ClinicalTrials.gg
Enrolling by invitationNCT06326177Updated Jul 24, 2024

Investigating Association Between Spine, Scapular, Shoulder and Core in Swimmers

An observational study in Postural Kyphosis, Postural Lordosis and Movement, Abnormal, sponsored by Yeditepe University. Enrolling by invitation at 1 site in Turkey. Open to participants aged 12 Years to 24 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-24.

Sponsored by Yeditepe University · Observational

From the registry’s dates

  • Primary completion was expected by Oct 2024, 2 years 1 month ago, but the record still lists the study as enrolling by invitation.
Study type
Observational
Model
Cohort
Time perspective
Cross-sectional
Enrollment
44
Ages
12 Years to 24 Years
Sex
All
01

Study summary

The aim of this observational study is to investigate relationship between cervical, thoracic, lumbar and thoracolumbar spine posture, spine movement, isometric and eccentric shoulder strength, scapular dyskinesis and core muscle endurance in healthy competitive young swimmers in comparison with healthy recreational swimmers. The main question is whether spine posture affects spine movement, shoulder strength, scapular dyskinesia and core endurance. Participants will asked to complete a warm up period, after that spine posture, spine movement, scapular dyskinesia, shoulder strength and core endurance will be assessed by examiner. Researchers will compare competitive swimmer group and recreational swimmer group. Additionally correlation between spine posture, spine movement, scapular dyskinesia, shoulder strength and core muscle endurance will be investigated in competitive swimmer group. Aim of the study is to determine whether posture have any effect upon these parameters.

Read the detailed description

The aim of this observational study is to investigate relationship between cervical, thoracic, lumbar and thoracolumbar spine posture, spine movement, scapular dyskinesia, shoulder strength and core muscle endurance in healthy competitive youth swimmers in comparison with healthy recreational swimmers. Study expected to include 44 participants which is distributed into experiment (n=22) and control (n=22) groups. The participants will be taken from Turkish swimming clubs which are Fenerbahçe, Galatasaray, ENKA, etc. between march and may of 2024. All of the research will be done in PT Academy clinic which is located in Turkey. The ages of the swimmers will be between 12-24. Experiment group should be a competitive swimmer that were also, participating swimming training in 6 days a week which is consisting of at least 12 hours of swimming training. They should pass Turkish swimming championship qualification times in order to participate in this study. Participants who have any systemic, neurologic, tumoral and cardiopulmonary pathologies excluded. Swimmers that compete in open water races are excluded. Participants that had orthopedic problem or surgical procedure in the past 6 months had been excluded. Inclusion criteria of the control group are different than the experiment group. They don't need to be a competitive swimmer as well as they don't need prerequisites of being a competitive swimmer. But, exclusion criteria remained same with experimental group except being open water swimmer. Before assessments participants will perform 10 minutes of warm up consisting of thigh, arm and core muscles as well as steady state aerobic exercise. Cervical lordosis, thoracal kyphosis, lumbar lordosis and thoracolumbar position degree will be assessed with double inclinometer. Core endurance will be assessed with trunk anterior flexion test, trunk posterior extensor test and lateral plank test. Ratios of core endurance parameters will be used in statistical analysis in order to compare with normative data. Spinal movement will be assessed via bubble inclinometer. For spinal movement cervical, lumbar, thoracal and thoracolumbar flexion and extension motion will be assessed. Also, thoracal and thoracolumbar rotation range of motion will be recorded. Scapular dyskinesia test will be used in order to assess scapular dyskinesia. Shoulder strength will be assessed via using microfet hand held dynamometer. Both isometric and eccentric shoulder external rotation strength will be measured. Ratios between these two values will be used in the statistical analysis. Results will be compared with each other between competitive and recreational swimmer group. SPSS analysis system will be used in order to make statistical analysis. For mean analysis t test or Mann Whitney u test will be used according to distributions of the groups. For the correlation analysis regression and mediation analysis will be used. Mean comparison will be done in between group setting. On the other hand correlation investigation of parameters will be done within group setting only including competitive swimmer group. As a result difference between recreational and competitive swimmers will be revealed as well as association between posture and other variables will be revealed with correlation between parameters.

