Effect of Core Stabilization Exercises on Patients With Cervical Radiculopathy

Effect of Lumbar Core Stabilization Exercises on Craniovertebral Angle and Functional Outcome in Patients With Cervical Radiculopathy

The goal of this clinical trial is to evaluate the effect of core stabilization exercise on functional outcome and craniovertebral angle which is the angle of forward head , in adults with cervical radiculopathy. The main questions it aims to answer are:

• Is there a significant effect of core stabilization exercises (CSEs) on craniovertebral angle (CVA) in patients with cervical radiculopathy?
• Is there a significant effect of core stabilization exercises (CSEs) on functional outcome in patients with cervical radiculopathy? Researchers will compare effect of adding core stabilization exercises to conventional physical therapy program (TENS, hot pack, US, manual therapy and strengthening exercises) Vs conventional physical therapy program alone to see if there is a beneficial effect of adding core stabilization exercises to physical therapy program Participants in study group will perform core stabilization exercises in addition to conventional PT program while participants in control group will receive conventional PT program

Study Overview

• Status: Completed
• Conditions: Cervical Radiculopathy
• Intervention / Treatment: Other: conventional physical therapy program; Other: Core stabilization exercises

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Giza, Egypt
    • Faculty of Physical Therapy Cairo University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Patients with Posterolateral cervical disc proplapse at level of C5-C6 and C6-C7 levels
2. Neck Disability Index (NDI) score exceeding 20%.
3. Neck pain of mild to moderate intensity (VAS ≥ 3).
4. Their symptoms lasting for a duration exceeding six weeks
5. Three out of four elements are positive in the following tests: spurling test, distraction test, upper limb tension test, shoulder abduction test.
6. Body mass index should not exceed 30 kg/m².
7. Patients complaining from neck pain and unilateral radicular pain, parathesia, motor manifestations or hyporeflexia
8. Their age will range from 35 to 50 years.
9. Their craniovertebral angle is less than 49 degrees.
10. Their mean of cervical joint position error is larger than 4.5 degrees.

Exclusion Criteria:

1. Cervical mylopathy or spinal tumors
2. History of cervical spine surgeries
3. Cervical fractures
4. Vertebrobasilar insufficiency (VBI)
5. Bone Infection

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: control group	Other: conventional physical therapy program; conventional physical therapy program will include TENS, hot pack, US, manual therapy and strengthening exercises
Experimental: study group	Other: conventional physical therapy program; conventional physical therapy program will include TENS, hot pack, US, manual therapy and strengthening exercises; Other: Core stabilization exercises; participants in study group will receive 30 mins and 3 sessions per week for 4 weeks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Craniovertebral Angle	Craniovertebral angle ( CVA ) will be measured through lateral photography of patients. Before capturing the picture, Plastic markers will be placed on C7 vertebra and on tragus of ear. Then the picture will be uploaded to kinovea software to measure CVA by measuring the angle between a line connecting two plastic markers and the horizontal. Values more than 49 degrees are considered abnormal indicating forward head posture while values lower than 49 degrees indicate normal head position	from enrollment to the end of treatment at 4 weeks
Arabic Version of Neck Disability Index (NDI)	Functional outcome will be assessed though Arabic Version of Neck Disability Index (NDI) which is a 10-item self-reported questionnaire. It measures the influence of neck pain on functioning and disability. The patient will be informed that this questionnaire had been designed to give us how your pain had affected your ability to function in daily life. Personal care, lifting, reading, work, driving, sleeping, recreational activities, pain intensity, concentration, and headache are examples of these questions. Each question is assessed on a six-point scale ranging from 0 (no disability) to 5 (major disability). The score will be calculated by adding the scores of each item together. The overall score is out of 50. The results can be expressed as a percentage by multiplying the score by two. The higher NDI score, the greater patient's perceived disability due to neck pain. The Arabic version of NDI is a strong valid method for assessing self-rated disability in patients with neck pain	from enrollment to the end of treatment at 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Neck Pain	Neck pain will be assessed though Visual Analogue Scale (VAS) which is used to measure the severity of neck pain. It is a straight line with one end representing no pain and the other end representing the worst imaginable pain. The subject will mark a point on the line that corresponds to the current level of pain he or she experiences. Higher values indicate higher levels of pain while lower values indicate lower levels of pain	from enrollment to the end of treatment at 4 weeks
Cervical Proprioception	Cervical proprioception will be assessed through measurement of cervical Joint Position Error (JPE). Instruments that will be utilized are laser pointer device mounted on participant's head and a chart with a reference point at its center. the chart is positioned 90cm in front of patients. A test of repositioning to a neutral head position (NHP) will be carried out to determine JPE. Participants will move their head away from the start position at the center of the chart which is the NHP to full range and then attempt to reposition the head back to the starting point as accurately as possible while they are blindfolded. The difference between the starting position (zero) and the returning point in the plane of movement will be measured in centimeters and then converted to degrees using this formula angle = tan-1 [error distance/90 cm]. Normal cervical JPE is 4.5 degree. Higher values indicate poor cervical proprioception	from enrollment to the end of treatment at 4 weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): September 3, 2025
• Primary Completion (Actual): March 3, 2026
• Study Completion (Actual): March 3, 2026

Study Registration Dates

• First Submitted: January 13, 2026
• First Submitted That Met QC Criteria: January 23, 2026
• First Posted (Actual): January 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 1, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: craniovertebral angle; Core stabilization exercises
• Additional Relevant MeSH Terms: Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Radiculopathy
• Other Study ID Numbers: P.T.REC/012/006086

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No