Swimmer ShoulderNCT07067216
Combined Effect of Biofeedback and Scapular Stabilization Exercises in Children With Swimmer's Shoulder
A study testing Designed scapular stabilization using pressure biofeedback and Designed physical therapy program in people with Swimmer Shoulder, run by Cairo University at 1 site in Egypt.
Trial summary
The purpose of this study is to investigate the combined effect of biofeedback and scapular stabilization exercises on swimmer's shoulder in pediatric elite swimmers. Read more about this study
- Who is it for?
- Ages 9 to 13 years
- Conditions the study is for
- Swimmer Shoulder
- What is being tested?
- Designed scapular stabilization using pressure biofeedback and Designed physical therapy program
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 siteEgypt
- Study dates
- 12 Jul 2025to 26 Oct 2025
- Phase
- Interventional
- 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 9 to 13 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Both sexes form 9-13 years old and active in competitive swimming clubs
- Swimming styles will be selected are butterfly and backstroke styles and the swimmers undergone an average minimum of 4 hours of swimming per week.
- All pediatric swimmers have shoulder pain.
- All of them are not allowed to practice swimming during study.
Who cannot join
- Pediatric swimmers who practice any sport related to overhead activities.
- Swimmers who had dermatological problems.
- Past history of upper limb fractures or surgeries.
- Swimmers who had any neurological condition (like winging scapula due to nerve damage).
- Swimmers who had dorsal scoliosis (s or c shaped).
- Swimmers who integrate in swimming competitions at the same time of study.
Trial locations and contacts
1 site in 1 country.
About this study
The purpose of this study is to investigate the combined effect of biofeedback and scapular stabilization exercises on swimmer's shoulder in pediatric elite swimmers.
Read the detailed description
Swimmer's shoulder is the most common injury in swimmers and is defined as a painful syndrome that occurs mostly in the anterior region of the shoulder and results from repetitive impingement of the rotator cuff under the coracoacromial arch during the technical gesture of swimming.
Shoulder injuries have been reported in up to 90% of swimmers. The scapula is vital in shoulder function and abnormal scapulothoracic mechanics and scapula-humeral rhythm have been implicated in shoulder pathologies, including glenohumeral impingement and rotator cuff tears.
When weakness or dysfunction is present in the scapular musculature, normal scapular positioning and mechanics may become altered which result in abnormal stresses to the capsular structures, rotator cuff compression and reduced performance.
Knowledge of scapulothoracic movements is regarded as crucial in the development of preventative strategies and treatment programs in athletes with shoulder pathology.
Scapula upward rotation is the dominant scapula action throughout shoulder elevation and has been previously implicated in the development of impingement.
In swimming, an athlete's scapular musculature plays a pivotal role in stabilizing and preventing impingement because its continuous activation is required throughout the swim stroke.
During all movements of the glenohumeral joint especially overhead elevation of the arm, it is of great importance that the scapular- stabilizing musculature should be strong enough to properly position the scapula. The main scapula stabilizers are the Levator Scapulae, Rhomboids major and minor, Serratus anterior, and Trapezii. These muscle groups function through synergistic co- contraction with rotator cuff to control the scapular movement. Scapular stabilization exercise aims to restore scapular position, orientations, motor control of muscles, and movement pattern, thereby attaining stability of scapula for better kinematics of shoulder. Due to lack of research area of scapular stabilization using a pressure biofeedback on swimmer's shoulder in pediatric swimmers, so the purpose of the study is to investigate the combined effect of scapular stabilization and biofeedback in children with swimmer's shoulder.
- Conditions
- Swimmer Shoulder
- Being tested
- Designed scapular stabilization using pressure biofeedback, Designed physical therapy program
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Designed scapular stabilization using pressure biofeedbackOther
Patients will attend 1-hour physical therapy sessions twice weekly for 6 weeks. The program will include posterior capsule mobilization, scapular stabilization using pressure biofeedback (targeting lower trapezius, latissimus dorsi, pectoralis major, deep cervical flexors, and scapular retractors), and strengthening exercises using therabands: external rotation, shoulder diagonals, rows, and extensions. Additional training will involve physioball scapular exercises (up/down \& side/side), prone scapular strengthening (e.g., TYI, superman), and scapular-clock drills to improve mobility, proprioception, and stability.
Designed physical therapy programOther
Patients will receive cryotherapy and perform stretching exercises for the pectoralis minor and posterior capsule. Strengthening exercises using theraband will target the rotator cuff (especially external rotators) and scapular depressors/retractors. Scapular stabilization will be trained through prone exercises on a ball (T, Y, W) and on a plinth, including rowing, horizontal abduction, extension, superman, and TYI exercises. Additionally, patients will perform the scapular-clock exercise to enhance mobility, control, and proprioception.
| Study group | Role | What they receive |
|---|---|---|
| Designed scapular stabilization using pressure biofeedback | Experimental | This group will consist of 20 participants, who will receive a designed scapular stabilization exercise program using pressure biofeedback. The program will be applied for one hour, two times per week, for 6 successive weeks. Receives: Other: Designed scapular stabilization using pressure biofeedback |
| Designed physical therapy program | Active comparator | This group will consist of 20 participants, who will receive a designed physical therapy program. The program will be applied for one hour, two times per week, for 6 successive weeks. Receives: Other: Designed physical therapy program |
What is being measured
The primary outcome is the main question the study is designed to answer.
