Effect of a Novel Stretching Technique on Shoulder Range of Motion and Voluntary Contraction in Overhead Athletes With Glenohumeral Internal Rotation Deficits "GIRD"
Condition: Glenohumeral Internal Rotation Deficits
Study type: Interventional

Summary: 
      To examine and compare the effect of a novel stretching technique and traditional stretching
      on glenohumeral range of motion, strength, maximum voluntary contraction, pain, and subject
      satisfaction in overhead athletes with glenohumeral internal rotation deficits through a
      randomized clinical study.
    

Detailed description: 
      To examine and compare the effect of a novel stretching technique and traditional stretching
      on glenohumeral range of motion, strength, maximum voluntary contraction, pain, and subject
      satisfaction in overhead athletes with glenohumeral internal rotation deficits through a
      randomized clinical study. The investigators hypothesize that this type of novel intervention
      will help subjects with GIRD to restore range of motion, experience less pain and maintain
      the strength and motor unit recruitment following the novel intervention. This will help us
      to assess the potential beneficial effect of such intervention and to fill the gap in
      knowledge and help health care professionals to adequately select the right treatment
      modality.

      Independent Variable

      1. Type of Intervention:

        -  Traditional Stretching (Modified Sleep Stretch). VS

        -  Novel Stretching (Active Shoulder Internal Rotation while Bridging) 2. Time

        -  Pre VS post intervention Dependent Variables

             1. Glenohumeral internal rotation ROM

             2. Maximal glenohumeral external rotation isometric strength.

             3. Mean motor unit recruitment (EMG) of the glenohumeral external rotator
                (infraspinatus) and internal rotators (pectoralis major and latissumus dorsi)

             4. Pain

             5. Subject satisfaction

      Instrumentation :

        1. Glenohumeral internal & external rotation ROM: will be measured at baseline and at week
           four-post intervention for all participants. We will use the digital inclinometer.
           Research by (Kolber et al.,2011 ) showed this instrument to be reliable with an
           intra-rater ICC =0.87 and inter-rater ICC =0.93

        2. Electronic push/pull dynamometer: At the end feel ROM, and before ROM is measured, the
           therapist will apply the same amount of pressure to all subjects to ensure reliable/
           valid ROM measurements.

        3. Maximal Glenohumeral External Rotation Isometric Strength will be measured using a
           MicroFET2 handheld digital dynamometer. This device was shown to be reliable with an
           intra-rater ICC =0.85 and inter-rater ICC =0.85.

        4. Maximum Voluntary Contraction: will be measured using a 44 Delsys Bagnoli portable
           surface electromyography (sEMG) system.

        5. Pain: will be measured using the Numeric Pain Rating Scale (NPRS). The NPRS has shown to
           have a valid, reliable and appropriate for use in clinical practice

      Procedures:

      All participants will perform the static stretching (SS) conditions by themselves. The two
      stretching techniques will be home-based program.
    

Intervention name(s): Stretching
Intervention type(s): Procedure
Intervention description(s): The novel stretching technique will be done on a supine position. subjects will be asked bridge as high as possible. After That, Participants will then flex their shoulder and elbow to 90°. Participants will use the other hand to push to the point of mild discomfort and simultaneously maintain contraction while progressing the stretch.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment