Neuromuscular Re-education on Pain, ROM and Disability in Cervical Radiculopathy

Effects of Neuromuscular Re-education on Pain, Range of Motion and Disability in Patients With Cervical Radiculopathy

This study explores the effectiveness of Neuromuscular Re-education compared to conventional therapies in managing pain, range of motion, and disability in patients with Cervical Radiculopathy

Study Overview

• Status: Not yet recruiting
• Conditions: Cervical Radicular Pain
• Intervention / Treatment: Other: Neuromuscular Re education; Other: Conventional Physical Therapy

Detailed Description

The study identifies a gap in the current literature surrounding the effectiveness of neuromuscular re-education interventions in targeting pain reduction, disability improvement, and enhancement of range of motion for CR patients. Previous studies emphasize conventional methods, such as proprioceptive neuromuscular facilitation and manual therapy, with a general focus on motor control and postural re-education. However, the precise benefits of structured NMR exercises tailored to CR symptoms, particularly targeting proprioceptive training and functional task simulation, are less explored, especially compared to traditional interventions like heat/cold application or general strengthening

• Study Type: Interventional
• Enrollment (Estimated): 52
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Munaab Khan, PhD; Phone Number: +923367993611; Email: muneeb.khan@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Sialkot, Punjab Province, Pakistan, 54500
      • National hospital sialkot
      • Contact: Javeria Ghazal, MS; Phone Number: 03335154664; Email: javeria.ghazal@riphah.edu.pk
      • Principal Investigator: Sofia Rehman, MS

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Participants of Age between 30 and 50 years old.
• Participants of both gender included.
• Participants having Unilateral upper extremity pain, paresthesia, or numbness
• Participants with Four positive findings required:
• Positive Spurling's test
• Positive distraction test
• Positive upper limb tension test
• Ipsilateral cervical rotation less than 60 degrees
• Participants must have experienced pain for at least 3 months.
• Participants must have a pain score of 4 to 6 on the 0-10 scale

Exclusion Criteria:

• Participants having prior cervical spine surgery.
• Participants with Cervical vertebral fracture
• Participants with severe osteoporosis, rheumatic disease, shoulder disease, or infection will be excluded.
• Participants with vertebro-basilar artery insufficiency and diabetic neuropathy

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Neuromuscular Re-education Group; postural training exercises, proprioceptive tasks, Dynamic control exercises, eye-head coordination tasks	Other: Neuromuscular Re education; A. Postural training and functional task simulation(chin tuck, Shoulder blade squeeze, reaching, carrying, lifting tasks) Proprioceptive tasks( single leg stance with head movement), deep cervical strengthening. 3 sessions per week, 30 minutes per session (10 mint each component),10 repetition per set, 2 set, 10 second Resting interval Resting period: 1 mint to next exercise
Active Comparator: Conventional Physical Therapy; Electrotherapy, Manual Therapy Techniques	Other: Conventional Physical Therapy; TENS and hot pack for 10 to 15 minutes; Manual therapy techniques (e.g., mobilizations grade II). 5 to 10 repetition; Cervical isometric exercises 10 reps; General education on posture and ergonomics guidelines; Frequency: 3 sessions per week; Duration: 50 minutes per session, 10 mint each component; Repetition: 10 repetition per set, 2 set , 10 second resting interval; Resting period: 1 mint to next exercise

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Goniometer	A goniometer is used to measure cervical range of motion (ROM) by aligning its fulcrum over a bony landmark (like the C7 vertebrae or external auditory meatus) and its arms with other bony landmarks (such as the nose, acromion, or sternal notch) to measure the angle of movement in degrees.	8th Week
NDI (Neck Disability Index)	The NDI is a 10-item questionnaire that assesses how neck pain affects daily activities(28). The Neck Disability Index (NDI) measures neck-specific disability through a 10-item questionnaire assessing pain and daily activities like personal care, lifting, and concentration. Scores range from 0-50 (or 0-100%), with higher scores indicating greater disability	8th week
NPRS (Numeric Pain Rate Scale)	The Numerical Pain Rating Scale (NPRS) has been used to assess the level of pain patients experience. It can be used to assess pain either verbally or through a self completion questionnaires. Patients are asked to circle a number on a scale that best describes the pain the experience. Patients are asked to recall from the pain scale from 0 to 10. 0 equals No pain, 1-3 equals Mild pain, 4-6 equals Moderate pain, 7-9 equals Severe pain, and 10 equals Very Severe pain. NPRS shows strong test-retest score even in illiterate and literate patients	8th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Javeria Ghazal, MS, Riphah International University

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2026
• Primary Completion (Estimated): June 16, 2026
• Study Completion (Estimated): July 15, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: March 27, 2026
• First Posted (Actual): April 1, 2026

Study Record Updates

• Last Update Posted (Actual): April 1, 2026
• Last Update Submitted That Met QC Criteria: March 27, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Range of Motion; Pain Management; Cervical Radiculopathy; Neuromuscular Re-education
• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neuromuscular Diseases; Peripheral Nervous System Diseases; Neurobehavioral Manifestations; Perceptual Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Radiculopathy; Agnosia
• Other Study ID Numbers: REC/RCR & AHS/24/0298

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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