Glenohumeral Internal Rotation Deficit (GIRD)RCTNCT07229274

Effect of Joint Mobilization and Movement Control Exercises on Shoulder Pain and Function in Fast Bowlers (RCT)

A study testing stretches, strengthening and mobilization with movement in people with Glenohumeral Internal Rotation Deficit (GIRD), run by Lahore University of Biological and Applied Sciences at 2 sites in Pakistan.

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

The goal of this clinical trial is to determine combined effects of the Kinetic control for shoulder on pain, range, and function among fast bowlers. The main question it aims to answer is: Does mulligan mobilization with movement along with kinetic medial rotation control work in decreasing pain, improving shoulder… Read more about this study

Who is it for?: Ages 18 to 45 years, men only
Conditions the study is for: Glenohumeral Internal Rotation Deficit (GIRD)
What is being tested?: stretches, strengthening and mobilization with movement
Could I receive a placebo?: No, everyone receives an active treatment
How many people: 50 participants
Where: 2 sitesPakistan
Study dates: 15 Feb 2025to 15 Mar 2026
Phase: Interventional
Are there results?: Yes, posted in the registrySummary in the doctors' view

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 18 to 45 years
Men only
No healthy volunteers
Adult

Who may be able to join

Male cricketers aged 18-45 years.
Participants experiencing persistent mild to moderate shoulder pain during overhead movements for more than 3 months.
Fast bowlers actively participating in regular cricket training sessions.
Presence of Glenohumeral Internal Rotation Deficit (GIRD) greater than 10 degrees, measured with a goniometer by comparing internal rotation of the dominant and non-dominant shoulders.

Who cannot join

Cricketers who have undergone shoulder (e.g., rotator cuff repair, arthroscopic labrum repair) or elbow surgery within the past 3 months.
Participants presenting with numbness or tingling sensations in the upper extremity.
Individuals with comorbidities such as a history of cardiac or pulmonary diseases.
Subjects with a history of recurrent shoulder dislocations or shoulder instability.

Trial locations and contacts

2 sites in 1 country.

Pakistan2 sites

Sehat Medical Complex
Lahore, Punjab Province, 54000
Bata Sports Club
Lahore, Punjab Province, 54850

Other trials in Pakistan

About this study

Official title: Combined Effects of Mulligan Mobilization With Movement and Kinetic Medial Rotation Control for Shoulder on Pain, Range of Motion, and Function Among Fast Bowlers

The goal of this clinical trial is to determine combined effects of the Kinetic control for shoulder on pain, range, and function among fast bowlers. The main question it aims to answer is:

Does mulligan mobilization with movement along with kinetic medial rotation control work in decreasing pain, improving shoulder internal range of motion and shoulder function in fast bowlers with glenohumeral internal rotation deficit? Is the combination of Mulligan mobilization with movement along with kinetic control therapy effective in fast bowlers with glenohumeral internal rotation deficit? Treatment arm will receive movement retraining exercises to develop kinetic control with mulligan mobilization and comparison arm will receive standard physical therapy exercises with mulligan mobilization.

Treatment group will receive shoulder warm up exercises, movement retraining exercises and mulligan mobilization with movement.

Comparison group will receive shoulder warm up exercises, modified sleeper stretch, shoulder isometrics and mulligan mobilization with movement.

Conditions: Glenohumeral Internal Rotation Deficit (GIRD)
Being tested: Kinetic control for shoulder internal rotation with mobilization with movement, stretches, strengthening and mobilization with movement
Keywords: Overhead Athletes, Internal Rotation, Kinetic Control, Sports Injury, Musculoskeletal Disorder
Medical subject headings: Athletic Injuries, Musculoskeletal Diseases

What participants receive

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

Kinetic control for shoulder internal rotation with mobilization with movementOther
stretches and strengthening along with mobilization with movement is given to participants. stretches include sleeper stretch and isometrics in strengthening
stretches, strengthening and mobilization with movementOther
Each person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used.

Study groups in NCT07229274
Study group	Role	What they receive
Movement control exercises with the concept of kinetic control and mobilization with movement	Experimental	Each person will follow this program three times a week. The session starts with a shoulder movement test to check how well the shoulder rotates-60 degrees inward and 45 degrees outward-without the shoulder blade or upper arm moving incorrectly. Next, movement retraining exercises are used to fix any incorrect shoulder movements. This includes helping the shoulder and shoulder blade move properly using hands-on support, along with exercises that may be supported or unsupported. Visual cues (like mirrors), touch, and manual guidance are used to teach correct movement. Lastly, Mobilization with Movement (MWM) is performed. This involves gently pushing the shoulder joint backward Receives: Other: Kinetic control for shoulder internal rotation with mobilization with movement
Stretches, strengthening and mobilization with movement	Active comparator	Each person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used. Receives: Other: stretches, strengthening and mobilization with movement