02

Conditions studied

  • Postural Kyphosis
  • Postural Lordosis
  • Movement, Abnormal
  • Spine Injury
  • Cervical Lordosis
03

In context

Dyskinesias

179 studies on the registry are indexed under Dyskinesias; 24 are open to participants now.

This study's planned enrollment of 44 is below the median of 54 across 35 observational studies indexed under Dyskinesias.

Browse Dyskinesias studies →

Lead sponsor

Yeditepe University is the lead sponsor of 131 studies on the registry; 29 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
12 Years to 24 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Study population will be selected from swimmers in Fenerbahçe, Galatasaray, ENKA, İstek and TOHM clubs. Study takes place in İstanbul. Study will include swimmers that are also swimming in USA for their university teams due to their education which are also competing in Turkey for their aforementioned clubs in the Turkish Championship. Participant pool approximately between 200-300 swimmers. Both gender will be included.

Eligibility criteria

Inclusion Criteria:

  • Being a competitive swimmer.
  • Being between 12-24 ages.
  • Participating swimming training at least 6 days a week.
  • Swimming faster than Turkish National Championship participation qualification times in their age group.
  • Participating swimming training at least 12 hours a week.
  • Should start swimming at least 6 years before.

Exclusion Criteria:

  • Being an open water swimmer.
  • Having systemic, cardiopulmonary and neurological pathology.
  • Having orthopedic pathology in the past 6 months.
  • Having surgical history in past 6 months.
  • Having tumoral condition.
  • Having spine pathology in past 6 months.

Inclusion criteria for control group:

  • Being a recreational swimmer.
  • Being between 12-24 ages.

Exclusion criteria for control group:

  • Having systemic, cardiopulmonary and neurological pathology.
  • Having orthopedic pathology in the past 6 months.
  • Having surgical history in past 6 months.
  • Having tumoral condition.
  • Having spine pathology in past 6 months.
05

Study design

Observational model
Cohort
Time perspective
Cross-sectional
Enrollment
44 participants (estimated)
Target follow-up
1 Day
Patient registry
Yes

Groups and cohorts

  • Competitive Swimmer Group

    Spine posture, spine movement, scapular dyskinesia, ısometric and eccentric shoulder strength and core muscle endurance will be assessed.

    Procedure: Spine Posture Assessment · Procedure: Spine Movement Assessment · Procedure: Core Muscle Endurance Assessment · Procedure: Scapular Dyskinesia · Procedure: Shoulder Strength

  • Recreational Swimmer Group

    Spine posture, spine movement, scapular dyskinesia, ısometric and eccentric shoulder strength and core muscle endurance will be assessed.

    Procedure: Spine Posture Assessment · Procedure: Spine Movement Assessment · Procedure: Core Muscle Endurance Assessment · Procedure: Scapular Dyskinesia · Procedure: Shoulder Strength

Interventions

  • ProcedureSpine Posture Assessment

    Spine posture will be assessed with double inclinometer method. After determining landmarks for each assessment, inclinometers will be placed and degree will be noted. Both degree which are obtained with different inclinometers will be used to summed up for determining postural alteration degree. Cervical, thoracal, thoracolumbar and lumbar spinal postures will be used. Spine postures are going to be expressed as, cervical lordosis degree, thoracal kyphosis degree, thoracolumbar posture degree and lumbar lordosis degree. Landmarks for cervical lordosis are C2 and C7, for thoracal kyphosis are T1 and T12, for lumbar lordosis are T12 and S1, for thoracolumbar posture C7 and S1.

