IRCT | Investigation and Comparison of the Efficacy of Standard Corrective Exercises versus Sensorimotor Exercises on Improving Shoulder Proprioception in Overhead Athletes with Scapular Dyskinesis.

Protocol summary

Study aim: Investigation and Comparison of the Efficacy of Standard Corrective Exercises versus Sensorimotor Exercises on Improving Shoulder Joint Proprioception in Overhead Athletes with Scapular Dyskinesis
Design: A randomized, single-blind (participant-blinded), controlled, parallel-group clinical trial involving 24 patients. Block randomization will be used for random allocation.
Settings and conduct: Volunteers presenting to Dr. Rezaian's physiotherapy clinic in Isfahan during the study will be enrolled, if they meet the eligibility criteria and will be randomly allocated to the intervention and control groups using block randomization. The study will be conducted as a single-blind trial.
Participants/Inclusion and exclusion criteria: Inclusion: Athletes (18-45 yrs) with at least 3 yrs experience - dominant scapular dyskinesia - shoulder abduction/flexion ability - no similar training (past 3 months), BMI 18.5-26.9 ؛ Exclusion: Shoulder/upper limb injury (past 6 months), shoulder/upper limb/spine surgery - neuromuscular/rheumatologic/systemic diseases - active shoulder/elbow/wrist pain - spinal/thoracic abnormalities - pregnancy/lactation.
Intervention groups: Group 1: Participants will undergo standard corrective exercises for scapular dyskinesis. The intervention will be conducted over 4 weeks with 3 sessions per week. Each treatment session will last between 40 to 50 minutes with 45 to 60 seconds of rest allocated between each set or exercise. Group 2: Participants will undergo a sensorimotor exercise intervention. The intervention will be implemented over 4 weeks with 3 sessions per week. Each treatment session will last approximately 30 to 40 minutes with 45 to 60 seconds of rest allocated between each set or exercise.
Main outcome variables: Shoulder Joint Proprioception, Upper Extremity Performance, Scapular Dyskinesis

General information

Reason for update
Acronym: -
IRCT registration information: IRCT registration number: IRCT20180711040419N4

Registration date: 2026-06-14, 1405/03/24

Registration timing: prospective

Last update: 2026-06-14, 1405/03/24

Update count: 0
Registration date: 2026-06-14, 1405/03/24

Registrant information: Name

Katayoon Rezaei

Name of organization / entity

Country

Iran (Islamic Republic of)

Phone

+98 71 3627 1551

Email address

rezaeik@sums.ac.ir

Recruitment status: Not yet recruiting
Funding source

Expected recruitment start date: 2026-06-22, 1405/04/01
Expected recruitment end date: 2026-11-22, 1405/09/01
Actual recruitment start date: empty
Actual recruitment end date: empty
Trial completion date: empty

Scientific title: Investigation and Comparison of the Efficacy of Standard Corrective Exercises versus Sensorimotor Exercises on Improving Shoulder Proprioception in Overhead Athletes with Scapular Dyskinesis.

Public title: The Effect of Standardized Corrective Exercise on Shoulder Joint Proprioception in Overhead Athletes with Scapular Dyskinesis: A Randomized Controlled Trial
Purpose: Other
Inclusion/Exclusion criteria: Inclusion criteria:

Age between 18 and 45 years. Athletes in overhead sports (e.g., volleyball, basketball, handball) with at least 3 years of regular training experience. Presence of scapular dyskinesis in the dominant limb. Ability to perform shoulder abduction and flexion without severe limitations or functional impairment (i.e., defined as the inability to perform at least 90 degrees of flexion or abduction, or the presence of severe pain (VAS > 7)). No participation in similar training programs within the past 3 months. Body Mass Index (BMI) between 18.5 and 26.9.

