The structures of shoulder complex are designed primarily for mobility, allowing to move and position hand through a wide range of space during tasks. Glenohumeral joint linking the humerus and scapula, has the greater mobility. So, stable scapula enables the rest of the shoulder to function correctly.

When shoulder joint is considered, it is important to look not only at shoulder, but also the whole kinetic chain refers to the linkage of multiple segments of the body that allow the transfer of forces and motion to shoulder, arm and hand.

Lack of researches are done on hand grip strengthening exercise given in impingement syndrome individuals to reduce pain, improve shoulder muscle strength and function.

Scapular stabilization exercise is also an adjunct therapy to reduce pain, improve shoulder muscle strength and shoulder joint function.

So, need of the study is to evaluate and compare the effect of hand grip strengthening exercise and scapular stabilization exercise in shoulder impingement syndrome.

aim : 

Aim of the study is to compare the effect of hand grip strengthening exercise and scapular stabilization exercise on shoulder pain, shoulder muscle strength and function in individuals with shoulder impingement syndrome.

objective: â€¢       To find out the effect of hand grip strengthening exercise on shoulder pain by visual analog scale (VAS) in individuals with shoulder impingement syndrome.

•        To find out the effect of hand grip strengthening exercise on shoulder strength by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To find out the effect of hand grip strengthening exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder pain by visual analog scale (VAS) in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder strength   by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on pain by VAS in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on shoulder Strength by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome. 

•       To find out the effect of hand grip strengthening exercise on shoulder pain by visual analog scale (VAS) in individuals with shoulder impingement syndrome.

•        To find out the effect of hand grip strengthening exercise on shoulder strength by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To find out the effect of hand grip strengthening exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder pain by visual analog scale (VAS) in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder strength   by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To find out the effect of scapular stabilization exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on pain by VAS in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on shoulder Strength by hand held dynamometer in individuals with shoulder impingement syndrome.

•       To compare the effect of hand grip strengthening exercise and scapular stabilization exercise on shoulder function by shoulder pain and disability index (SPADI) in individuals with shoulder impingement syndrome.

procedure:

group A: ( hand grip strengthening exercise )

Handgrip-strengthening exercises (HGSE) were performed under therapeutic supervision in addition with the standardized conventional intervention for the patients with shoulder impingement syndrome in experimental group as previously mentioned in the literature.

An adjustable heavy-grip hand gripper was used to perform hand grip strengthening exercise. Patients were asked to perform the exercises in a standing position with their back against a wall, arm at either 30, 60, or 90° of abduction, and with 90° external rotations. In this position, patients performed three sets of 10 squeezes at 1 minute once a day. 

T to Y:

Patient is positioned in a prone with arms abducted to 90° (the letter T); Then flexed the elbows to 90°, retracted his scapulas and externally rotated his arms while keeping his arm in 90° abduction. Maintaining retraction of scapula, the patient raised his arms above the head and extended the elbow while arm flexed and abducted to 120° (the letter Y).

T to Y to W:

Patient is positioned in a prone and formed the letter T (as previous description) Then he changed his position to letter Y with his thumbs up. He retracted and depressed scapulas while he raised his arms 10-15 cm. Maintaining retraction of scapula, he flexed his elbows and extended his shoulders to form the letter W.