  • ProcedureSpine Movement Assessment

    Spine movement will be assessed via using bubble inclinometer in terms of degree. Bony landmarks will be spotted like done in spine posture assessment after that full spinal flexion and extension wanted in order to record degrees in inclinometers at the end range. As a result the difference between two inclinometer will give the motion of that segment. Lumbar and thoracolumbar spinal movement will be assessed with this method. For thoracal and cervical range of motion values will be recorded separately without substruction from both inclinometer. Thoracal rotation range of motion will be assessed with two landmarks and will be recorded separately according to landmark. Thoracolumbar range of motion will be assessed with two substruction of degrees. Landmarks for cervical range of motion are vertex and C7, for thoracal range of motion are T1 and T12, for lumbar range of motion are T12 and S1, for thoracolumbar range of motion C7 and S1.

  • ProcedureCore Muscle Endurance Assessment

    Core muscle endurance is divided into three components. Trunk anterior flexion test will be used to assess anterior core region endurance. Lateral plank test will be used to determine lateral core muscle endurance. Trunk posterior extensor test will be used to determine endurance of the posterior core musculature. All of these test are calculated in predetermined positions according to literature with static contractions. Maximum duration of maintaining that position is needed. In trunk anterior flexion test participant will sit with 60 degree inclination from the ground while making contact with their feet when hips and knees are flexed. In lateral plank test participants should place their elbow to ground and lift their hip while feet are in contact with ground in side lying position. In trunk extensor endurance test participants will lie prone to the bed while maintaining contact with their ASIS and lower extremity. The upper body should stay outside of the bed.

  • ProcedureScapular Dyskinesia

    Scapular dyskinesia will be assessed with scapular dyskinesia test. Dumbbells which are 1,5kg will be used in the testing setting. Participant will perform full shoulder abduction for 5 times while examiner assesses the movement quality by ranking it as subtle dyskinesis, obvious dyskinesis and no dyskinesis according to the movement of the scapula. After that participant will perform 5 repetitions of shoulder flexion.

  • ProcedureShoulder Strength

    Shoulder strength will be assessed via usage of microfet hand held dynamometer. Isometric shoulder strength will be calculated in supine lying position while participant holding their arm at side with 90 degree elbow flexion. After that participant will apply maximal contraction towards external rotation while examiner resists that motion in order to prevent any motion with dynamometer. Eccentric shoulder strength will be assessed in sitting position. Participant will hold their shoulder at 90 degrees of abduction with 90 degree external rotation. Also elbow should be in 90 degree flexed position. After that examiner will give force towards neutral rotation while holding the arm. Participant will resist this motion eccentrically until neutral rotation is reached. Velocity of the shoulder should be same throughout all motion due to creation of isokinetic environment.

06

What researchers measure

Primary outcomes

  1. Spinal Posture

    Cervical lordosis, thoracal kyphosis, lumbar lordosis and thoracolumbar posture will be recorded. All parameters will be calculated in degree.

    Time frame: 1 Day

  2. Cervical Movement

    Cervical flexion and extension will be calculated. All parameters will be calculated in degree.

    Time frame: 1 Day

  3. Thoracic Movement

    Thoracic flexion and extension will be recorded. Also thoracal rotation will be recorded. All parameters will be calculated in degree.

    Time frame: 1 Day

  4. Lumbar Movement

    Lumbar flexion and extension will be recorded. All parameters will be calculated in degree.

    Time frame: 1 Day

  5. Thoracolumbar Movement

    Thoracolumbar flexion and extension will be recorded. Thoracolumbar rotation will be recorded. All parameters will be calculated in degree.

    Time frame: 1 Day

Secondary outcomes

  1. Anterior Core Musculature Assessment

    Trunk anterior flexion test will be used to assess anterior core region endurance. Score will be calculated in seconds.

    Time frame: 1 Day

  2. Lateral Core Musculature Assessment

    Lateral plank test will be used to determine lateral core muscle endurance. Score will be calculated in seconds.

