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SwimmingShoulderNCT06909864

Competitive Swimming and Shoulder Adaptations: The Role of Stroke Specialty in Adolescent Swimmers

An observational study of Swimming and Shoulder, run by Hacettepe University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Objectives: To examine the sport-specific adaptations and investigate the effect of swimming stroke specialization in shoulder complex among adolescent competitive swimmers. Design: Observational study. Setting: Athletic facilities. Read more about this study

Who is it for?
Ages 13 to 18 yearsHealthy volunteers can take part
Conditions the study is for
Swimming, Shoulder, Adolescent
How many people
76 participants
Where
1 siteTurkey (Türkiye)
Study dates
16 Oct 2019to 16 Oct 2021
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 13 to 18 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Study population: A total of 55 adolescent competitive swimmers and 40 non-athlete peers were screened. 48 swimmers and 28 non-athlete peers aged between 13 to 18 years met the inclusion criteria and participated in this study

Who may be able to join

  • aged between 13 to 18 years
  • the asymptomatic swimmers with no history of major upper limb injury or surgery and no injury history of upper limb in last 6 months
  • having experience in at least 5 years competitive swimming,
  • actively participating in competitive swimming at least 1 year,
  • competing at least in national level and having swimming stroke specialization in competitive swimming
  • aged between 13 to 18 years,
  • no competed in overhead sports like swimming, basketball, volleyball, tennis, baseball as professional or recreational,
  • no history of major upper limb injury or surgery in last 6 months.

Who cannot join

  • if they had at least two positive signs by shoulder screening tests (Hawkin's/Kennedy Subacromial Impingement Test, Jobe/Empty Can Test, External Rotation Resistance Test, Apprehension Instability Test, Speed Test and Gerber Lift-Off Test),
  • a BMI of 30 kg/m² or greater than 30 kg/m²,
  • competing in paralympic sports,
  • if they had any major upper limb injuries or surgeries,
  • if they had any systemic, neurological or rheumatological diseases,
  • being pre-pubertal stage (Tanner I) according to Tanner Scale,
  • indicated their unwillingness to participate to this study.

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Cebeci Sports Complex

    Istanbul

Other trials in Turkey (Türkiye)

About this study

Objectives: To examine the sport-specific adaptations and investigate the effect of swimming stroke specialization in shoulder complex among adolescent competitive swimmers.

Design: Observational study.

Read more

Setting: Athletic facilities.

Participants: A total of 76 adolescents participated including n = 28 non-swimmers as Control Group (CG) and n = 48 competitive swimmers as Swimmers Group (SWG).

Main Outcome Measures: Strength of glenohumeral (GH) and scapular muscles (SM), mobility of GH (GH ROMs) joint, proprioception, pectoralis minor length (PML), posterior shoulder tightness (PST) were evaluated for all participants. Kerlan Jobe Orthopaedic Score (KJOC) was sed to evaluate for SWG. The tested shoulder physical performance parameters were compared between the groups.

Keywords
Swimming, Shoulder, Adolescent, Musculoskeletal screening

What participants receive

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

Study groups in NCT06909864
Study groupRoleWhat they receive
Swimming Group (SWG)The asymptomatic swimmers with no history of major upper limb injury or surgery and no injury history of upper limb in last 6 months, having experience in at least 5 years competitive swimming, actively participating in competitive swimming at least 1 year, competing at least in national level and having swimming stroke specialization in competitive swimming were included
Control Group (CG)The non-athlete peers with no competed in overhead sports like swimming, basketball, volleyball, tennis, baseball as professional or recreational, no history of major upper limb injury or surgery and no injury history in last 6 months participated in this study.

What is being measured

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

  1. Muscle Strength

    Muscle strength was assessed with break test by using hand-hold dynamometer (Jamaar Hand Dynamometer, USA). Assessments were applied for both shoulders and 3 times for each position. Shoulder flexion, extension, abduction, full-can, glenohumeral IR and ER, upper, middle and lower trapezius, serratus anterior muscle tests were applied. GH ER/IR ratio was calculated as well (21-26). Measurements were recorded in Newton (N).

