posterior capsule thickness
Time frame: baseline
Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC)
Time frame: baseline
Posterior capsule elasticity
Time frame: baseline
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 17 Dec 2025.
- Background: PubMed 10696154Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000 Mar;80(3):276-91.
- Background: PubMed 27632891Mine K, Nakayama T, Milanese S, Grimmer K. Effectiveness of Stretching on Posterior Shoulder Tightness and Glenohumeral Internal-Rotation Deficit: A Systematic Review of Randomized Controlled Trials. J Sport Rehabil. 2017 Jul;26(4):294-305. doi: 10.1123/jsr.2015-0172. Epub 2016 Aug 24.
- Background: PubMed 22893856Aldridge R, Stephen Guffey J, Whitehead MT, Head P. The effects of a daily stretching protocol on passive glenohumeral internal rotation in overhead throwing collegiate athletes. Int J Sports Phys Ther. 2012 Aug;7(4):365-71.
- Background: PubMed 29845083Johnson JE, Fullmer JA, Nielsen CM, Johnson JK, Moorman CT 3rd. Glenohumeral Internal Rotation Deficit and Injuries: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2018 May 22;6(5):2325967118773322. doi: 10.1177/2325967118773322. eCollection 2018 May.
- Background: PubMed 15722284Meister K, Day T, Horodyski M, Kaminski TW, Wasik MP, Tillman S. Rotational motion changes in the glenohumeral joint of the adolescent/Little League baseball player. Am J Sports Med. 2005 May;33(5):693-8. doi: 10.1177/0363546504269936. Epub 2005 Feb 16.
- Background: PubMed 24565823Freehill MT, Archer KR, Diffenderfer BW, Ebel BG, Cosgarea AJ, McFarland EG. Changes in collegiate starting pitchers' range of motion after single game and season. Phys Sportsmed. 2014 Feb;42(1):69-74. doi: 10.3810/psm.2014.02.2049.
- Background: PubMed 25811844Astolfi MM, Struminger AH, Royer TD, Kaminski TW, Swanik CB. Adaptations of the Shoulder to Overhead Throwing in Youth Athletes. J Athl Train. 2015 Jul;50(7):726-32. doi: 10.4085/1062-6040-50.1.14. Epub 2015 Mar 26.
- Individual participant dataSharing planned: No
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?
An observational study of Glenohumeral Internal Rotation Deficit, run by National Taiwan University Hospital 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 3 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 17 Dec 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?
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?
Active joint reposition test (time frame: baseline). 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?
On the ClinicalTrials.gov record for NCT06704529, which also lists 7 linked publications.
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 17 Dec 2025.