The study aimed to
* Investigate the relation of cranio-vertebral angle with lumbar proprioception in patients with cervical radiculopathy. * Investigate the relation of cranio-vertebral angle with trunk muscles strength in patients with cervical radiculopathy. Cervical radiculopathy is a condition that causes neck pain radiating to the arm due to nerve root compression. The study seeks to explore whether posture and trunk control are affected in these patients. Participants will be assessed for craniovertebral angle, lumbar proprioception, and trunk muscle strength using standardized physical therapy evaluation methods. The findings may help in understanding postural and neuromuscular changes associated with cervical radiculopathy and improve rehabilitation programs
Patients with cervical radiculopathy with ≥3 months history of neck pain radiating to only one upper extremity (unilateral)
Patients with forward head posture and craniovertebral angle <50°
Age between 30 and 55 years
Body mass index (BMI) between 18 and 29.9 kg/m²
Cervical myelopathy
Acute cervical radiculopathy
Neck pain without radiculopathy
Diabetic neuropathy
Adults aged 30-55 years diagnosed with cervical radiculopathy, of both sexes, attending outpatient clinics. Participants should be able to understand instructions to compete methods of assessment
Other
Cross-sectional
Not listed
Craniovertebral angle
The craniovertebral angle will be measured using digital photography to assess forward head posture in patients with cervical radiculopathy. The assessment of the FHP will be carried out by measuring the craniovertebral angle. Standing cervical posture alignment will be measured with photogrammetry, which provides a valid and reliable indicator of forward head posture using the CVA . A smartphone will be mounted on a tripod and positioned 1.5 meters away from the participant, with the height adjusted to the level of the participant's shoulder. Adhesive markers will be placed on a participant's C7 spinous process and tragus of the ear. The therapist will observe the participant from the lateral side while standing and then will take a picture of the participant from a fixed distance 1.5 meters
Tunk muscles strength
Trunk flexor and extensor muscle strength will be measured once using an isokinetic dynamometer at two angular velocities (60°/s and 120°/s) to evaluate muscle performance in patients with cervical radiculopathy The Biodex System 3 Pro (Biodex Medical Systems IIVC;Shirley , Shirley, NY, USA) will be used to conduct the isokinetic and isometric trunk strength test . Peak torque will be the primary outcome to be asessed in trunk isokinetic variables, peak torque indicates the highest muscle force output through the range of motion and reflects muscle strength .The trunk range of movement will be limited at 50°, with 30° (-30°) of trunk flexion and 20° (+20°) of trunk extension. It will started from the flexion position and will be performed with 60°/s and 120°/s angular velocities
Lumbar proprioception
Lumbar joint position sense will be assessed once by measuring the difference between the target and reproduced trunk flexion angle at 30 degrees using an isokinetic device to evaluate proprioceptive accuracy in patients with cervical radiculopathy The Biodex System 3 Pro Isokinetic Dynamometer (Biodex Medical Systems, Shirley, NY, USA) will be used to assess lumbar proprioception. The dynamometer with a specific reclining back attachment is designed to assess the lumbar region's repositioning accuracy. Its validity is ICC = 0.99 and reliability is ICC = 0.99 for evaluating joint position sensation. Testing active repositioning of the lumbar spine is at 30°/s During the training, the participants will be instructed to maintain a specific spinal range of motion, which range from neutral extension of the lumbar spine to 30° flexion. This range is chosen because of the ability of all participants to do it .
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