Purpose of the study: * To investigate the effect of rotator cuff training on hand grip strength in adults with different body mass index. * To investigate the effect of rotator cuff training on hand grip static endurance in adults with different body mass index. * To investigate the effect of rotator cuff training on hand grip dynamic endurance in adults with different body mass index. * To investigate the effect of rotator cuff training on upper limb function in adults with different body mass index.
Rotator cuff muscles are considered to be the key dynamic muscles in shoulder stabilization since they contribute significantly to shoulder stability in a number of different ways. They work not only as a dynamic stabilizer but also as static stabilizers because of their orientation and location around the shoulder joint. Several studies revealed the strong relationship between the rotator cuff muscles and hand grip strength. Studies proved the strong correlation between grip strength and rotator cuff strength ,which suggests that assessment of grip strength could be used to monitor the function of the rotator cuff, once baseline readings have been attained during training and rehabilitation . Previous publications revealed significant positive associations between handgrip strength, body mass index (BMI) and physical activity in adult men and women. Worldwide, 31.1% of adults are reported to be physically inactive. Some studies and reports indicate that 20% of the global populace within the age range of 18-64 years comply with the minimum physical activity guidelines for improved health. Overweight and obesity are identified as a constant negative influence on physical activity, regardless of age. Studies proved that weight, height, and BMI have a significant correlation on hand grip strength. As the weight increase hand muscle strength and endurance time also decrease. Subjects in this study will be recruited from the students , employees and faculty members of the faculty of physical therapy, Cairo University.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
open chain exercises for rotator cuff muscles, three times per week for six weeks.
Advices for postural correction like neutral position of head and neck, aliening the shoulder and hip and using a foot stool to rest the feet.
Hand grip strength
The JAMAR Hydraulic hand dynamometer is used to measure hand grip strength in (Kg) , It will be evaluated before and after training for each subject in both groups. Each subjects will be asked to grasp the handle with the dominant hand and perform hand grip with maximum effort only during exhalation and after a verbal cue given by the examiner " one, two, three, go". The subjects will be instructed to maintain maximum contraction for 5 seconds. Three measurements will be taken with a rest interval of 60 seconds between trials in order to avoid muscle fatigue during the assessment and the average of the three measurements will be calculated to measure hand grip strength.
Time frame: up to six weeks
Hand grip static endurance
It will be evaluated before and after training for each subject in both groups by using JAMAR Hydraulic hand grip dynamometer, Subjects will be seated in initial position. They will be asked to grip the hand grip dynamometer at 60% of their maximum voluntary contraction (MVC). The duration for which they maintained the grip strength will be noted in seconds. Subjects will be verbally encouraged to maintain the contraction at the set target for as long as possible. The test will be terminated when the subjects fail to maintain the 60% MVC for two consecutive times. Two recordings will be obtained with a gap of five minutes between each effort.
Time frame: up to six weeks
Hand grip dynamic endurance
It will be evaluated before and after training for each subject in both groups by using JAMAR Hydraulic hand dynamometer, After static hand grip endurance test, the subjects will perform the dynamic hand grip endurance test. Subjects will be instructed to give repetitive contractions at 60% of their maximal voluntary contraction (MVC) on the beat of the metronome set at 70 beeps per minute until fatigue set in and they will be no longer able to produce the same intensity of contraction. Number of repetitions will be measured.
Time frame: up to six weeks
Upper limb function
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Each subject in both groups will receive and fill the items of Arabic version of The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire before and after training. The DASH is a 30-item self-report questionnaire designed to evaluate impairments and activity limitations, as well as participation restrictions for both leisure activities and work. Response options range from 1 to 5 (1: no difficulty; 2: mild difficulty; 3: moderate difficulty; 4: severe difficulty; 5: unable). The DASH produces scores between 0 and 100 for each module, in which a high DASH score indicates severe disability.
Time frame: up to six weeks