Isokinetic Assessment of Wrist Muscle Performance Among Medical Students With Neck Pain

BACKGROUND:

Although it is widely acknowledged that chronic non-specific neck pain is linked to hand disability as previously studied on dentists and ministry of health care stuff, there is still a gap in illustrating the effect of chronic non-specific neck pain on Egyptian physical therapy students' functional ability of wrist in the upper limb. However, the assessment of extensor / flexor wrist strength ratio has only recently gained attention. Furthermore, there is limited research investigating the strength control ratio that incorporates both concentric and eccentric muscle actions, and additional scientific evidence is needed to establish the relationship between chronic non-specific neck pain and upper limb disability. This study will be conducted to set new assessment and rehabilitation goals. This will subsequently be translated into home therapy program, contributing to decrease the burden of neck pain economically and on health care management.

Our study aims to evaluate peak torque of wrist extensor and flexor muscle/ body weight and extensor / flexor wrist ratio and wrist extensor and flexor muscle endurance among Egyptian physical therapy students with non-specific neck pain. Torque results are adjusted for body weight and compared to normative data for the gender and activity specialty to determine whether the unaffected limb is strong enough to act as a reference for the afflicted limb also compared between right- and left-handed subjects.

HYPOTHESES:

• There will be no significant effect of chronic non-specific neck pain on peak torque of wrist extensor and flexor muscles /body weight.
• There will be no significant effect of chronic non-specific neck pain on extensor / flexor wrist ratio.
• There will be no significant effect of chronic non-specific neck pain on wrist extensor and flexor muscles endurance.

RESEARCH QUESTIONS:

• Does chronic non-specific neck pain affect wrist extensor and flexor muscles performance among Egyptian physical therapy students?
• Does chronic non-specific neck pain affect peak torque of wrist extensor and flexor muscles/ body weight among Egyptian physical therapy students?
• Does chronic non-specific neck pain affect extensor / flexor wrist ratio among Egyptian physical therapy students?
• Does chronic non-specific neck pain affect wrist extensor and flexor muscles endurance among Egyptian physical therapy students?

Inclusion criteria

• Both sexes
• Duration of neck pain (> 3 months)
• Age from 18 to 23 years
• The neck pain intensity is between 3 and 8 on the Numerical Pain Rating Scale
• Neck pain-related disability was between 5 and 14 points on the Neck Disability Index
• Body mass index from 18.5 to 29.5

Exclusion criteria

• Neurological conditions (i.e., Parkinson's disease, multiple sclerosis, head injury, peripheral neuropathy, stroke, or nerve root entrapment)
• Headache
• Cancer, infection, or any other illness symptoms.
• Trauma
• Cardiovascular problems or cerebrovascular insufficiency symptoms.
• Musculoskeletal disorder (i.e., joint replacement, amputation, physically limiting arthritis, contractures of fixed deformity, or muscular dystrophy)
• Orthopedic or neurological conditions such as fractures, surgeries on the upper limb or hand, carpal tunnel syndrome, De Quervain's syndrome, or diabetic mellitus
• Cervical spine spondylosis, disc prolapse, spinal stenosis, cervical fracture, etc.
• Any recent treatment for neck pain.
• Visual, auditory and speech problems
• Forward head posture.