What is being measured

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

Pain Intensity
Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS) ranging from 0 to 10, where 0 indicates no pain, 1-3 represents mild pain, 4-6 indicates moderate pain, and 7-10 reflects severe pain.
Measured: From enrollment to the end of treatment at 6 weeks
Shoulder Range of Motion
Shoulder range of motion will be measured in all planes of movement using a universal goniometer. The movements will include:
Internal Rotation (0-90°) All measurements will be recorded in degrees to assess improvement in joint mobility across these planes.
Measured: From enrollment to the end of treatment at 6 weeks
Functional Disability
Functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI), which provides a percentage score ranging from 0 to 100%. A low score (0-29%) represents minimal disability, a moderate score (30-59%) indicates moderate disability, and a high score (60-100%) signifies severe functional limitation.
Measured: From enrollment to the end of treatment at 6 weeks

Timeline

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

15 Feb 202515 Mar 2026

First posted14 Nov 2025
Study start15 Feb 2025
Primary completion15 Feb 2026
Study completion15 Mar 2026

Resources

Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
Other trials for Glenohumeral Internal Rotation Deficit (GIRD)Studies of the same condition, open and under way.
More trials run by Lahore University of Biological and Applied SciencesThe 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: Single blind
Who is masked: Outcomes assessor
Enrolment: 50 participants (actual)

IDs, dates and publications

ClinicalTrials.gov ID: NCT07229274
Sponsor's protocol ID: UBAS/ERB/FoRS/25/022
Acronym: RCT
Status last verified: Jun 2026
First submitted: 2 Oct 2025
Last updated: 10 Aug 2026
Results posted: Yes, on ClinicalTrials.gov
Data monitoring committee: Yes
FDA-regulated drug: No
FDA-regulated device: No
Individual data sharing: Undecided

Study at a glance

From the registry record, last updated by the sponsor on 10 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.

Official title: Combined Effects of Mulligan Mobilization With Movement and Kinetic Medial Rotation Control for Shoulder on Pain, Range of Motion, and Function Among Fast Bowlers
ClinicalTrials.gov ID: NCT07229274
Acronym / sponsor ID: RCT / UBAS/ERB/FoRS/25/022
Conditions: Glenohumeral Internal Rotation Deficit (GIRD)
Keywords: Overhead Athletes, Internal Rotation, Kinetic Control, Sports Injury, Musculoskeletal Disorder
Study type: Interventional
Recruitment status: Completed
Enrolment: 50 participants (actual)
Lead sponsor: Lahore University of Biological and Applied SciencesUniversity, hospital or other
Study start: 15 Feb 2025 (actual)
Primary completion: 15 Feb 2026 (actual)
Study completion: 15 Mar 2026 (actual)
First posted: 14 Nov 2025 (actual)
Results: Posted 10 Aug 2026

Clinical summary

The research question as the sponsor registered it. This describes what the study plans to test, not what it found.

The goal of this clinical trial is to determine combined effects of the Kinetic control for shoulder on pain, range, and function among fast bowlers. The main question it aims to answer is:

Treatment group will receive shoulder warm up exercises, movement retraining exercises and mulligan mobilization with movement.

Comparison group will receive shoulder warm up exercises, modified sleeper stretch, shoulder isometrics and mulligan mobilization with movement.

Study design

Primary purpose: Treatment
Allocation: Randomised
Intervention model: Parallel groups
Masking: Single blind (outcomes assessor)
Number of arms: 2

Arm	Type	Receives
Movement control exercises with the concept of kinetic control and mobilization with movement	Experimental	Other: Kinetic control for shoulder internal rotation with mobilization with movementEach person will follow this program three times a week. The session starts with a shoulder movement test to check how well the shoulder rotates-60 degrees inward and 45 degrees outward-without the shoulder blade or upper arm moving incorrectly. Next, movement retraining exercises are used to fix any incorrect shoulder movements. This includes helping the shoulder and shoulder blade move properly using hands-on support, along with exercises that may be supported or unsupported. Visual cues (like mirrors), touch, and manual guidance are used to teach correct movement. Lastly, Mobilization with Movement (MWM) is performed. This involves gently pushing the shoulder joint backward
Stretches, strengthening and mobilization with movement	Active comparator	Other: stretches, strengthening and mobilization with movementEach person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used.

Who may qualify

Ages: 18 to 45 years
Sex: Male only
Healthy volunteers: Not accepted
Age groups: Adult

Key inclusion criteria (4 listed)

Male cricketers aged 18-45 years.
Participants experiencing persistent mild to moderate shoulder pain during overhead movements for more than 3 months.
Fast bowlers actively participating in regular cricket training sessions.
Presence of Glenohumeral Internal Rotation Deficit (GIRD) greater than 10 degrees, measured with a goniometer by comparing internal rotation of the dominant and non-dominant shoulders.

Key exclusion criteria (4 listed)

Cricketers who have undergone shoulder (e.g., rotator cuff repair, arthroscopic labrum repair) or elbow surgery within the past 3 months.
Participants presenting with numbness or tingling sensations in the upper extremity.
Individuals with comorbidities such as a history of cardiac or pulmonary diseases.
Subjects with a history of recurrent shoulder dislocations or shoulder instability.

