Effects of Exercises and Electrical Current Application Aiming to Strengthen Neck and Shoulder Blades Muscles on Symptoms of a Pinched Nerve in the Neck

Summary

Cervical Radiculopathy (CR) is an objective loss of sensory and/or motor function as a result of compression or irritation of the cervical spinal nerve root.

The individuals with CR present with findings indicating an altered neural control of the neck musculature, leaving the cervical spine vulnerable to reactive forces.

Thus, physical therapy options should mainly focus on improving muscle function of the neck.

Given the promising results of electrical muscle stimulation and exercise therapy in recent literature the proposed study is aimed to investigate the effects of exercise therapy with electrical muscle on cervical muscle function and see, if muscle control has any impact on CR findings.

A superiority, randomized trial, with 2 intervention groups and allocation ratio of 1:1. 50 students, at the age from 18 to 29, from healthcare - related departments of European University of Lefke, who are diagnosed with CR will be recruited in the study.

To assess neck muscle function - Deep Neck Flexors Endurance time (s) and Cervical Progressive Iso - inertial Lifting scores (kg) will be used. Pain (Numeric Rating Scale 0 -10) and Muscle strength (grades 0 -5) will be used to measure the impact on CR findings.

All of the therapeutic exercises prescription parameters for warm-up (deep cervical flexors training), strengthening (cervical and scapulo-thoracic resistance training) and cool - down (flexibility training), will be the same for both groups: 60 minutes per session, 2 days in a week, for 6 weeks. In total each participant will recieve 12 sessions.

For the intervention details, while 'Intervention Group 1' will recieve only active exercises under supervision of the physiotherapist, in 'Intervention Group 2' as a part of the strengthening protocol, EMS will be applied over scapular region, bilaterally.

Conditions

• Cervical Radiculopathy
• Cervical Radicular Pain
• Neck Pain
• Numbness
• Paresthesia
• Weakness, Muscle
• Endurance

Interventions

PROCEDURE

Exercise Therapy

Active therapeutic exercises prescription in face - to - face therapy sessions under supervision, for the duration of approximately 60 minutes per session. Therapy session will start with a warm - up including segmental stability exercise , i.e. deep cervical flexors training to improve neuromuscular coordination of the neck: Participant will do chin - tucks (cervical retraction and axial extension) for 2 sets of 5 seconds hold for 12 repetions, with between set rest interval of 2 minutes, in sitting. Next, participant will perform global stability exercises emphasizing flexor and extensor group musculature, with a gym ball, as a part of strengthening protocol. Lastly, as a cool -down, participant performs: pectoralis stretch, scalene stretch, suboccipitals stretch. Each position is held for 15 seconds and repeated 4 times for each muscle group bilaterally.

PROCEDURE

Superimposition of electrical muscle stimulation on active movement

EMS will be applied over scapular region, bilaterally. Electophysiological motor points of upper trapezius will be identified through surface mapping with a pen electrode to minimize limited spatial recruitment of motor units, that occurs due to poor electrodes placement. Reference electrode is placed at the antagonist muscle, i.e. insertion of lower trapezius over the medial end of spine of scapula. Self - adhesive, disposable electrodes (4pcs) will be allocated for each participant at the first session. Movements of the participants will be synchronized with the EMS impulses, i.e. motion intiation - ramp up, hold - on time, rest - off time. Since present systematic reviews contain low quality evidence and EMS parameters are highly heteregenous, choice of the parameters will be done activating slow - twitch endurance muscle fibers.

Sponsors & Collaborators

• European University of Lefke

  lead OTHER

Principal Investigators

• Zhanna Abdrakhmanova, BSc in Physical Therapy · European University of Lefke

• Nazemin Gilanlıoğulları, Asst. Prof. Dr., PhD in Rehabilitation · Faculty of Health Sciences, Vice Dean, European University of Lefke

• Beraat Alptuğ, Asst. Prof. Dr., PhD in Physical Therapy · Head of the Department of Physiotherapy and Rehabilitation Faculty of Health Sciences European University of Lefke

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

29 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-12-01

Primary Completion

2026-03-23

Completion

2026-03-23

Countries

• Cyprus

Study Locations