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NCT Number: NCT07321119

Correlation Between Cervical Deep Flexors Endurance and Proprioception Function in Cervical Radiculopathy

In cervical radiculopathy, reduced endurance of the deep cervical flexor muscles is associated with impaired cervical proprioception. This relationship reflects altered sensorimotor control due to muscle dysfunction and neural compromise, emphasizing the need for deep flexor endurance training in rehabilitation.

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Key information

Conditions

Cervical Radiculopathy Nervous System Diseases Neuromuscular Diseases Peripheral Nervous System Diseases Radiculopathy

Age range

30 year–45 year

Sex eligibility

All sexes

Study type

Observational

About this study

In patients with cervical radiculopathy, endurance of the deep cervical flexor muscles (longus capitis and longus colli) plays a crucial role in maintaining cervical segmental stability and accurate sensorimotor control. These muscles are rich in muscle spindles and provide continuous afferent input necessary for cervical proprioception, including joint position sense and movement accuracy. When deep cervical flexor endurance is reduced, there is increased reliance on superficial neck muscles, leading to altered motor patterns and diminished quality of proprioceptive feedback.

Cervical radiculopathy further disrupts proprioceptive function through nerve root compression, inflammation, and impaired neural conduction, which affect both sensory input and motor output. This neuromuscular dysfunction results in increased joint position errors, delayed muscle activation, and poor postural control. Consequently, a significant correlation is observed between decreased deep cervical flexor endurance and impaired cervical proprioception, suggesting that deficits in muscle endurance contribute directly to sensorimotor dysfunction. These findings support rehabilitation approaches that emphasize endurance training of the deep cervical flexors to restore proprioceptive accuracy and cervical motor control in patients with cervical radiculopathy.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Adults diagnosed with cervical radiculopathy based on clinical examination (± imaging confirmation).

Presence of neck pain with radiating symptoms to the upper limb for at least 4 weeks.

Age range 20-60 years.

Ability to understand instructions and participate in cervical endurance and proprioception assessments.

Exclusion criteria

History of cervical spine surgery or acute cervical trauma.

Presence of neurological disorders other than cervical radiculopathy (e.g., stroke, multiple sclerosis).

Vestibular disorders or conditions affecting balance and head position sense.

Inflammatory, rheumatologic, or severe musculoskeletal conditions involving the cervical spine.

Treatment and study plan

cevical range of motion device

Device

Cervical proprioception was evaluated using the Cervical Range of Motion (CROM) device by assessing joint position sense (JPS). With the participant seated in an upright position, the CROM device was securely fitted to the head. The patient was instructed to actively move the head from a neutral starting position into a specific direction (flexion, extension, rotation, or lateral flexion), then return to the perceived neutral position with eyes closed.

The difference between the starting neutral position and the repositioned angle was recorded as the joint position error (JPE), measured in degrees. Multiple trials were performed for each movement direction, and the mean JPE value was calculated. Higher JPE values indicated poorer cervical proprioceptive accuracy. The CROM device is considered a reliable and valid clinical tool for quantifying cervical proprioception in patients with cervical radiculopathy.

Primary outcomes

Cervical proprioception errors by using joint position sense via CROM device

Time frame: baseline

Cervical proprioception was assessed using the CROM device by measuring joint position sense error. Participants were seated upright with the trunk stabilized and the CROM mounted on the head; visual input was eliminated by closing the eyes. From a neutral head position, participants actively moved the head to a predetermined target angle (approximately 50-60% of available cervical range of motion) in flexion, extension, or rotation, held the position briefly, returned to neutral, and then attempted to reproduce the target position. The absolute difference between the target and reproduced angles, recorded in degrees by the CROM, represented the joint position error, and the mean of three trials for each movement direction was used for analy

Secondary outcomes

Deep flexor cervical muscle endurance using biofeedback device

Time frame: baseline

Deep cervical flexor muscle endurance was assessed using a pressure biofeedback unit. Participants were positioned in crook-lying with the pressure cuff placed suboccipitally and inflated to a baseline pressure of 20 mmHg. After instruction and practice of the craniocervical flexion action, participants were asked to incrementally increase and maintain pressure (22-30 mmHg) by performing a gentle nodding movement without activation of superficial neck muscles. Endurance was recorded as the maximum pressure level that could be held steadily for 10 seconds with correct technique, and the total performance score was determined based on the highest successfully maintained pressure level.

Study contacts

Contact information is provided by the study sponsor or research team.

ibrahim A abu ella, Phd

CONTACT

[email protected]

+201008442281

Sponsors and collaborators

Lead sponsor

Delta University for Science and Technology

Other

Registry information

Official study title

Correlation Between Endurance and Proprioception Function in Cervical Radiculopathy

Important dates

Study start: 2026
Primary completion: 2026
Study completion: 2026
First posted: Jan 6, 2026
Registry last updated: Jan 6, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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