Exclusion criteria:

History of structural injuries to the shoulder or upper extremity within the past 6 months (e.g., fracture, dislocation, rotator cuff tear, or labral tear). History of surgery involving the shoulder, upper extremity or spine. Neuromuscular, rheumatologic, or systemic diseases affecting proprioception (e.g., diabetes, rheumatoid arthritis, thoracic outlet syndrome, cervical radiculopathy, etc.). Presence of acute and active pain in the shoulder, elbow or wrist at the time of testing or during activities of daily living. Evident structural abnormalities of the spine or thoracic cage, such as kyphosis or scoliosis, that may influence shoulder movement patterns. Pregnancy or breastfeeding in female athletes.
Age: From 18 years old to 45 years old
Gender: Both

Phase

N/A

Groups that have been masked

Participant
Data analyser

Sample size

Target sample size: 24

Randomization (investigator's opinion)

Randomized

Randomization description

Participants will be randomly allocated to one of two groups using block randomization. A block size of 4 and a total of 6 blocks will be used.

Blinding (investigator's opinion)

Single blinded

Blinding description

The random sequence will be generated prior to the start of the study by an independent individual, and opaque sealed envelopes will be used for allocation concealment. After each participant is enrolled, the corresponding envelope will be opened and the intervention group will be assigned. Data analysts will also be blinded to participant group assignment through coding in order to minimize the risk of bias.

Placebo

Not used

Assignment

Parallel

Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee: Name of ethics committee

Ethics committee of Shiraz University of Medical Sciences

Street address

Zand St., Imam Hossein Square, Shiraz Medical School, Building No. 3, Third Floor, Vice Chancellor for Research, Medical School

City

Shiraz

Province

Fars

Postal code

7134845794
Approval date: 2026-05-12, 1405/02/22
Ethics committee reference number: IR.SUMS.REHAB.REC.1405.002

Health conditions studied

1

Description of health condition studied: Scapular Dyskinesis
ICD-10 code
ICD-10 code description

Primary outcomes

1

Description: Shoulder Joint Proprioception
Timepoint: The absolute Angular Error of active shoulder joint reconstruction is measured before and after the exercises in both groups.
Method of measurement: The absolute Angular Error of active regeneration of the dominant shoulder joint is measured using an isokinetic device in three movements of internal and external rotation (45 °) and flexion (90 °).

Secondary outcomes

1

Description: Upper extremity performance
Timepoint: The mean scores of upper extremity performance are measured before and after the exercises in both groups.
Method of measurement: Quick-Disabilities of the Arm, Shoulder and Hand questionnaire includes 11 questions. Scoring 1 to 5, calculated as (average × 25).

2

Description: Scapular Dyskinesis
Timepoint: The mean scores of the scapular movement pattern are measured in the scapular Dyskinesis test before and after the exercises in both groups.
Method of measurement: Scapular Dyskinesis Test

