Effects of a Therapeutic Exercise Program for Injuries Prevention in Wheelchair Basketball (WB) Players

Study Overview
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Brief Summary
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Shoulder pain is the most common symptom of physical dysfunction in wheelchair basketball players. About the 85% of this population had shoulder pain in some moment of their life. Some studies suggest that exercise is an important tool as an element to treat and prevent shoulder injuries. For that reason, an intervention program would be a useful tool for prevent shoulder injuries in this population. The purpose of this study is determine the effects of therapeutic exercise program wheelchair basketball players, in order to prevent shoulder injuries.

Detailed Description
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The hypothesis of the study was that the exercise program was effective to prevent shoulder injuries in this population.

Official Title
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Effects of a Therapeutic Exercise Program for Injuries Prevention in Wheelchair Basketball (WB) Players

Conditions
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Athletic Injuries, Shoulder Pain, Shoulder Injury

Intervention / Treatment
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* Behavioral: Exercise group


Participation Criteria
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Eligibility Criteria
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Study Population 36 wheelchair basketball players belonging to the male and female preselection Spanish wheelchair basketball national team were recruiting during a campus. The inclusion and exclusion criteria were chosen to include a specific population. Inclusion Criteria: Players belonging to the male and female preselection Spanish wheelchair basketball national team. Have the federal license at the Spanish Sport Federation for People with Physical Disabilities available at the time of the study (2015-2016 season). For players using wheelchair for daily activities, to use the manual wheelchair at least for 3 hours a day and 6 hours of wheelchair basketball training per week. For players not using wheelchair for daily activities, to use the manual wheelchair at least for 6 hours of wheelchair basketball training per week. Use wheelchair at least one year before the study and at least one year of experience in the sport competition. Acceptance of informed consent. Exclusion Criteria: History of acute injuries in the post-surgical process or dislocation along the year before the study. These conditions may affect the effective of the exercise intervention. Differential diagnosis as acute injuries at cervical region and recent traumatic injury in shoulder one year before the study. The exercise program may not be appropriate for these conditions.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise group<br>Wheelchair basketball players participating in home therapeutic exercise program that use the protocol of postural hygiene. | Behavioral: Exercise group<br>* This group will receive a home exercise program of shoulder based on mobility, strength and strengthening exercises, lasting 10 weeks, 3 times per weeks. The target dose use for mobility consisted in 8 repetitions for each 4 movements, for strengthening using resistive bands, 3 sets (including 5 exercises) of 10 repetitions with a 45 second rest between sets and 5 repetitions for each 5 strength with a 30 second rest and general protocol of postural hygiene. The instructional of the program is 30 minutes each day during the time of the study (10 weeks) with a screening about the exercise program and the daily activities performed every 4 weeks. Physiotherapist provided support to subjects through email along 10 weeks.<br>|
| No Intervention: Control group<br>Wheelchair basketball players that not participate in home therapeutic exercise program and use a protocol of postural hygiene provided. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline shoulder pain at 10 weeks | The presence of shoulder pain will be measured at the beginning and at 10 weeks with Shoulder Pain Index for Wheelchair Basketball (SPI-WB) (submitting). | Baseline and at 10 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neer test | Neer's Test assesses for possible rotator cuff impingement. Pain is a positive test. | Baseline and at 10 weeks | 
| Hawkins-Kennedy test | Hawkins-Kennedy's test indicative a possible impingement between the greater tuberosity of the humerus against the coraco- humeral ligament. | Baseline and at 10 weeks | 
| Jobe test | Jobe's test assesses for possible supraspinatus weakness and/or impingement. | Baseline and at 10 weeks | 
| Patte test | Patte's test measure for possible infraspinatus and teres minor weakness and/or impingement. | Baseline and at 10 weeks | 
| Shoulder range of motion | The range of motion will be evaluated in flexion, extension, internal rotation, external rotation and abduction with a goniometric at the beginning and at 10 weeks. | Baseline and at 10 weeks | 
| Players´ adherence to the exercise program | Players will complete a questionnaire rating their adherence to the exercise program. | At 4 and 8 weeks | 
| Players´ self-efficacy to the exercise program | Players will complete a questionnaire about the self-efficacy according to the exercise program. | Baseline | 
| Players adherence to the protocol of postural hygiene. | Players will complete a follow-up questionnaire rating their adherence to the protocol of postural hygiene. | At 4 and 8 weeks | 
| Activities performed outside of the training and exercise program. | Players will be complete a follow-up questionnaire about the activities performed outside of the training and exercise program. | At 4 and 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise Therapy, Shoulder pain, Shoulder injuries, Shoulder function, Prevention, Wheelchair users