This study is conducted to investigate:
1. The efficiency of combination of KT and proprioceptive exercises on neck proprioception in patients with CR. 2. The efficiency of combination of KT and proprioceptive exercises on neck pain, neck function and neuropathic pain in patients with CR.
Age from 35-50years (Rafiq et al. 2022).
BMI from 18 to 29.9 kg /m2 (Morsi et al., 2022.
Current continuous or intermittent pain that has persisted for more than 3 months (Persson et al., 1997, Purves et al., 1998).
Paresthesia or numbness along the course of the nerve (Young et al., 2009).
History of surgical procedures for pathologies giving rise to neck pain or CTS (Wainner et al., 2003).
Clinical signs or symptoms of medical "red flags" or serious pathology (infection, cancer, and cardiac involvement) (George et al., 2015).
Any systematic disease such as rheumatism and tuberculosis, cervical myelopathy, or multiple sclerosis (Joghataei et al., 2004).
Systemic disease is known to cause generalized peripheral neuropathy as diabetes millitus (Wainner et al., 2003).
Parallel
proprioceptive neck exercises
Other interventionProprioceptive craniocervical exercises The patient will sit on a swivel chair with a backrest in front of a wall at a distance of 90 cm. A laser pointer will be fixed to the highest point of the patient's head, so the laser light will be projected on a target hanging on the wall (Espí-López et al., 2020). Then active cervical movements will be performed.
Kinesiotaping
Other interventionFor kinesio tape application, a method of brachial plexus application will be chosen .
Cervical proprioception
The most common method used for assessment of cervical proprioception is Joint Position Error test, the active movement angle reproduction test, which requires the subject to relocate a neutral head position or a target head position selected by the investigator (Loudon et al., 1997; Hillier et al., 2015). In head position sense measurement studies, the variable measured is the difference between the reference point position entrenched initially (either a neutral or target position) and the position produced by the subject when attempting to match the target position , This difference is called JPE and has angular units of degrees (°) (Hillier et al., 2015). JPE test demonstrates good intra- and inter-rater reliability and acceptable validity for evaluating cervical proprioception (Revel et al., 1991; Kristjansson et al., 2003). JPE test will be measured by Laser Pointer Device.
Cervical pain
The ANPRS is used to capture the patient's level of pain. It is an 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable). The (NPRS) has been reported to be moderate (ICC value 0.63) in patients with CR (Cleland et al., 2006), and with acceptable reliability (ICC value 0.76) in patients with neck pain (Cleland et al., 2008).
Function
The neck disability index (NDI) is the most widely used and validated instrument to assess the impact of neck pain on patients' functional activities and to measure outcomes in clinical practice and research. It consists of 10 questions: pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleepi ng, and recreation (Vernon \& Mior, 1991). The Arabic version of NDI is a condition-specific valid tool to assess the level of disabilities in patients with neck pain. The NDI-Ar is a reliable and valid questionnaire in neck pain patients with test-retest reliability; the ICC of the Arabic version was 0.96 (Shaheen et al., 2013).
Radicular pain
The Upper Limb Tension Test 1 (ULTT1) will be used as both a screening tool for detecting radicular pain and as an outcome measure to evaluate changes in neural mobility and symptoms improvement throughout the intervention period.This test is commonly used in patients with cervical radiculopathy and has been shown to be both reliable and clinically relevant in identifying altered neural dynamics (Nee et al., 2012).
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Fadia Ahmed Fawzy
Lead sponsor
Cairo University
Sponsor institution
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