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
Kinetic control for shoulder internal rotation with mobilization with movementstretches and strengthening along with mobilization with movement is given to participants. stretches include sleeper stretch and isometrics in strengthening	Other	Movement control exercises with the concept of kinetic control and mobilization with movement
stretches, strengthening and mobilization with movementEach person in the control group will do these exercises three times a week. The session starts with shoulder warm-up exercises like arm circles, shoulder rolls, and reaching overhead. These are done in 2 sets of 10 reps. Next is the modified sleeper stretch. This is repeated 3 times, with a 30-second rest between each stretch. Then, isometric shoulder exercises are done in standing. The person pushes their arm inward against resistance without actually moving it. Finally, Mobilization with Movement (MWM) is used.	Other	Stretches, strengthening and mobilization with movement

Primary outcome

Pain Intensity
Time frame: From enrollment to the end of treatment at 6 weeks
Pain intensity will be evaluated using the Numeric Pain Rating Scale (NPRS) ranging from 0 to 10, where 0 indicates no pain, 1-3 represents mild pain, 4-6 indicates moderate pain, and 7-10 reflects severe pain.
Shoulder Range of Motion
Time frame: From enrollment to the end of treatment at 6 weeks
Shoulder range of motion will be measured in all planes of movement using a universal goniometer. The movements will include: Internal Rotation (0-90°) All measurements will be recorded in degrees to assess improvement in joint mobility across these planes.
Functional Disability
Time frame: From enrollment to the end of treatment at 6 weeks
Functional disability will be assessed using the Shoulder Pain and Disability Index (SPADI), which provides a percentage score ranging from 0 to 100%. A low score (0-29%) represents minimal disability, a moderate score (30-59%) indicates moderate disability, and a high score (60-100%) signifies severe functional limitation.

Results and safety

Results posted to the registry on 10 Aug 2026, as reported by the sponsor. Figures are copied from the record, not re-analysed. Full results on ClinicalTrials.gov.

Participant flow

Group	Started	Completed
Movement Control Exercises With the Concept of Kinetic Control and Mobilization With Movement	25	25
Stretches, Strengthening and Mobilization With Movement	25	25

Primary outcome: Pain Intensity

Time frame: From enrollment to the end of treatment at 6 weeks. Mean (Standard Deviation). Unit: Score on scale

Measure	Movement Control Exercises With the Concept of Kinetic Control and Mobilization With Movement n = 25	Stretches, Strengthening and Mobilization With Movement n = 25
Value	0.96 (0.34)	1.36 (0.86)

Population analysed: The Outcome Measure Time Frame and/or Measure Description has been revised to clarify that only the final assessment values collected at 6 weeks were analyzed and reported in the data table. Although assessments were performed at baseline and 3 weeks, these interim time points were not pre-specified for separate outcome reporting and therefore are not included in the presented results.

Primary outcome: Shoulder Range of Motion

Time frame: From enrollment to the end of treatment at 6 weeks. Mean (Standard Deviation). Unit: Degrees

Measure	Movement Control Exercises With the Concept of Kinetic Control and Mobilization With Movement n = 25	Stretches, Strengthening and Mobilization With Movement n = 25
Value	73.83 (6.72)	67.96 (5.72)

Population analysed: The final assessment values collected at 6 weeks were analyzed and reported in the data table. Although assessments were performed at baseline and 3 weeks, these interim time points were not pre-specified for separate outcome reporting and therefore are not included in the presented results. Because the participants had internal rotation deficit, so only internal rotation range of shoulder was measured as an outcome of the treatment.

Primary outcome: Functional Disability

Time frame: From enrollment to the end of treatment at 6 weeks. Mean (Standard Deviation). Unit: Score on Scale

Measure	Movement Control Exercises With the Concept of Kinetic Control and Mobilization With Movement n = 25	Stretches, Strengthening and Mobilization With Movement n = 25
Value	27.76 (12.36)	38.58 (9.57)

Adverse events

Time frame: Adverse events were monitored during the 6-week intervention period. Other adverse events reported at 3% frequency or more

Group	Serious adverse events	Other adverse events	Deaths
Movement Control Exercises With the Concept of Kinetic Control and Mobilization With Movement	0 of 25 (0%)	1 of 25 (4%)	0 of 25
Stretches, Strengthening and Mobilization With Movement	0 of 25 (0%)	2 of 25 (8%)	0 of 25

Limitations and caveats (from the sponsor): Pressure Biofeedback unit wasn't used to stabilize glenohumeral joint movement for any excessive or irrelevant movement

Loading the posted results from ClinicalTrials.gov…

Research links

Official record on ClinicalTrials.govLast updated by the sponsor 10 Aug 2026.
Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
Individual participant dataSharing planned: Undecided

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.

Hammad Haider, MS-MSK PT principal investigator

Lahore University of Biological and Applied Sciences

2 sites in 1 country: see every site and its status.

Questions about this trial

What is this clinical trial studying?

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 4 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 10 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Pakistan. 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?

Yes. Results are posted in the registry (first posted 10 Aug 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Pain Intensity (time frame: From enrollment to the end of treatment at 6 weeks). The study lists 3 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 NCT07229274.

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 10 Aug 2026.