Relationship Between Craniovertebral Angle, Lumbar Proprioception, and Trunk Muscle Strength in Cervical Radiculopathy

NCT07240090 | Not Yet Recruiting

• 2 other identifiers: P.T.REC/012/005966CU2025-01
• Study Type: observational
• Target: 64
• Locations: 1 country
• Sites: 1

Brief Summary

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

Conditions

Cervical Radiculopathy

Keywords

Craniovertebral Angle; Lumbar Proprioception; Trunk Muscle Strength; Cervical Radiculopathy; Forward Head Posture; Low Back Pain

Outcome Measures

Primary Outcomes (3)

• 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

  baseline

• 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

  baseline

• 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 .

  baseline

Eligibility Criteria

• Age: 30 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

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

You may qualify if:

• 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

You may not qualify if:

• Cervical myelopathy
• Acute cervical radiculopathy
• Neck pain without radiculopathy
• Diabetic neuropathy
• Previous cervical surgery
• Cervical trauma
• Entrapment neuropathies in the upper limbs
• Rheumatoid arthritis
• Tumors or infections involving the cervical or lumbar spine
• Acute or chronic lumbar radiculopathy
• Vertebral fractures
• Lumbar spinal stenosis
• Cauda equina syndrome
• Previous lumbar surgery
• Lumbar spondylolisthesis

Sponsors & Collaborators

• Basma Ashraf Ali Mohamed: lead
• Cairo University: collaborator

Study Sites (1)

Faculty of Physical Therapy labs at Cairo University

Giza, Giza Governorate, 12556, Egypt

Location

Related Publications (8)

• Engebretsen KB, Taso M, Bjorland S, Jenssen HK, Skaara HE, Brox JI. A functional intervention within a cognitive approach to chronic cervical radiculopathy : Description of the non-surgical treatment arm in a randomised controlled trial evaluating the effectiveness of surgery. BMC Musculoskelet Disord. 2024 Aug 7;25(1):629. doi: 10.1186/s12891-024-07743-0.

  PMID: 39112984 BACKGROUND

• Brea-Gomez B, Torres-Sanchez I, Ortiz-Rubio A, Calvache-Mateo A, Cabrera-Martos I, Lopez-Lopez L, Valenza MC. Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Int J Environ Res Public Health. 2021 Nov 11;18(22):11806. doi: 10.3390/ijerph182211806.

  PMID: 34831562 BACKGROUND

• Coleman M, Linieres J, Thery C, Gautier A, Daste C, Rannou F, Nguyen C, Lefevre-Colau MM, Roren A. Changes in isokinetic trunk muscle strength and endurance after two different restoration programs in people with chronic low back pain: A longitudinal retrospective study. Heliyon. 2024 Jul 20;10(15):e34914. doi: 10.1016/j.heliyon.2024.e34914. eCollection 2024 Aug 15.

  PMID: 39145024 BACKGROUND

• Al-Shenqiti AM, Emara HA, Algarni FS, Khaled OA. Isokinetic trunk muscle performance in adolescents with different body mass indices. J Taibah Univ Med Sci. 2021 Apr 24;16(4):550-557. doi: 10.1016/j.jtumed.2021.03.008. eCollection 2021 Aug.

  PMID: 34408612 BACKGROUND

• Alkhamees NH, Ali OI, Abdelraouf OR, Ibrahim ZM, Mohamed AA. Assessment of Isokinetic Trunk Muscle Strength and Fatigue Rate in Individuals after Bariatric Surgery. Medicina (Kaunas). 2024 Mar 26;60(4):534. doi: 10.3390/medicina60040534.

  PMID: 38674180 BACKGROUND

• Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, Baciarello M, Manferdini ME, Fanelli G. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016 Jun 28;5:F1000 Faculty Rev-1530. doi: 10.12688/f1000research.8105.2. eCollection 2016.

  PMID: 27408698 BACKGROUND

• Baroncini A, Maffulli N, Al-Zyoud H, Bell A, Sevic A, Migliorini F. Nonopioid pharmacological management of acute low back pain: A level I of evidence systematic review. J Orthop Res. 2023 Aug;41(8):1781-1791. doi: 10.1002/jor.25508. Epub 2023 Feb 22.

  PMID: 36811209 BACKGROUND

• Baroncini A, Maffulli N, Eschweiler J, Knobe M, Tingart M, Migliorini F. Management of facet joints osteoarthritis associated with chronic low back pain: A systematic review. Surgeon. 2021 Dec;19(6):e512-e518. doi: 10.1016/j.surge.2020.12.004. Epub 2021 Feb 10.

  PMID: 33582054 BACKGROUND

MeSH Terms

Conditions

Radiculopathy; Low Back Pain

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Rowida A Abdelgaleel, PhD

  Cairo University - Faculty of Physical Therapy

  STUDY DIRECTOR

Central Study Contacts

Basma A Ashraf, BPT

CONTACT

+20 1097189492; basma.ashraf_a014@pt.kfs.edu.eg

Ashraf A Abdelmonem, PhD

CONTACT

+201111642073

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Demonstrator

Study Record Dates

• First Submitted: November 16, 2025
• First Posted: November 20, 2025
• Study Start: November 18, 2025
• Primary Completion: January 1, 2026
• Study Completion: January 15, 2026
• Last Updated: November 20, 2025

Record last verified: 2025-11

Locations

EG (1)