The Shoulder Pain and Disability Index (SPADI)
The SPADI uses a 10 cm visual analogue scale for each question, with anchors from "no pain/difficulty" to "worst pain imaginable/so difficult it required help." Pain (5 items) and disability (8 items) scores are calculated separately and converted to percentages: pain (/50), disability (/80), and total SPADI (/130). If questions are skipped, scores are divided by the total possible. The final score (0-100) reflects shoulder impairment, with higher scores indicating worse function. A change of at least 13 points is needed to be considered meaningful beyond measurement error.
Measured: 6 weeks
Secondary outcomes (3)
Digital Inclinometer
Scapular upward rotation will be assessed in the scapular plane at humeral elevation angles of 0°, 60°, 90°, and 120°. Humeral angles will be set using an inclinometer along the upper arm. Subjects will elevate their arm with the thumb up, using a wall as a guide, and hold each position while scapular rotation is measured using a digital level placed over the scapula. Measurements will follow a sequence (0°-120°), with one trial per angle. Locator rods will be placed on the posterolateral acromion and scapular spine root. Subjects will return to rest and take 20-60 seconds breaks between trials to avoid fatigue.
Measured: 6 weeks
Digital goniometer
Isolated glenohumeral internal-external rotation and elevation range of motion will be measured using standard techniques. Subjects will lie supine with the humerus at 90° abduction, neutral rotation, and the elbow flexed at 90°. The examiner will passively move the arm into internal or external rotation until a clinical endpoint is reached, then record the angle using a goniometer. These measurements will reflect pure glenohumeral motion by stabilizing the scapula during the assessment.
Measured: 6 weeks
Kibler's Test (Lateral Scapular Slide Test)
This test assesses scapular symmetry using a reference point on the nearest spinous process to the scapula's inferior angle. Measurements are taken with arms at rest, then with hands on hips (~45° abduction), and finally at 90° elevation with maximal internal rotation (thumb to floor). Each position increases muscular demand. Distances from the reference point to the inferior angles of both scapulae are compared. A difference ≥1 cm is clinically significant; 1.5 cm is considered abnormal, and up to 3 cm may be seen with pathology.
Measured: 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Jul 2025
- Study start12 Jul 2025
- Primary completion12 Oct 2025
- Study completion26 Oct 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Swimmer ShoulderStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe 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
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Osama Ali Hamed Mohamed, Cairo University
- Investigators
- Nanees Essam Mohamed Salem, PhD, Study chair, Professor, Cairo universityShimaa Mohamed Reffat, PhD, Study director, Assistant Professor, Cairo university
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07067216
- Sponsor's protocol ID
- P.T.REC/012/004998
- Status last verified
- Oct 2026
- First submitted
- 5 Jul 2025
- Last updated
- 21 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 21 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Combined Effect of Biofeedback and Scapular Stabilization Exercises in Children With Swimmer's Shoulder
- ClinicalTrials.gov ID
- NCT07067216
- Acronym / sponsor ID
- P.T.REC/012/004998
- Conditions
- Swimmer Shoulder
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 12 Jul 2025 (actual)
- Primary completion
- 12 Oct 2025 (actual)
- Study completion
- 26 Oct 2025 (actual)
- First posted
- 16 Jul 2025 (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 purpose of this study is to investigate the combined effect of biofeedback and scapular stabilization exercises on swimmer's shoulder in pediatric elite swimmers.
Detailed description
Swimmer's shoulder is the most common injury in swimmers and is defined as a painful syndrome that occurs mostly in the anterior region of the shoulder and results from repetitive impingement of the rotator cuff under the coracoacromial arch during the technical gesture of swimming.
Shoulder injuries have been reported in up to 90% of swimmers. The scapula is vital in shoulder function and abnormal scapulothoracic mechanics and scapula-humeral rhythm have been implicated in shoulder pathologies, including glenohumeral impingement and rotator cuff tears.
When weakness or dysfunction is present in the scapular musculature, normal scapular positioning and mechanics may become altered which result in abnormal stresses to the capsular structures, rotator cuff compression and reduced performance.
Knowledge of scapulothoracic movements is regarded as crucial in the development of preventative strategies and treatment programs in athletes with shoulder pathology.
Scapula upward rotation is the dominant scapula action throughout shoulder elevation and has been previously implicated in the development of impingement.
In swimming, an athlete's scapular musculature plays a pivotal role in stabilizing and preventing impingement because its continuous activation is required throughout the swim stroke.
