## Protocol Section
### Identification Module
**NCT ID:** NCT04668079

**Brief Title:** Modified Cross Body Stretch Verses Modified Sleeper Stretch in Basketball Players for Posterior Capsule Tightness

**Official Title:** Comparison of Modified Cross Body Stretch and Modified Sleeper Stretch in Basketball Players for Posterior Capsule Tightness in Basketball Players

#### Organization Study ID Info
**ID:** REC/00720 Rubina Naz
#### Organization
**Class:** OTHER
**Full Name:** Riphah International University
### Status Module
#### Completion Date
**Date:** 2020-12-08

**Type:** ACTUAL

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2020-12-17

**Type:** ACTUAL

**Last Update Submit Date:** 2020-12-15

**Overall Status:** COMPLETED

#### Primary Completion Date
**Date:** 2020-11-01

**Type:** ACTUAL

#### Start Date
**Date:** 2020-04-01

**Type:** ACTUAL

**Status Verified Date:** 2020-12

#### Study First Post Date
**Date:** 2020-12-16
**Type:** ACTUAL
**Study First Submit Date:** 2020-12-09
**Study First Submit QC Date:** 2020-12-14
### Sponsor Collaborators Module

#### Lead Sponsor

**Class:** OTHER

**Name:** Riphah International University

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Is FDA Regulated Device:** False

**Is FDA Regulated Drug:** False

**Oversight Has DMC:** False

### Description Module

**Brief Summary:** The aim of this research is to compare the effect of modified cross body stretch and modified sleeper stretch on pain, range of motion, disability and throwing ability in athletes with posterior capsule tightness. Randomized controlled trials done at International Islamic University. The sample size was 32. The subjects were divided in two groups, 16 subjects in modified cross body stretch group and 16 in modified sleeper stretch group. Study duration was of 6 months. Sampling technique applied was non probability connivance sampling technique. Tools used in the study are PENN shoulder score, gonoiometer, thumb up back(TUB) and seated basketball throw test(SBBT). Data was be analyzed through SPSS 21.

**Detailed Description:** Basketball is considered as the highly demanding sports due to high demand and complexity of the game. The overhead throwing activities makes it more vulnerable to the injuries. In repetitive throwing there are different type of violet forces placed on shoulder joint It causes adaptation in soft tissue anatomically which in turn limits ROM of shoulder joint and Posterior shoulder tightness.

Posterior capsule tightness can result due to abnormal humeral head motion which decreases subacromial space during overhead activities leading to compression of tissues causing limited shoulder flexion, internal rotation and horizontal adduction. Posterior capsule tightening occurs when the capsular tissue and musculature of the shoulder tighten, usually due to "repeated overload in the eccentric portion of arm deceleration. This loss of internal rotation results from contracture and tightening of the posterior inferior portion of the glenohumeral joint capsule, which occurs from the repetitive microtrauma imparted during the deceleration phase of the throwing motion. Repetitive throwing motion creates adaptive increased external rotation and decreased internal rotation in the dominant shoulder joint which is termed as GIRD (Glenohumeral internal rotation deficit).Posterior capsule tightness is often treated without surgery. It can be treated by strengthening, stretching, neuromuscular control exercises. Strengthening protocol can perform specifically on Weak muscles by using resistance and weight. The neuromuscular training helps the body to act and react on different pattern of stress demand on it through neural pathways. The mainstay of the posterior capsule tightness treatment for athlete is the stretching of the posterior capsule. One author proposed the modified forms, the modified sleeper stretch and the modified cross body stretch. And found these modified stretching more effective and beneficial than the sleeper and cross body stretch Literature review: Kevin et al investigated the acute effects of sleeper stretch on posterior shoulder tightness and internal rotation of shoulder. There was significant improvement in results.

A study conducted in 2018 to determine whether posterior shoulder stretch was effective in increasing internal rotation and horizontal adduction ROM in volleyball and tennis players with internal rotation deficit \>¬¬15 degrees. The intervention group performs the sleeper stretch daily for 8 weeks. Results showed significant improvement in internal rotation and horizontal adduction.

Another article was published in 2014, with the aim to compare the effects of horizontal adduction stretch with scapular stabilization versus horizontal adduction stretch without scapular stabilization on posterior shoulder tightness and passive internal rotation. Results showed significant improvement among the scapular stabilization group.

A RCT conducted in which each subject completed stretching interventions for two days. Purpose of the study was to investigate acute effects of modified sleeper stretch and modified cross body stretch on posterior shoulder tightness and glenohumral internal rotation deficit with more than 10-degree loss.

