Effects of Exercises and Electrical Current Application Aiming to Strengthen Neck and Shoulder Blades Muscles on Symptoms of a Pinched Nerve in the Neck

NCT07375823 | Completed

• 1 other identifier: BAYEK057.12
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Cervical Radiculopathy (CR) is an objective loss of sensory and/or motor function as a result of compression or irritation of the cervical spinal nerve root. The individuals with CR present with findings indicating an altered neural control of the neck musculature, leaving the cervical spine vulnerable to reactive forces. Thus, physical therapy options should mainly focus on improving muscle function of the neck. Given the promising results of electrical muscle stimulation and exercise therapy in recent literature the proposed study is aimed to investigate the effects of exercise therapy with electrical muscle on cervical muscle function and see, if muscle control has any impact on CR findings. A superiority, randomized trial, with 2 intervention groups and allocation ratio of 1:1. 50 students, at the age from 18 to 29, from healthcare - related departments of European University of Lefke, who are diagnosed with CR will be recruited in the study. To assess neck muscle function - Deep Neck Flexors Endurance time (s) and Cervical Progressive Iso - inertial Lifting scores (kg) will be used. Pain (Numeric Rating Scale 0 -10) and Muscle strength (grades 0 -5) will be used to measure the impact on CR findings. All of the therapeutic exercises prescription parameters for warm-up (deep cervical flexors training), strengthening (cervical and scapulo-thoracic resistance training) and cool - down (flexibility training), will be the same for both groups: 60 minutes per session, 2 days in a week, for 6 weeks. In total each participant will recieve 12 sessions. For the intervention details, while 'Intervention Group 1' will recieve only active exercises under supervision of the physiotherapist, in 'Intervention Group 2' as a part of the strengthening protocol, EMS will be applied over scapular region, bilaterally.

Conditions

Cervical Radiculopathy; Cervical Radicular Pain; Neck Pain; Numbness; Paresthesia; Weakness, Muscle; Endurance

Keywords

cervical radiculopathy (CR); radicular pain; radicular symptoms; scapular dyskinesia; cervical deep flexors endurance (CDFE); cervical spine functional performance; electrical muscle stimulation; resistance training; superimposition

Outcome Measures

Primary Outcomes (2)

• Deep Neck Flexors Endurance Test

  To assess motor control of the neck, deep neck flexors endurance test will be used as a measure of neck muscle function. The reliability indexes suggest that the Deep Neck Flexors Endurance Test (DNFET )is an appropriate measure for group comparisons.

  From pre - treatment (at the enrollment stage) to post - treatment assessment after 6 weeks (12th session).

• Cervical Progressive Iso - Inertial Lifting Evaluation

  Cervical Progressive Iso - Inertial Lifting Evaluation is functional restoration measure in spinal disorders. The endurance test of the short neck flexors and the cervical PILE test can be regarded as appropriate instruments for measuring different aspects of neck muscle function in patients with non-specific neck pain. Moreover, the cervical PILE test - showed high inter-rater reliability and between-days repeatability out of 8 physical performance tests.

  From pre - treatment (at the enrollment) to post - treatment assessment after 6 weeks (12th session).

Secondary Outcomes (2)

• Muscle Strength Assessment

  From pre - treatment (at the enrollment) to post - treatment assessment at 6 weeks (after 12th session).

• Pain (Numeric Pain Rating Scale)

  From pre - treatment (at enrollment stage) to post - treatment assessment at 6 weeks (after 12th session).

Study Arms (2)

Voluntary Exercise

ACTIVE COMPARATOR

Active therapeutic exercises prescription for neck and scapular region, including warm-up, strengthening and cool - down under supervision of a physiotherapist.

Procedure: Exercise Therapy

Electrically Stimulated Exercise

EXPERIMENTAL

All of the therapeutic exercises prescription parameters for warm-up, strengthening and cool - down, including patient positioning, type of exercise, duration, frequency and intensity will be the same as in 'Voluntary Exercise'. For the intervention details, while 'Voluntary Exercise' will recieve only active exercises under supervision of the physiotherapist, in 'Electrically Stimulated Exercise' as a part of the strengthening protocol, electrical muscle stimulation unit will be applied over scapular region, bilaterally.

Procedure: Superimposition of electrical muscle stimulation on active movement

Interventions

Exercise Therapy PROCEDURE

Active therapeutic exercises prescription in face - to - face therapy sessions under supervision, for the duration of approximately 60 minutes per session. Therapy session will start with a warm - up including segmental stability exercise , i.e. deep cervical flexors training to improve neuromuscular coordination of the neck: Participant will do chin - tucks (cervical retraction and axial extension) for 2 sets of 5 seconds hold for 12 repetions, with between set rest interval of 2 minutes, in sitting. Next, participant will perform global stability exercises emphasizing flexor and extensor group musculature, with a gym ball, as a part of strengthening protocol. Lastly, as a cool -down, participant performs: pectoralis stretch, scalene stretch, suboccipitals stretch. Each position is held for 15 seconds and repeated 4 times for each muscle group bilaterally.

