Association Between Cervical Sagittal Alignment, Cervical Muscle Function, and Scapular Alignment in Patients with Cervical Radiculopathy in Lahore City.
Keywords:
Cervical Radiculopathy; Neck Disability; Cervical Muscle Function; Scapular Dyskinesis; Upper Limb FunctionAbstract
Background: Cervical radiculopathy is a frequent musculoskeletal disorder, associated with neck pain, neurological symptoms and functional deficit with significant impact on quality of life. The role of the cervical muscles in interaction with scapular position, postural awareness, and disability is key for best rehabilitation results. Objective: To examine the relationship between cervical muscle function, scapular alignment, and postural awareness and upper-limb function with neck disability in patients with cervical radiculopathy. Methods: This cross-sectional analytical study included 150 patients who were clinically diagnosed with cervical radiculopathy from physiotherapy and orthopedic clinics of Lahore, Pakistan. The validated tools that were used to assess were: the NPRS for pain intensity, the NDI for neck disability, the QuickDASH for upper-limb disability, the SDSQ for scapular dyskinesis and the PAS for postural awareness. Spearman's correlation and Mann–Whitney U test were used, as well as multiple linear regression analyses. Results: There are strong positive relationships between pain intensity, neck disability, cervical muscle dysfunction, upper-limb disability and scapular dyskinesis; and strong negative relationships between postural awareness and these variables (p < 0.001). Pain intensity (β = 0.300, p < 0.001) and upper-limb disability (β = 0.644, p < 0.001) independently predicted neck disability. Descriptive analysis showed that participants had a mean age of 36.25 ± 9.27 years, with moderate neck disability (NDI: 30.35 ± 8.59) and considerable upper-limb disability (QuickDASH: 60.61 ± 16.99). There were no significant gender differences found. Conclusion: Neck disability in patients with cervical radiculopathy is most strongly influenced by pain severity and upper limb disability. Systematic rehabilitation programs including pain management, restoration of upper-limb function, cervical muscle performance and postural correction and scapular mechanics improve functional outcomes..
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References
Iyer S, Kim HJ. Cervical radiculopathy. Current reviews in musculoskeletal medicine. 2016 Sep;9(3):272-80.
2. Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. HSS Journal®. 2011 Oct;7(3):265-72.
3. Corey DL, Comeau D. Cervical radiculopathy. Medical Clinics. 2014 Jul 1;98(4):791-9.
4. Carette S, Fehlings MG. Cervical radiculopathy. New England Journal of Medicine. 2005 Jul 28;353(4):392-9.
5. Mansfield M, Smith T, Spahr N, Thacker M. Cervical spine radiculopathy epidemiology: a systematic review. Musculoskeletal Care. 2020 Dec;18(4):555-67.
6. Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am. 2003;14:455–72. doi: 10.1016/s1047-9651(03)00041-x.
7. Bussières, A. E., Taylor, J. A., & Peterson, C. (2007). Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach— Part 3: Spinal Disorders. Journal of Manipulative and Physiological Therapeutics, 31(1), 33-88.
8. Bono, C. M., Ghiselli, G., Gilbert, T. J., Kreiner, D. S., Reitman, C., Summers, J. T., Baisden, J. L., Easa, J., Fernand, R., Lamer, T., Matz, P. G., Mazanec, D. J., Resnick, D. K., Shaffer, W. O., Sharma, A. K., Timmons, R. B., & Toton, J. F. (2010). An evidence based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. The Spine Journal, 11(1), 64-72
9. Spurling SG. Lateral rupture of the cervical intervertebral discs. A common cause of shoulder and arm pain. Surg. Gynec. Obstet.. 1944;78:350-8.
10. DAVIDSON, ROBIN I. MD*; DUNN, EDWARD J. MD†; METZMAKER, JEFFREY N. MD‡. The Shoulder Abduction Test in the Diagnosis of Radicular Pain in Cervical Extradural Compressive Monoradiculopathies. Spine 6(5):p 441-446, September 1981.
11. Elvey, R. L. (1997). Physical evaluation of the peripheral nervous system in disorders of pain and dysfunction. Journal of Hand Therapy, 10(2), 122-129.
12. Jull G, Moore A, Falla D, Lewis J, McCarthy C, Sterling M, editors. Grieve's modern musculoskeletal physiotherapy.
13. Levine, Marc J. MD; Albert, Todd J. MD; Smith, Michael D. MD. Cervical Radiculopathy: Diagnosis and Nonoperative Management. Journal of the American Academy of Orthopaedic Surgeons 4(6):p 305-316, November 1996.
14. Polston, D. W. (2007). Cervical Radiculopathy. Neurologic Clinics, 25(2), 373-385.
15. Harrison DE, Harrison DD, Troyanovich SJ. Three- 250 dimensional spinal coupling mechanics, Part I: A review of 251 the literature. J Manipulative Physiol Ther 1998; 21(2): 101- 252 13.
16. Moustafa IM, Diab AA, Hegazy FA, Harrison DE. Does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects?. Journal of Back and Musculoskeletal Rehabilitation. 2017 Jul;30(4):937-41.
17. Carzoli, J. (2014). ADDRESSING SCAPULAR MOVEMENT AND ALIGNMENT IMPAIRMENTS IN THE MANAGEMENT OF CHRONIC RECURRENT CERVICAL RADICULOPATHY: A CASE REPORT: OPO2274. Journal of Orthopaedic & Sports Physical Therapy, 44(1), A119...
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