    Measured: From October 2019 to September 2021

  2. Range of Motion

    Passive Range of Motion (PROM) of both shoulders was assessed using a digital inclinometer (Get My ROM, version 1.0.3 for iOS; Interactive Medical Productions, Hampton, NH, USA). Shoulder internal rotation (IR), external rotation (ER), and total-rotational ROM were assessed (ICC = 0.92-94). Shoulder IR and ER PROM were obtained with the participant lying supine on a standard examination table, with the shoulder initially abducted to 90° with 0° rotation and the elbow flexed to 90° with neutral pronation/supination. In addition, Total-rotational ROM was calculated by summing the IR and ER ROMs average degrees of each shoulder.

    Measured: From October 2019 to September 2021

  3. Pectoralis Minor Length

    Digitized 2 anatomical landmarks representing the length of the pectoralis minor. These 2 points were the medial-inferior angle of the coracoid process and just lateral to the sternocostal junction of the inferior aspect of the fourth rib. Measurements of pectoralis minor muscle length was taken with tape measure (ICC = 0.96). Because of height and muscle length variability among subjects, a normalization index was developed. The pectoralis minor index (PMI) was calculated by dividing the resting muscle length measurement by the subject height and multiplying by 100.

    Measured: From October 2019 to September 2021

  4. Proprioception

    For proprioception testing, participants attempted to reproduce 45° ER angle. Participants were positioned as lying supine with arm abducted to 90°, elbow flexed at 90°. The ''Get My ROM'' digital inclinometer was used to measure the angles; the iPhone was securely attached to participants forearm using a strap with the screen facing the tester (ICC = 0.87-89). The participant was instructed to close their eyes by using an eye patch throughout testing. The arm was passively rotated to 45° ER and held in this position for 3 seconds. The participant was asked to remember this position. Following the return to neutral the participant was asked to actively return the arm back to the angle shown. The amount of degrees away from 45° was recorded.

    Measured: From October 2019 to September 2021

  5. Posterior Shoulder Tightness

    Participants were positioned supine with both shoulders flush against a standard examination table. The tester stood at the head of the examination table toward the head of the subject and positioned the test shoulder and elbow in 90 of both abduction and flexion. To measure GH horizontal adduction, The ''Get My ROM'' digital inclinometer was aligned with the ventral midline of the humerus. The angle created by the end position of the humerus with respect to 0 of horizontal adduction was then recorded as the total amount of GH horizontal adduction motion (ICC = 0.79).

    Measured: From October 2019 to September 2021

Secondary outcomes (2)
  1. Scapular Dyskinesis

    Each participant performed 5 repetitions of bilateral, active, weighted shoulder flexion and bilateral, active, weighted shoulder abduction (frontal plane) while they were observed from the posterior views. First of all, the scapula was observed while participants in rest and then weighted shoulder flexion and abduction movements from the posterior views. Kibler et al. reported the reliability of a visually based classification system for scapular dysfunction that defined 3 different types of motion abnormalities: Type 1 = inferior angle prominence, Type II = medial border prominence and Type III = excessive superior border elevation. Normal, symmetric scapular motion was considered Type IV (ICC = 0.32-42).

    Measured: From October 2019 to September 2021

  2. Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC)

    KJOC has been designed specifically as a subjective assessment tool to measure functional status of the upper extremities in overhead athletes. The KJOC was translated from English to Turkish to enable use of questionnaires in Turkish overhead athletes by Turgut et al. KJOC was used to measure functional status of the upper extremities in competitive adolescent swimmers and the scores compared in different stroke specialty among the swimmers in this study.

    Measured: From October 2019 to September 2021

Timeline

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

  1. First posted4 Apr 2025
  2. Study start16 Oct 2019
  3. Primary completion10 Sep 2021
  4. Study completion16 Oct 2021

Resources

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
Case-control
Time perspective
Cross-sectional
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06909864
Sponsor's protocol ID
GO 19/823
Acronym
Shoulder
Status last verified
Mar 2025
First submitted
20 Mar 2025
Last updated
4 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Laudner KG, Stanek JM, Meister K. Assessing posterior shoulder contracture: the reliability and validity of measuring glenohumeral joint horizontal adduction. J Athl Train. 2006 Oct-Dec;41(4):375-80.