### Conditions Module

**Conditions:**

- Shoulder Capsulitis

**Keywords:**

- Modified cross body stretch

- Modified sleeper stretch

- Posterior capsule tightness

- Range of motion

- Seated basketball throw

- Thumb up back

### Design Module

#### Design Info

**Allocation:** RANDOMIZED

**Intervention Model:** PARALLEL

##### Masking Info

**Masking:** DOUBLE

**Who Masked:**

- PARTICIPANT

- OUTCOMES_ASSESSOR

**Primary Purpose:** TREATMENT

#### Enrollment Info

**Count:** 32

**Type:** ACTUAL

**Phases:**

- NA

**Study Type:** INTERVENTIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** modified cross body stretch

**Intervention Names:**

- Other: Modified cross body stretch

**Label:** Modified cross body stretch

**Type:** EXPERIMENTAL

#### Arm Group 2

**Description:** modified sleeper stretch

**Intervention Names:**

- Other: Modified sleeper stretch

**Label:** Modified sleeper stretch

**Type:** EXPERIMENTAL

### Interventions

#### Intervention 1

**Arm Group Labels:**

- Modified cross body stretch

**Description:** Athlete was in side lying positioned. trunk was moved posteriorly 200 to 300 and shoulder is raised to 900 and semi flex both knees. Athlete was ask to passively pull the humerus across the body into horizontal adduction with the opposite hand.

5 reps once daily 3 sets for 4 weeks was given

**Name:** Modified cross body stretch

**Type:** OTHER

#### Intervention 2

**Arm Group Labels:**

- Modified sleeper stretch

**Description:** Athlete was in side lying positioned on the involved side, trunk was rolled posteriorly 200 to 300 and shoulder is raised to 900 and elbow is flexed to 900 and semiflex both knees. athlete was ask to perform internal rotation passively by using the opposite arm.

5 reps once daily 3 sets for 4 weeks was given

**Name:** Modified sleeper stretch

**Type:** OTHER

### Outcomes Module

#### Primary Outcomes

**Description:** The disability of shoulder conditions was measured by Penn score. Which consists of 3 categories i.e.; pain, satisfaction and functional ability. Pain consists of 3 questionnaires that consists of 10 scores each (total 30) and then satisfaction, it consists of 1 questionnaire consists of 10 scores, functional ability consists of 20 questionnaires with 10 scores each for the questionnaire (total 60)

**Measure:** PENN shoulder score

**Time Frame:** 4th week

**Description:** SBBT (seated basketball throws) was used to test the explosiveness of the upper extremity.

**Measure:** Seated basketball throw

**Time Frame:** 4th week

**Description:** (Thumb-up-the back- measurement) was used to measure the ability to actively move thumb up the back with the help of inch tape.

**Measure:** Thumb up back(TUB)

**Time Frame:** 4th week

#### Secondary Outcomes

**Description:** Changes from the Baseline ROM range of Motion of Shoulder flexion was taken with the Help of Goniometer

**Measure:** Shoulder ROM (flexion)

**Time Frame:** 4th week

**Description:** Changes from the Baseline ROM range of Motion of Shoulder extension was taken with the Help of Goniometer

**Measure:** Shoulder ROM Extension

**Time Frame:** 4th week

**Description:** Changes from the Baseline ROM range of Motion of shoulder abduction was taken with the Help of Goniometer

**Measure:** Shoulder ROM abduction

**Time Frame:** 4th week

**Description:** Changes from the Baseline ROM range of Motion of shoulder adduction was taken with the Help of Goniometer

**Measure:** Shoulder ROM adduction

**Time Frame:** 4th week

**Description:** Changes from the Baseline ROM range of Motion of Shoulder external rotation was taken with the Help of Goniometer

**Measure:** Shoulder ROM external rotation

**Time Frame:** 4th week

**Description:** Changes from the Baseline ROM range of Motion of Shoulder internal rotation was taken with the Help of Goniometer

**Measure:** Shoulder ROM internal rotation

**Time Frame:** 4th week

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

* Basketball Players
* Internal rotation deficit greater than 20° degrees
* BMI 18.5-24.9

Exclusion Criteria:

* Having a systemic pathology including inflammatory joint disease
* Having musculoskeletal or neurological disease
* Having taken anti-inflammatory medication

