Background Children with Down syndrome (DS) are characterized by hypotonia resulting in reduced grip and pinch strength. This study aimed to investigate the influence of shoulder stabilization exercises on hand grip strength in children with Down syndrome. Thirty children with DS assigned randomly into 2 groups each group consists of 15 children. Handheld Dynamometer was used to measure grip strength and different pinch grasps for both groups before and after treatment. Both groups receive the same vocational school activities and the study group receives shoulder stabilization exercises for 3 months. Results Results revealed significant increase in the grip strength and different pinch grasps for dominant and non-dominant hands post-treatment in both groups as the main effect of time was statistically significant. Study group showed significant improvement than the control group post-treatment as the main effect of group and time × group interaction effect was statistically significant for dominant and non-dominant hands. Conclusion Shoulder stabilization exercises and regular vocational school activities have a positive effect on different grip strength in children with Down syndrome. Trial registration PACTR201907896910981. Registered 5 July 2019. A written consent form was introduced to all participant and signed by their parents.

Objective. To study if different cervical mobilizations have a long-term effect on pain relief and strengthening of external rotators and abductors in rotator cuff tendinitis. Method. Seventy-five patients with rotator cuff tendinitis were recruited from outpatient clinic, with age ranged from 25 to 40 years. Group A: C5-6 antero-posterior cervical mobilization and ultrasound therapy. Group B: C5-6 lateral glide cervical mobilization and Ultrasound. Group C: C5-6 Postero-anterior cervical mobilization and US. The Visual Analogue Scale measured pain severity level and Lafayette Manual Muscle Tester measured shoulder external rotators and abductors isometric muscle strength. Results. The Wilcoxon test revealed a statistically significant difference in shoulder external rotators, abductors strength, and pain reduction between pre, immediate post-mobilization, 10 minutes post-mobilization, and 30 minutes post-mobilization within the three groups. But, the immediate post-mobilization and 10 minute post-mobilization median values of external rotators were statistically significant differences among the three groups, while the 30 minute post-mobilization median values of external rotators were not. For Abductors: Among the three groups, there were no statistically significant differences in abductors’ immediate post-mobilization, 10 minute post-mobilization, or 30 minute post-mobilization, but there were statistically significant differences in pain scores immediate post-mobilization, 10 minute post-mobilization, and 30 minute post-mobilization. Conclusion. The study found that all three kinds of cervical mobilization are useful in reducing pain and strengthening the external rotators and abductors muscles and that the most effective method is antero-posterior in treating rotator cuff tendinitis.

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