Effect of Kinetic Control Training on Flexion Relaxation Phenomenon and Craniovertebral Angle in Cervical Radiculopathy Patients

Neck pain is a major health issue with high rates of recurrence. The current literature suggests people with cervical pain have altered movement control strategies and that these changes are associated with pain and disability.

These altered strategies will influence the control of movement which can present as both uncontrolled translatatory movement and uncontrolled range or physiological motion. Either movement dysfunction will present clinically as areas of relative flexibility (increase in translational movement) or areas of relative stiffness.

Changes in alignment in the cervical spine may result in a forward head posture position demonstrating an increase in low cervical flexion.

The greater the forward head posture, the greater the disability. Regions and segments of less mobility have been noted in the cervical spine which will present clinically as regions of relative stiffness.

Disturbance in neck flexor synergy has been commonly observed in patients with neck pain. This disturbed neck flexor synergy presents as altered pattern of muscle activity, where impairment in deep cervical flexors appears to be compensated by increased activity in superficial muscles (sternocleidomastoid and anterior scalene) and it is also reported that the amplitude of upper trapezius and cervical extensors have been dramatically increased among those patients. Such impairments may contribute to the development of pain and disability in patients with neck pain.

The Kinetic Control retraining strategy consists of patient education about his uncontrolled movement, retraining the coordination of movement direction control and muscle synergy retraining. Movement retraining interventions that are matched to correcting specific impairments can restore movement and performance solutions, elevating movement health and the quality of life it supports.

Inclusion criteria

• Patients will be referred from neurologist with the diagnosis cervical spondylosis.
• Patients will be included if they have unilateral radiculopathy due to spondylotic changes of the lower cervical spine (C5-C6 and C6-C7).
• Duration of symptoms is more than three months to avoid acute stage of inflammation.
• Patient's age ranged from 40 to 55 years.
• Patients from both sexes.
• Body mass index of all patients is ranged from 25-30 kg/m2.
• Patients will be screened prior to inclusion by measuring the craniovertebral angle, if the angle was less than 50, then a participant will be referred to the study

Exclusion criteria

• Spinal canal stenosis.
• Rheumatoid arthritis.
• Vertebrobasilar insufficiency.
• Spinal instability due to structural cause e.g., spondylolisthesis.
• Systemic disease (cardiovascular, infectious and/or metabolic disease that could interrupt exercises).
• Spinal tumors.