**Maximum Age:** 30 Years

**Minimum Age:** 15 Years

**Sex:** ALL

**Standard Ages:**

- CHILD

- ADULT

### Contacts Locations Module

#### Locations

**Location 1:**

**City:** Islamabad

**Country:** Pakistan

**Facility:** Islamic international medical college

**State:** Punjab

**Zip:** 46000

#### Overall Officials

**Official 1:**

**Affiliation:** Riphah International University

**Name:** Aisha Razzaq, MSPT-OMPT

**Role:** PRINCIPAL_INVESTIGATOR

### IPD Sharing Statement Module

**IPD Sharing:** NO

### References Module

#### References

**Citation:** Vukasevic V, Mitrovic M, Masanovic B. A comparative study of motor ability between elite basketball players from different regions. Sport Mont. 2020;18(1):Ahead of Print

**Citation:** Ekhtiari S, Khan M, Burrus T, Madden K, Gagnier J, Rogowski JP, Maerz T, Bedi A. Hip and Groin Injuries in Professional Basketball Players: Impact on Playing Career and Quality of Life After Retirement. Sports Health. 2019 May/Jun;11(3):218-222. doi: 10.1177/1941738119838274. Epub 2019 Apr 23.

**PMID:** 31013191

**Citation:** Drakos MC, Domb B, Starkey C, Callahan L, Allen AA. Injury in the national basketball association: a 17-year overview. Sports Health. 2010 Jul;2(4):284-90. doi: 10.1177/1941738109357303.

**PMID:** 23015949

**Citation:** Quartey J, Davor SF, Kwakye SK. An injury profile of basketball players in Accra, Ghana. S Afr J Physiother. 2019 Mar 27;75(1):467. doi: 10.4102/sajp.v75i1.467. eCollection 2019.

**PMID:** 31061911

**Citation:** Grow K. The Sleeper Stretch: Effects on Range of Motion and Injury in Baseball Players. 2010

**Citation:** McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther. 2007 Mar;37(3):108-14. doi: 10.2519/jospt.2007.2337.

**PMID:** 17416125

**Citation:** Rao MS, Tejitha S. COMPARISON OF 3 STRETCHING PROTOCOLS FOR POSTERIOR SHOULDER TIGHTNESS IN THROWERS. Int J Physiother Res. 2016;4(2):1429-35

**Citation:** Myers JB, Laudner KG, Pasquale MR, Bradley JP, Lephart SM. Glenohumeral range of motion deficits and posterior shoulder tightness in throwers with pathologic internal impingement. Am J Sports Med. 2006 Mar;34(3):385-91. doi: 10.1177/0363546505281804. Epub 2005 Nov 22.

**PMID:** 16303877

**Citation:** Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008 Jul-Aug;43(4):359-63. doi: 10.4085/1062-6050-43.4.359.

**PMID:** 18668168

**Citation:** Chepeha JC, Magee DJ, Bouliane M, Sheps D, Beaupre L. Effectiveness of a Posterior Shoulder Stretching Program on University-Level Overhead Athletes: Randomized Controlled Trial. Clin J Sport Med. 2018 Mar;28(2):146-152. doi: 10.1097/JSM.0000000000000434.

**PMID:** 28731885

**Citation:** Salamh PA, Kolber MJ, Hanney WJ. Effect of scapular stabilization during horizontal adduction stretching on passive internal rotation and posterior shoulder tightness in young women volleyball athletes: a randomized controlled trial. Arch Phys Med Rehabil. 2015 Feb;96(2):349-56. doi: 10.1016/j.apmr.2014.09.038. Epub 2014 Oct 23.

**PMID:** 25450120

**Citation:** Immediate effects of two types of stretching techniques on glenohumeral internal rotation deficit and posterior shoulder tightness; a crossover randomised controlled trial

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000007592

- Term: Joint Diseases

- ID: D000009140

- Term: Musculoskeletal Diseases

### Condition Browse Module - Browse Branches

- Abbrev: BC05

- Name: Musculoskeletal Diseases

- Abbrev: All

- Name: All Conditions

- Abbrev: Rare

- Name: Rare Diseases

### Condition Browse Module - Browse Leaves

- ID: M5332

- Name: Bursitis

- Relevance: HIGH

- As Found: Capsulitis

- ID: M10621

- Name: Joint Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M12097

- Name: Musculoskeletal Diseases

- Relevance: LOW

- As Found: Unknown

- ID: T4202

- Name: Oculocerebral Syndrome With Hypopigmentation

- Relevance: LOW

- As Found: Unknown

### Condition Browse Module - Meshes

- ID: D000002062

- Term: Bursitis

### Misc Info Module

- Version Holder: 2024-05-24