    Time frame: 1 Day

  3. Posterior Core Musculature Assessment

    Trunk posterior extensor test will be used to determine endurance of the posterior core musculature. Score will be calculated in seconds.

    Time frame: 1 Day

  4. Core Musculature Ratio Assessment

    Trunk anterior musculature and trunk posterior musculature ratio, ratio of two sides of lateral core musculature and lateral trunk musculature and extensor trunk musculature will be used.

    Time frame: 1 Day

  5. Shoulder Strength Assessment

    Isometric and eccentric shoulder external rotation strength will be recorded in Newton unit.

    Time frame: 1 Day

  6. Shoulder Strength Ratio Assessment

    Ratio between shoulder internal rotation and external rotation strength will be used.

    Time frame: 1 Day

  7. Scapular Dyskinesia

    Scapular dyskinesia will be recorded with Scapular Dyskinesia Test by using dumbbells which was described by McClure. Scapular dyskinesia will be measure as normal scapular motion, subtle dyskinesis and obvious dyskinesis.

    Time frame: 1 Day

07

Study locations

1 site
  • PT Academy
    Istanbul, Kadıköy 34744, Turkey
08

References and documents

Publications

  • Lewis JS, Wright C, Green A. Subacromial impingement syndrome: the effect of changing posture on shoulder range of movement. J Orthop Sports Phys Ther. 2005 Feb;35(2):72-87. doi: 10.2519/jospt.2005.35.2.72. PubMed 15773565 ↗
  • Dimitriadis Z, Parintas I, Karamitanis G, Abdelmesseh K, Koumantakis GA, Kastrinis A. Reliability and Validity of the Double Inclinometer Method for Assessing Thoracolumbar Joint Position Sense and Range of Movement in Patients with a Recent History of Low Back Pain. Healthcare (Basel). 2022 Dec 29;11(1):105. doi: 10.3390/healthcare11010105. PubMed 36611565 ↗
  • Abdelraouf OR, Abdel-Aziem AA. THE RELATIONSHIP BETWEEN CORE ENDURANCE AND BACK DYSFUNCTION IN COLLEGIATE MALE ATHLETES WITH AND WITHOUT NONSPECIFIC LOW BACK PAIN. Int J Sports Phys Ther. 2016 Jun;11(3):337-44. PubMed 27274419 ↗
  • Kolber MJ, Pizzini M, Robinson A, Yanez D, Hanney WJ. The reliability and concurrent validity of measurements used to quantify lumbar spine mobility: an analysis of an iphone(R) application and gravity based inclinometry. Int J Sports Phys Ther. 2013 Apr;8(2):129-37. PubMed 23593551 ↗
  • Salamh PA, Kolber M. The reliability, minimal detectable change and concurrent validity of a gravity-based bubble inclinometer and iphone application for measuring standing lumbar lordosis. Physiother Theory Pract. 2014 Jan;30(1):62-7. doi: 10.3109/09593985.2013.800174. Epub 2013 Jul 17. PubMed 23862655 ↗
  • Mayer TG, Tencer AF, Kristoferson S, Mooney V. Use of noninvasive techniques for quantification of spinal range-of-motion in normal subjects and chronic low-back dysfunction patients. Spine (Phila Pa 1976). 1984 Sep;9(6):588-95. doi: 10.1097/00007632-198409000-00009. PubMed 6238424 ↗
  • Laudner K, Lynall R, Williams JG, Wong R, Onuki T, Meister K. Thoracolumbar range of motion in baseball pitchers and position players. Int J Sports Phys Ther. 2013 Dec;8(6):777-83. PubMed 24377063 ↗
  • van Baalen GB, Vanwanseele B, Venter RR. Reliability and Validity of a Smartphone Device and Clinical Tools for Thoracic Spine Mobility Assessments. Sensors (Basel). 2023 Sep 2;23(17):7622. doi: 10.3390/s23177622. PubMed 37688076 ↗