    PubMed 17273461
  • Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003 Mar-Apr;11(2):142-51. doi: 10.5435/00124635-200303000-00008.

    PubMed 12670140
  • McClure P, Tate AR, Kareha S, Irwin D, Zlupko E. A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train. 2009 Mar-Apr;44(2):160-4. doi: 10.4085/1062-6050-44.2.160.

    PubMed 19295960
  • Higson E, Herrington L, Butler C, Horsley I. The short-term effect of swimming training load on shoulder rotational range of motion, shoulder joint position sense and pectoralis minor length. Shoulder Elbow. 2018 Oct;10(4):285-291. doi: 10.1177/1758573218773539. Epub 2018 May 12.

    PubMed 30214495
  • Ager AL, Roy JS, Roos M, Belley AF, Cools A, Hebert LJ. Shoulder proprioception: How is it measured and is it reliable? A systematic review. J Hand Ther. 2017 Apr-Jun;30(2):221-231. doi: 10.1016/j.jht.2017.05.003.

    PubMed 28641738
  • Robertson JA. F. P. Kendall and E. K. McCreary "Muscles, Testing and Function" (Third Edition). Br J Sports Med. 1984;18(1):25-.

  • Michener LA, Boardman ND, Pidcoe PE, Frith AM. Scapular muscle tests in subjects with shoulder pain and functional loss: reliability and construct validity. Phys Ther. 2005 Nov;85(11):1128-38.

    PubMed 16253043
  • Hislop H, Avers D, Brown M. Daniels and Worthingham's muscle Testing-E-Book: Techniques of manual examination and performance testing: Elsevier Health Sciences; 2013.

  • Itoi E, Kido T, Sano A, Urayama M, Sato K. Which is more useful, the "full can test" or the "empty can test," in detecting the torn supraspinatus tendon? Am J Sports Med. 1999 Jan-Feb;27(1):65-8. doi: 10.1177/03635465990270011901.

    PubMed 9934421
  • Hayes K, Walton JR, Szomor ZL, Murrell GA. Reliability of 3 methods for assessing shoulder strength. J Shoulder Elbow Surg. 2002 Jan-Feb;11(1):33-9. doi: 10.1067/mse.2002.119852.

    PubMed 11845146
  • McLaine SJ, Ginn KA, Fell JW, Bird ML. Isometric shoulder strength in young swimmers. J Sci Med Sport. 2018 Jan;21(1):35-39. doi: 10.1016/j.jsams.2017.05.003. Epub 2017 May 25.

    PubMed 28844605
  • Harput G, Guney H, Toprak U, Kaya T, Colakoglu FF, Baltaci G. Shoulder-Rotator Strength, Range of Motion, and Acromiohumeral Distance in Asymptomatic Adolescent Volleyball Attackers. J Athl Train. 2016 Sep;51(9):733-738. doi: 10.4085/1062-6050-51.12.04. Epub 2016 Nov 4.

    PubMed 27813683
  • Rose MB, Noonan T. Glenohumeral internal rotation deficit in throwing athletes: current perspectives. Open Access J Sports Med. 2018 Mar 19;9:69-78. doi: 10.2147/OAJSM.S138975. eCollection 2018.

    PubMed 29593438
  • Wymore L, Reeve RE, Chaput CD. No correlation between stroke specialty and rate of shoulder pain in NCAA men swimmers. Int J Shoulder Surg. 2012 Jul;6(3):71-5. doi: 10.4103/0973-6042.102555.

    PubMed 23204760
  • Park HB, Yokota A, Gill HS, El Rassi G, McFarland EG. Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. J Bone Joint Surg Am. 2005 Jul;87(7):1446-55. doi: 10.2106/JBJS.D.02335.

    PubMed 15995110

Questions about this trial

What is this clinical trial studying?

An observational study of Swimming and Shoulder, run by Hacettepe University at 1 site in Turkey (Türkiye).

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 8 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: finished, as of the sponsor's last update on 4 Apr 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 Turkey (Türkiye). 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?

Muscle Strength (time frame: From October 2019 to September 2021). The study lists 5 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 NCT06909864, which also lists 25 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 4 Apr 2025.

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