Intervention groups

1

Description: Intervention group: Participants in the intervention group will only undergo standard corrective exercises for scapular dyskinesis. This combined protocol is based on the clinical guideline provided by Seitz at the Denver Shoulder Specialty Clinic, which has demonstrated effectiveness in correcting shoulder position and movement. The intervention will last for 4 weeks, with 3 sessions per week. Each treatment session will last between 40 to 50 minutes (warming-up, corrective exercises, cooling down), and to maintain exercise quality and prevent early muscle fatigue, rest periods of 45 to 60 seconds will be allocated between sets or exercises. Throughout all sessions, the number of repetitions will be kept constant to preserve the quality of each movement. During the treatment, participant body positions (including head, neck, shoulder, and scapula posture) will be monitored and corrected in sitting and standing positions. The exercises in this group follow three main axes: stretching shortened muscles, strengthening weak muscles, and motor control exercises to correct scapular functional patterns. Exercises will start with low intensity and progress gradually according to the principle of overload. The weekly progression pattern of the exercises is as follows: in the first week, focus is on correcting posture, reducing movement constraints, and initial activation of stabilizer muscles, with exercises performed at an easy and manageable level. In the second week, range of motion and motor control are increased, and light resistance with elastic bands is added. In the third week, participants will engage in more functional and multi-joint exercises (such as Push-up Plus), with increased bodyweight challenges. In the fourth week, exercise intensity is increased by adding more resistance, including advanced exercises like Shoulder Press, as well as strengthening core muscles to stabilize the thorax and improve scapular control. Complete description of standard corrective exercises: __ Week 1: Exercises: Chin Tucks, Scapular Retraction, Arm Swing, Wall Slides Posture: Sitting / Standing Repetitions/Sets: 2–3 sets of 10–12 repetitions or 2–3 sets lasting 1–2 minutes __ Week 2: Exercises: Wall Slides + Serratus Punch, Scapular Clock, Prone Y Raise, Scapular Retraction with light resistance band Posture: Prone / Sitting / Standing Repetitions/Sets: 2–3 sets of 10–12 repetitions __ Week 3: Exercises: Pectoralis Minor stretch, Dynamic Hug, Push-Up Plus, Scapular Wall Push-Ups Posture: Standing / Functional Repetitions/Sets: 2–3 sets of 10–12 repetitions or 20–30 seconds holds __ Week 4: Exercises: External shoulder rotation with band, Lat Pull-Downs with band, Functional exercises (Shoulder Presses), Core strengthening exercises (Plank and Side Plank) Posture: Standing / Functional Repetitions/Sets: 2–3 sets of 10–12 repetitions
Category: Rehabilitation

2

Description: Control group: Participants in the control group will undergo sensorimotor exercises designed to improve proprioception, glenohumeral joint stability, and neuromuscular control of the shoulder girdle in overhead athletes with scapular dyskinesis. This intervention will be implemented over 4 weeks, with 3 sessions per week. Each treatment session will last approximately 30 to 40 minutes (warm-up, sensorimotor exercises, and cool-down), and rest periods of 45 to 60 seconds will be allocated between sets or exercises to maintain movement quality and prevent early fatigue of the stabilizer muscles. To ensure the effectiveness of the intervention, the correct execution and quality of the exercises will be supervised and corrected by a specialized physical therapist in all sessions. Furthermore, the structure of this protocol is based on progressive advancement from stable to unstable surfaces to incrementally enhance sensorimotor stimulation, neuromuscular coordination, and reactive shoulder control. In the first week, the focus is on performing exercises on stable surfaces, establishing controlled hand contact with the surface, and enhancing joint position perception. Gradually, in the second week, the exercises shift to semi-unstable surfaces, and simple, unidirectional movements are initiated. In the third week, the level of surface instability increases, and the athlete is challenged with multi-directional movements, greater movement variability, and higher weight-bearing on the upper extremity. Finally, in the fourth week, the exercises continue with more advanced challenges, such as stabilization on a ball, rapid changes in direction, and the addition of rotational and combined shoulder patterns, so that the neuromuscular system trains for faster and more precise responsiveness. Complete description of sensorimotor exercises: __ Week 1: Maintaining balance with both hands on the floor (3 sets × 30–40 seconds hold), Maintaining one, handed balance with circular movements on the wall (3 sets × 12–15 revolutions). __ Week 2: Maintaining hand balance on a balance board in a kneeling position, forward-backward movement (3 sets × 12–15 repetitions), Dynamic stabilization on a ball or single-handed (3 sets × 30–40 seconds hold). __ Week 3: Hand balance on a balance board in a kneeling position (movement in four directions0 (3 sets × 12–15 repetitions per direction), Single-handed stabilization on the floor (3 sets × 30–40 seconds hold). __ Week 4: Dynamic single-handed stabilization on a ball (3 sets × 15 repetitions), Catching a ball in a 90° abduction and 90° flexion position + performing internal-external rotation (3 sets × 15 repetitions).
Category: Rehabilitation