  • Holt KL, Raper DP, Boettcher CE, Waddington GS, Drew MK. Hand-held dynamometry strength measures for internal and external rotation demonstrate superior reliability, lower minimal detectable change and higher correlation to isokinetic dynamometry than externally-fixed dynamometry of the shoulder. Phys Ther Sport. 2016 Sep;21:75-81. doi: 10.1016/j.ptsp.2016.07.001. Epub 2016 Jul 9. PubMed 27500450 ↗
  • Johansson FR, Skillgate E, Lapauw ML, Clijmans D, Deneulin VP, Palmans T, Engineer HK, Cools AM. Measuring Eccentric Strength of the Shoulder External Rotators Using a Handheld Dynamometer: Reliability and Validity. J Athl Train. 2015 Jul;50(7):719-25. doi: 10.4085/1062-6050-49.3.72. Epub 2015 May 14. PubMed 25974381 ↗
  • Uga D, Endo Y, Nakazawa R, Sakamoto M. Electromyographic analysis of the infraspinatus and scapular stabilizing muscles during isometric shoulder external rotation at various shoulder elevation angles. J Phys Ther Sci. 2016 Jan;28(1):154-8. doi: 10.1589/jpts.28.154. Epub 2016 Jan 30. PubMed 26957748 ↗
  • Papotto BM, Rice T, Malone T, Butterfield T, Uhl TL. Reliability of Isometric and Eccentric Isokinetic Shoulder External Rotation. J Sport Rehabil. 2016 Jun 6;25(2):2015-0046. doi: 10.1123/jsr.2015-0046. Print 2016 May 1. PubMed 26562351 ↗
  • Tate AR, McClure P, Kareha S, Irwin D, Barbe MF. A clinical method for identifying scapular dyskinesis, part 2: validity. J Athl Train. 2009 Mar-Apr;44(2):165-73. doi: 10.4085/1062-6050-44.2.165. PubMed 19295961 ↗
  • McClure P, Tate AR, Kareha S, Irwin D, Zlupko E. A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train. 2009 Mar-Apr;44(2):160-4. doi: 10.4085/1062-6050-44.2.160. PubMed 19295960 ↗
  • McFarland C, Wang-Price S, Richard S. Clinical measurements of cervical lordosis using flexirule and inclinometer methods in individuals with and without cervical spine dysfunction: A reliability and validity study. J Back Musculoskelet Rehabil. 2015;28(2):295-302. doi: 10.3233/BMR-140517. PubMed 25096317 ↗
  • Tawde P, Dabadghav R, Bedekar N, Shyam A, Sancheti P. Assessment of cervical range of motion, cervical core strength and scapular dyskinesia in violin players. Int J Occup Saf Ergon. 2016 Dec;22(4):572-576. doi: 10.1080/10803548.2016.1181892. Epub 2016 May 27. PubMed 27232160 ↗
  • Wolfenberger VA, Bui Q, Batenchuk GB. A comparison of methods of evaluating cervical range of motion. J Manipulative Physiol Ther. 2002 Mar-Apr;25(3):154-60. doi: 10.1067/mmt.2002.122327. PubMed 11986576 ↗

Individual participant data

Plan to share: Undecided — Only result and certain characteristics may be shared.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Aug 2024; primary completion for Oct 2024, 1 month later.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 5, 2024
First posted
Mar 22, 2024
StartEst.
Aug 10, 2024
Primary completionEst.
Oct 1, 2024
CompletionEst.
Dec 1, 2024
Last update
Jul 24, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 24, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06326177
Responsible party
Poyraz Tuncer (Physiotherapist, Yeditepe University) — Principal investigator
First posted
Mar 22, 2024
Start date
Aug 10, 2024 (estimated)
Primary completion
Oct 1, 2024 (estimated)
Completion
Dec 1, 2024 (estimated)
Last update
Jul 24, 2024

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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