Sports-Specific Core and Thoracic Mobility Training Versus General Physiotherapy on Scapulothoracic Mechanics and Shoulder Function in Young Football Players After Chest Wall Surgery: A 12-Week Randomized Controlled Trial
Main Article Content
Abstract
Background: Young football players recovering from chest wall surgery may experience reduced thoracic mobility, altered scapulothoracic mechanics, and impaired shoulder function, which can limit functional rehabilitation and sport-specific recovery. Objective: To compare the effects of sports-specific core and thoracic mobility training with general physiotherapy on scapulothoracic mechanics, thoracic mobility, and shoulder function in young football players after chest wall surgery. Methods: This parallel-group randomized controlled trial enrolled 70 young football players who had undergone chest wall surgery and were medically cleared for rehabilitation. Participants were randomized into an experimental group receiving sports-specific core and thoracic mobility training or a control group receiving general physiotherapy for 12 weeks. Outcomes were assessed at baseline and post-intervention. Data were analyzed using paired comparisons, between-group comparisons, ANCOVA adjusted for baseline values, and multiple linear regression. Results: Sixty-five participants completed the study. Shoulder function improved more in the experimental group than in the control group (19.1 vs. 10.6 points), as did thoracic mobility (10.6 vs. 5.4 points) and scapulothoracic control, expressed as reduction in dysfunction score (1.5 vs. 0.9 points). Adjusted analysis favored the experimental group for shoulder function, thoracic mobility, and scapulothoracic mechanics. Conclusion: Sports-specific core and thoracic mobility training produced greater short-term improvement than general physiotherapy in shoulder function, thoracic mobility, and scapulothoracic control after chest wall surgery
Article Details
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Douglas SR, Olafsen NP. Chest wall injuries in athletes. Curr Phys Med Rehabil Rep. 2023;11(4):450-457.
2. Tomesch AJ, Negaard M, Keller-Baruch O. Chest and thorax injuries in athletes. Clin Sports Med. 2023;42(3):385-400. doi:10.1016/j.csm.2023.03.001.
3. Hooda Z, Rajaram R. Physiologic and functional outcomes following chest wall resection. Thorac Surg Clin. 2026;36(2):215-222. doi:10.1016/j.thorsurg.2025.12.006.
4. Forster C, Jacques V, Abdelnour-Berchtold E, Krueger T, Perentes JY, Zellweger M, et al. Enhanced recovery after chest wall resection and reconstruction: a clinical practice review. J Thorac Dis. 2024;16(4):2604-2612.
5. Choi M, Chung J. Biomechanical and functional analysis of the shoulder complex and thoracic spine in patients with subacromial impingement syndrome: a case control study. Medicine (Baltimore). 2023;102(4).
6. Park SJ, Kim SH, Kim SH. Effects of thoracic mobilization and extension exercise on thoracic alignment and shoulder function in patients with subacromial impingement syndrome: a randomized controlled pilot study. Healthcare (Basel). 2020;8(3):316. doi:10.3390/healthcare8030316.
7. Ferlito R, Testa G, McCracken KL, Moscato S, Zerbito GM, Panvini FMC, et al. Effectiveness of therapeutical interventions on the scapulothoracic complex in the management of patients with subacromial impingement and frozen shoulder: a systematic review. J Funct Morphol Kinesiol. 2023;8(2):38. doi:10.3390/jfmk8020038.
8. Melo ASC, Moreira JS, Afreixo V, Moreira-Gonçalves D, Donato H, Cruz EB, et al. Effectiveness of specific scapular therapeutic exercises in patients with shoulder pain: a systematic review with meta-analysis. JSES Rev Rep Tech. 2024;4(2):161-174. doi:10.1016/j.xrrt.2023.12.006.
9. Yuksel E, Yesilyaprak SS. Scapular stabilization exercise training improves treatment effectiveness on shoulder pain, scapular dyskinesis, muscle strength, and function in patients with subacromial pain syndrome: a randomized controlled trial. J Bodyw Mov Ther. 2024;37:101-108. doi:10.1016/j.jbmt.2023.11.005.
10. Rodríguez-Perea Á, Reyes-Ferrada W, Jerez-Mayorga D, Chirosa Ríos L, Van den Tillar R, Chirosa Ríos I, et al. Core training and performance: a systematic review with meta-analysis. Biol Sport. 2023;40(4):975-992. doi:10.5114/biolsport.2023.123319.
11. Dong K, Yu T, Chun B. Effects of core training on sport-specific performance of athletes: a meta-analysis of randomized controlled trials. Behav Sci (Basel). 2023;13(2):148. doi:10.3390/bs13020148.
12. Stathas I, Koundourakis N, Christoforidis C, Kouvidis G, Christakou A. From injury to impact: optimizing return-to-play outcomes and reinjury prevention via four-pillar rehabilitation strategy in elite football-a clinical study in a sports scenario. Muscles (Basel). 2026;5(1):11. doi:10.3390/muscles5010011.
13. Ramsuchit B, Martinez Ugarte S, Kao LS, Meyer D. A contemporary review of operative indications for chest wall trauma. Thorac Surg Clin. 2026;36(2):223-234. doi:10.1016/j.thorsurg.2025.12.004.
14. Fani M, Ebrahimi S, Ghanbari A. Evaluation of scapular mobilization and comparison to pectoralis minor stretching in individuals with rounded shoulder posture: a randomized controlled trial. J Bodyw Mov Ther. 2020;24(4):367-372. doi:10.1016/j.jbmt.2020.07.021.
15. Kasamasu T, Ishida Y, Hayami T, Uematsu R, Fujitani J, Mase Y, et al. Comparison of thoracic spine range of motion in different types of sports and relationship to low back pain. J Sports Med Phys Fitness. 2026.
16. Pieters L, Lewis J, Kuppens K, Jochems J, Bruijstens T, Joossens L, et al. An update of systematic reviews examining the effectiveness of conservative physical therapy interventions for subacromial shoulder pain. J Orthop Sports Phys Ther. 2020;50(3):131-141. doi:10.2519/jospt.2020.8498.
17. Satpute K, Reid S, Mitchell T, Mackay G, Hall T. Efficacy of mobilization with movement for shoulder conditions: a systematic review and meta-analysis. J Man Manip Ther. 2022;30(1):13-32. doi:10.1080/10669817.2021.1955181.
18. Olguín-Huerta C, Araya-Quintanilla F, Moncada-Ramírez V, Estrella-Flores E, Cuyúl-Vásquez I, Gutiérrez-Espinoza H. Effectiveness of scapular mobilization in patients with primary adhesive capsulitis: a systematic review and meta-analysis. Medicine (Baltimore). 2023;102(22). doi:10.1097/MD.0000000000033929.
19. Vicente J, Wooley R. The addition of thoracic spine manipulation or mobilization to exercise in adults with subacromial impingement syndrome: a critically appraised topic. J Sport Rehabil. 2025;34(6):677-681. doi:10.1123/jsr.2024-0135.