Recruitment centers

1

Recruitment center: Name of recruitment center

Dr. Rezaian’s Physiotherapy Clinic

Full name of responsible person

Katayoon Rezaei

Street address

Dr. Rezaian’s Physiotherapy Clinic, Unit 7, 2nd Floor, Mahan Building, near Bastani Makhsous, next to Sepah Bank, Bozorgmehr St., towards Bozorgmehr Sq. after Noorbaran Intersection

City

Isfahan

Province

Isfehan

Postal code

8153994527

Phone

+98 31 3275 1592

Email

RezaeiK@Sums.ac.ir

Web page address

1

Sponsor: Name of organization / entity

Shiraz University of Medical Sciences

Full name of responsible person

Hamid Mohammadi

Street address

Zand St., Central Building of Shiraz University of Medical Sciences, 7th floor, Vice Chancellor for Research and Technology

City

Shiraz

Province

Fars

Postal code

7134814336

Phone

+98 71 3212 2430

Email

vcrdep@sums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?: No
Title of funding source: Shiraz University of Medical Sciences
Proportion provided by this source: 100
Public or private sector: Public
Domestic or foreign origin: Domestic
Category of foreign source of funding: empty
Country of origin
Type of organization providing the funding: Academic

Person responsible for general inquiries

Contact: Name of organization / entity

Shiraz University of Medical Sciences

Full name of responsible person

Katayoon Rezaei

Position

Assistant Professor

Latest degree

Ph.D.

Other areas of specialty/work

Physiotherapy

Street address

Sadra City - After Amir Al-Momenin Burns Hospital - Shahid Doran Campus - Faculty of Rehabilitation Sciences

City

Shiraz

Province

Fars

Postal code

7198754361

Phone

+98 71 3212 2600

Email

RezaeiK@Sums.ac.ir

Person responsible for scientific inquiries

Contact: Name of organization / entity

Shiraz University of Medical Sciences

Full name of responsible person

Katayoon Rezaei

Position

Assistant Professor

Latest degree

Ph.D.

Other areas of specialty/work

Physiotherapy

Street address

Sadra City - After Amir Al-Momenin Burns Hospital - Shahid Doran Campus - Faculty of Rehabilitation Sciences

City

Shiraz

Province

Fars

Postal code

7198754361

Phone

+98 71 3212 2600

Email

rezaeik@sums.ac.ir

Person responsible for updating data

Contact: Name of organization / entity

Shiraz University of Medical Sciences

Full name of responsible person

Katayoon Rezaei

Position

Assistant Professor

Latest degree

Ph.D.

Other areas of specialty/work

Physiotherapy

Street address

Sadra City - After Amir Al-Momenin Burns Hospital - Shahid Doran Campus - Faculty of Rehabilitation Sciences

City

Shiraz

Province

Fars

Postal code

7198754361

Phone

+98 71 3212 2600

Email

rezaeik@sums.ac.ir

Sharing plan

Deidentified Individual Participant Data Set (IPD): Yes - There is a plan to make this available
Study Protocol: Yes - There is a plan to make this available
Statistical Analysis Plan: Yes - There is a plan to make this available
Informed Consent Form: Yes - There is a plan to make this available
Clinical Study Report: Yes - There is a plan to make this available
Analytic Code: Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary: Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document: Information collection, informed consent form and SPSS file
When the data will become available and for how long: After publication the results of the study
To whom data/document is available: Researchers working in academic and scientific institutions
Under which criteria data/document could be used: Only for recording information in scientific databases
From where data/document is obtainable: Correspondence with the project manager by email. rezaeik@sums.ac.ir
What processes are involved for a request to access data/document: Maximum one month after sending the request by email
Comments

Investigation and Comparison of the Efficacy of Standard Corrective Exercises versus Sensorimotor Exercises on Improving Shoulder Proprioception in Overhead Athletes with Scapular Dyskinesis.