During all movements of the glenohumeral joint especially overhead elevation of the arm, it is of great importance that the scapular- stabilizing musculature should be strong enough to properly position the scapula. The main scapula stabilizers are the Levator Scapulae, Rhomboids major and minor, Serratus anterior, and Trapezii. These muscle groups function through synergistic co- contraction with rotator cuff to control the scapular movement. Scapular stabilization exercise aims to restore scapular position, orientations, motor control of muscles, and movement pattern, thereby attaining stability of scapula for better kinematics of shoulder. Due to lack of research area of scapular stabilization using a pressure biofeedback on swimmer's shoulder in pediatric swimmers, so the purpose of the study is to investigate the combined effect of scapular stabilization and biofeedback in children with swimmer's shoulder.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Designed scapular stabilization using pressure biofeedback | Experimental | Other: Designed scapular stabilization using pressure biofeedbackThis group will consist of 20 participants, who will receive a designed scapular stabilization exercise program using pressure biofeedback. The program will be applied for one hour, two times per week, for 6 successive weeks. |
| Designed physical therapy program | Active comparator | Other: Designed physical therapy programThis group will consist of 20 participants, who will receive a designed physical therapy program. The program will be applied for one hour, two times per week, for 6 successive weeks. |
Who may qualify
- Ages
- 9 to 13 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Both sexes form 9-13 years old and active in competitive swimming clubs
- Swimming styles will be selected are butterfly and backstroke styles and the swimmers undergone an average minimum of 4 hours of swimming per week.
- All pediatric swimmers have shoulder pain.
- All of them are not allowed to practice swimming during study.
Key exclusion criteria (6 listed)
- Pediatric swimmers who practice any sport related to overhead activities.
- Swimmers who had dermatological problems.
- Past history of upper limb fractures or surgeries.
- Swimmers who had any neurological condition (like winging scapula due to nerve damage).
- Swimmers who had dorsal scoliosis (s or c shaped).
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 |
|---|---|---|
| Designed scapular stabilization using pressure biofeedbackPatients will attend 1-hour physical therapy sessions twice weekly for 6 weeks. The program will include posterior capsule mobilization, scapular stabilization using pressure biofeedback (targeting lower trapezius, latissimus dorsi, pectoralis major, deep cervical flexors, and scapular retractors), and strengthening exercises using therabands: external rotation, shoulder diagonals, rows, and extensions. Additional training will involve physioball scapular exercises (up/down \& side/side), prone scapular strengthening (e.g., TYI, superman), and scapular-clock drills to improve mobility, proprioception, and stability. | Other | Designed scapular stabilization using pressure biofeedback |
| Designed physical therapy programPatients will receive cryotherapy and perform stretching exercises for the pectoralis minor and posterior capsule. Strengthening exercises using theraband will target the rotator cuff (especially external rotators) and scapular depressors/retractors. Scapular stabilization will be trained through prone exercises on a ball (T, Y, W) and on a plinth, including rowing, horizontal abduction, extension, superman, and TYI exercises. Additionally, patients will perform the scapular-clock exercise to enhance mobility, control, and proprioception. | Other | Designed physical therapy program |
Primary outcome
The Shoulder Pain and Disability Index (SPADI)
Time frame: 6 weeks
The SPADI uses a 10 cm visual analogue scale for each question, with anchors from "no pain/difficulty" to "worst pain imaginable/so difficult it required help." Pain (5 items) and disability (8 items) scores are calculated separately and converted to percentages: pain (/50), disability (/80), and total SPADI (/130). If questions are skipped, scores are divided by the total possible. The final score (0-100) reflects shoulder impairment, with higher scores indicating worse function. A change of at least 13 points is needed to be considered meaningful beyond measurement error.
3 secondary outcomes
Digital Inclinometer
Time frame: 6 weeks
Digital goniometer
Time frame: 6 weeks
Kibler's Test (Lateral Scapular Slide Test)
Time frame: 6 weeks
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 21 Oct 2026.
Related trials for Swimmer Shoulder
RecruitingObservational study
Relation Between Swimming Stroke Types And Scapular Dyskinesia In Swimmers: A Cross - Sectional Study
Scapular Dyskinesis, Scapuloshoulder Disorders
Active, not recruitingObservational study
Differences in Shoulder Girdle Muscles in Young Swimmers
Young People
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.
Nanees Essam Mohamed Salem, PhD study chair
Professor, Cairo university
Shimaa Mohamed Reffat, PhD study director
Assistant Professor, Cairo university
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Designed scapular stabilization using pressure biofeedback and Designed physical therapy program in people with Swimmer Shoulder, run by Cairo University at 1 site in Egypt.
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 4 inclusion and 6 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 21 Oct 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 Egypt. 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?
The Shoulder Pain and Disability Index (SPADI) (time frame: 6 weeks). 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 21 Oct 2026.