Voluntary Exercise

Superimposition of electrical muscle stimulation on active movement PROCEDURE

EMS will be applied over scapular region, bilaterally. Electophysiological motor points of upper trapezius will be identified through surface mapping with a pen electrode to minimize limited spatial recruitment of motor units, that occurs due to poor electrodes placement. Reference electrode is placed at the antagonist muscle, i.e. insertion of lower trapezius over the medial end of spine of scapula. Self - adhesive, disposable electrodes (4pcs) will be allocated for each participant at the first session. Movements of the participants will be synchronized with the EMS impulses, i.e. motion intiation - ramp up, hold - on time, rest - off time. Since present systematic reviews contain low quality evidence and EMS parameters are highly heteregenous, choice of the parameters will be done activating slow - twitch endurance muscle fibers.

Electrically Stimulated Exercise

Eligibility Criteria

• Age: 18 Years - 29 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Student must be enrolled in the last 2 years of Bachelor degree or in Master's degree in one of the healthcare - related programs at the European University of Lefke;
• Age 18 - 29 years old;
• Neck pain of minimum 4 or more on numerical rating scale (0 - 10);
• Duration of symptoms 3 \< months \< 6, i.e. subacute symptoms with chronic/stable presentation;
• Has 1 or more of the following symptoms: paresthesia of 1 or both upper extremities at the level below elbow; pain radiating from neck to shoulder/arm/below elbow; feeling of weakness in 1 or both of the upper extremities, stiffness and/or tenderness and/or hyperalgesia in the cervical and/or upper thoracic area;
• Obtained "Cervical Radiculopathy" diagnosis from a physician, according to neurological examination findings: Positive cervical radiculopathy specific provocative tests (Spurling's Maneuver, Upper Limb Tension Test; Reduced Deep Tendon Reflexes of brachioradialis, biceps and triceps.

You may not qualify if:

• Any recent head/neck or shoulder trauma in the last 3 months;
• Received physiotherapy for neck - related complaints in the last 3 months;
• Received or currently receiving any kind of pharmacological intervention (muscle relaxants, NSAIDs, corticosteroids injections) in the last 3 months;
• Presents with symptoms favoring shoulder pathology: pain localized at the shoulder that worsens at night, positive Drop Arm Test, pain referral patterns are localized in the upper arm above elbow;
• Any recent surgeries to the neck, upper extremities within the last 6 months;
• Any diagnosed neurologic or musculoskeletal conditions that could mimic cervical radiculopathy, i.e. peripheral neuropathies of different origin, thoracic outlet syndrome medial/lateral epicondylitis, myofascial pain syndrome, etc.;
• Any cardiovascular (recent DVT, congestive heart failure), metabolic (diabetic polyneuropathy), neurologic (impaired consciousness, epilepsy), malignant conditions in which application of electrotherapy or exercises imposes risk on the patient;
• Presence of pregnancy;
• Active implants, e.g. cardiac pacemaker;
• Any skin lesions in the cervical and/or scapular region, i.e. infections, open - wounds;
• Refuses to participate in the study.

Sponsors & Collaborators

• European University of Lefke: lead

Study Sites (1)

European University of Lefke

Lefka, Cyprus

Location

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• Wong, J. J., Côté, P., Quesnele, J. J., Stern, P. J., & Mior, S. A. (2014). The course and prognostic factors of symptomatic cervical disc herniation with radiculopathy: A systematic review of the literature. The Spine Journal, 14(8), 1781-1789. https://doi.org/10.1016/j.spinee.2014.02.032

  BACKGROUND

• Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015;28(5):E251-9. https://doi.org/10.1097/BSD.0000000000000284

  BACKGROUND

• YEŞİLYURT, M., & FAYDALI, S. (2020). Ağri Değerlendi̇rmesi̇nde Tek Boyutlu ölçekleri̇n Kullanimi. Journal of Anatolia Nursing and Health Sciences. https://doi.org/10.17049/ataunihem.508877

  BACKGROUND

• Yousif, M. S., Occhipinti, G., Bianchini, F., Feller, D., Schmid, A. B., & Mourad, F. (2025). Neurological examination for cervical radiculopathy: A scoping review. BMC Musculoskeletal Disorders, 26(1). https://doi.org/10.1186/s12891-025-08560-9

  BACKGROUND

• Zhao Jie Wu, Kunwei HW, Xiaoyu Hu, Xianyue Z. Influencing factors and preventive measures of spondylosis in college students. Healthmust Readmagazine. 2020;22:244.

  BACKGROUND

MeSH Terms

Conditions

Radiculopathy; Neck Pain; Hypesthesia; Paresthesia; Muscle Weakness

Interventions

Exercise Therapy

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Somatosensory Disorders; Sensation Disorders; Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Manifestations; Pathologic Processes

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities

Study Officials

• Zhanna Abdrakhmanova, BSc in Physical Therapy

  European University of Lefke

  PRINCIPAL INVESTIGATOR

• Nazemin Gilanlıoğulları, Asst. Prof. Dr., PhD in Rehabilitation

  Faculty of Health Sciences, Vice Dean, European University of Lefke

  STUDY CHAIR

• Beraat Alptuğ, Asst. Prof. Dr., PhD in Physical Therapy

  Head of the Department of Physiotherapy and Rehabilitation Faculty of Health Sciences European University of Lefke

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physiotherapist

Study Record Dates

• First Submitted: January 22, 2026
• First Posted: January 29, 2026
• Study Start: December 1, 2025
• Primary Completion: March 23, 2026
• Study Completion: March 23, 2026
• Last Updated: March 24, 2026

Record last verified: 2026-02

Locations

CY (1)