This study determined the efficacy of neck muscle activation alongside conventional care versus strengthening exercise with conventional care for cervical radiculopathy.
This study was a 5-week parallel, two-arm randomized clinical trial on 80 participants with chronic cervical radiculopathy according to ICD-10 (lasting over 3 months) between July and December 2023. Participants were recruited from Dhaka's Agrani Specialized Physiotherapy Center in Bangladesh and randomly assigned to two groups in a 1:1 ratio. Both groups received 14 sessions, each lasting 30-45 minutes. Post-treatment evaluations were employed on the brief pain inventory (BPI) scale, cranio-vertebral angle (CV angle), endurance, and neck disability index (NDI) after 5 weeks. Primary outcomes (endurance, cranio-vertebral angle) were measured using a digital inclinometer, and goniometer. Secondary outcomes (pain, neck disability) were assessed through the brief pain inventory (BPI) scale, digital inclinometer, and neck disability index (NDI). Data were analyzed using SPSS version 22, employing parametric and non-parametric tests to evaluate baseline differences and treatment outcomes.
Baseline characteristics showed no significant differences (p > 0.05) between the experimental and control groups in pain, cervical endurance, cranio-vertebral angle, and neck disability scores. Flexor endurance was 26.51±5.67 overall, with an average craniovertebral angle of 51.49±5.57.
Both activation and strengthening groups had significant outcomes compared to baseline (p.05) in endurance, cranio-vertebral angle, pain, and neck disability after the 5-weeks intervention period. However, the experimental group's outcome was superior to the conventional group in all outcome measures (p.05), and the overall effect size was larger in the activation group than strengthening, except neck disability index. The neck disability score (t=-2.846, p0.01) was significantly lower, showing superior functional outcomes in the neck muscle activation group across various measures.
The study reveals that muscle activation combined with conventional care is more effective than strengthening exercises with conventional care alone for patients with chronic cervical radiculopathy.
This study highlights that neck muscle activation when combined with conventional care, offers superior outcomes compared to strengthening exercises alone for chronic cervical radiculopathy. So clinicians may consider prioritizing activation-based exercises in patients with chronic cervical radiculopathy in their treatment plans to improve endurance, posture (cranio-vertebral angle), pain management, and functional outcomes.
neck muscle activation
strengthening exercise
