The Acute Effect of a Mobilization With Movement Technique to Improve Internal Rotation of the Shoulder
Condition: Disorder of Shoulder; Other Musculoskeletal Disorder; Contracture
MeSH terms: Contracture; Musculoskeletal Diseases
Study type: Interventional
Phase: Early Phase 1

Summary: 
      For many years researchers have been documented that the shoulder of the throwing athlete
      acquires a increase in external rotation of the dominant limb compared to the contralateral
      side.This fact is followed with a loss of the internal rotation of the shoulder, which is
      related with a higher rate of injuries in this joint and it´s known as Glenohumeral Internal
      Rotation Deficit (GIRD).

      Among the approaches for this condition the literature is inconclusive due to the low
      methodological quality of clinical trials made,however, the manual therapy has been used with
      success to relief the pain and restore the range of motion.

      The purpose of this study is to analyse the effectiveness of a mobilization with movement
      technique to improve the internal rotation of the shoulder in throwing athletes with GIRD.

      It will be a randomized controlled trial with the CONSORT bases with 40 participants that
      will be divided into two groups:

        -  Control group that will be submitted for an evaluation of shoulder range of motion
           (internal/external rotation)of both limbs, upper limb active movements to warm-up (five
           minutes), posterior capsule stretching (Cross-body stretch for 3 sets of 30 seconds) and
           revaluation immediately post-intervention and four weeks post-intervention.

        -  Mobilization group that will be submitted for an evaluation of shoulder range of motion
           (internal/external rotation)of both limbs, upper limb active movements to warm-up(five
           minutes), posterior capsule stretching (Cross-body stretch for 3 sets of 30 seconds)
           plus a mobilization with movement technique to improve internal rotation of the dominant
           shoulder (three sets of 10 repetitions)and revaluation immediately post-intervention and
           four weeks post-intervention.

      To evaluate the range of movement it will be use a standard goniometer with an attached
      customizes bubble inclinometer to ensure proper perpendicular alignment of the goniometer to
      the ground.

      The investigators hypothesis is that both group will have improvements in the internal
      rotation of the dominant shoulder, however, the mobilization group will have a statistically
      significant difference compared to control group immediately post-intervention. Four weeks
      post-intervention this difference will equalize, because of the only intervention applied.

      Results will be expressed as hazard ratios (HR) with their respective confidence intervals at
      95% and adopting α = 0.05. All analyzes will be performed by SPSS version 17.0
    


Intervention name(s): Posterior capsule stretching; Mobilization with movement
Intervention type(s): Other; Other
Intervention description(s): Control group that will be submitted for an evaluation of shoulder range of motion (internal/external rotation)for both limbs, upper limb active movements to warm-up (five minutes), posterior capsule stretching (Cross-body stretch for 3 sets of 30 seconds) and revaluation immediately post-intervention and four weeks post-intervention.; Mobilization group that will be submitted for an evaluation of shoulder range of motion (internal/external rotation) for both limbs, upper limb active movements to warm-up (five minutes), posterior capsule stretching (Cross-body stretch for 3 sets of 30 seconds) plus a mobilization with movement to improve internal rotation of the dominant shoulder (three sets of 10 repetitions)and revaluation immediately post-intervention and four weeks post-intervention.
Other intervention name(s): Control group; Experimental Group
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Physical Therapy; Glenohumeral Internal Rotation Deficits; Joint Mobilization; Posterior capsule; Capsular contracture