There is no study in the current literature that systematically investigates the extent of upper-extremity proprioceptive impairment in patients with radicular neuropathic symptoms secondary to cervical disc herniation, nor its association with clinical findings. Although existing reviews emphasize proprioceptive deficits in populations with neck pain or cervical spondylosis, no studies specifically address the subgroup of cervical disc-related radiculopathy. This gap in knowledge hinders the integration of proprioceptive assessments with upper-extremity functional outcome measures in diagnostic and rehabilitative processes, suggesting a need for more specific data to guide sensory-motor training approaches. The primary aim of the present study is to assess upper-extremity proprioception in patients with cervical radiculopathy by comparing them with a healthy control group. The secondary aim is to examine the relationship between upper-extremity proprioception and clinical outcomes, including parameters such as pain and functional status.
Being between 18 and 65 years of age
Presence of radicular pain diagnosed through clinical examination and cervical -MRI imaging Patients with cervical MRI findings demonstrating cervical disc herniation at least at one level consistent with their symptoms
Willingness to participate in the study
History of cervical physical therapy within the past year
Symptoms or diagnosis of upper-extremity entrapment neuropathy
Patients with documented vitamin B12 or vitamin D deficiency within the last 2 years in available medical records
History of cervical surgery or cervical trauma
Patients aged 18-65 years who are diagnosed with cervical radiculopathy based on history, physical examination, and clinical evaluation will be assessed according to the inclusion and exclusion criteria. Two groups will be formed: the cervical radiculopathy group and a healthy volunteer group matched for age, sex, and BMI.
Case-control
Cross-sectional
Not listed
The Upper Limb Proprioception Reaching Test (PRO-Reach)
PRO-Reach is a 90 × 110 cm plastic poster mounted on the wall using bilateral magnetic strips. Round stickers with a diameter of 0.6 cm, manually numbered (1-3), are used to mark the three free-reach attempts for each target. Seven targets are used and are named according to the movement direction of the dominant limb: the left side of the poster represents the dominant side for left-handed participants, while the right side corresponds to non-dominant (ND) cross-body movements. The opposite applies to right-handed participants. The targets are labeled as follows: superior (S), superior-lateral dominant (SLD) and non-dominant (SLND), lateral-dominant (LD) and non-dominant (LND), and inferior-lateral dominant (ILD) and non-dominant (ILND). The (S) target is used for evaluation in participants without limb dominance. The (S) target is also used for the three familiarization trials (three memorization and reposition attempts). The purpose is to "assess the ability to reproduce movements
The Numeric Rating Scale (NRS)
The Numeric Rating Scale (NRS) is a unidimensional, self-reported measure of pain intensity that is widely used in both clinical practice and research, including studies involving patients with chronic pain. On this scale, patients rate their current level of pain on an 11-point numeric range from 0 to 10, where 0 represents "no pain" and 10 represents "the worst pain imaginable." Higher scores indicate greater pain intensity.
DN-4 Quastionnaire
The DN-4 (Douleur Neuropathique en 4 Questions) is a brief and reliable screening questionnaire used to determine whether a patient's pain is of neuropathic origin. It consists of a total of 10 items. Its name, DN-4, derives from the fact that it includes 4 main sections. Seven of the questions relate to patient-reported sensory symptoms, while three are based on clinical examination findings. Each "yes" response scores 1 point, yielding a total score ranging from 0 to 10. A score above 4 indicates a high likelihood of neuropathic pain.
SHORT FORM-12
The Short Form-12 (SF-12) is a health-related quality of life assessment tool that summarizes an individual's physical and mental health status through 12 items. It is a shortened version of the SF-36 questionnaire and measures eight health domains: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health. The SF-12 produces two composite scores - the Physical Component Summary (PCS) and the Mental Component Summary (MCS) - which are standardized to a mean of 50 and a standard deviation of 10 in the general population. Higher scores indicate better health status and quality of life.
Handgrip Strength Test(Jamar Hand Dynamometer)
The Jamar hand dynamometer is a hydraulic measurement device used to assess hand grip strength in an objective and reproducible manner. It is considered the gold standard in musculoskeletal research, rehabilitation, neurological evaluation, and work capacity assessments. The patient is seated with back support, the shoulder in a neutral position, the elbow flexed at 90°, and the forearm in a neutral position. The dynamometer is placed in the patient's hand, and they are instructed to "squeeze maximally." Typically, three trials are performed for each hand, and either the highest value or the mean value is used. Measurements are generally recorded in kilograms (kg) or pounds (lb). Higher scores indicate greater grip strength, whereas lower scores suggest reduced muscle strength and may reflect sarcopenia, as well as potential neurological or musculoskeletal functional impairment.
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