Cervical Radiculopathy

This research aims to evaluate the effects of two different physical therapy techniques, Neuromuscular Reeducation (NMR) and Post Facilitation Stretch (PFS), on Upper Cross Syndrome among IT professionals. The study involves adults aged 20 to 40 years who have been diagnosed with this condition and have experienced pain for at least two months. The goal is to compare these techniques for improving symptoms related to this syndrome. Participants are divided into two groups: one group receives the NMR technique, which involves deep pressure along the muscles from origin to insertion combined with active movement and rest periods. The other group receives the PFS technique, which consists of isometric muscle contractions followed by rapid stretching and relaxation. Both groups also perform strengthening exercises for weak muscles as part of their treatment. The treatments are applied specifically to tight muscles including the levator scapulae, upper trapezius, and pectoralis major. Before treatment, baseline measurements are taken for neck range of motion (ROM), pain intensity using the Numeric Pain Rating Scale (NPRS), and neck disability index. After two weeks of treatment, these measures are repeated to assess changes. Participants undergo assessments at the start and after two weeks to compare improvements. The study monitors neck function, pain levels, and disability related to the syndrome throughout the treatment period.

Researchers are investigating the use of vagus nerve stimulation (VNS) combined with rehabilitation to improve arm movement after an ischemic stroke. This clinical trial compares active VNS paired with rehabilitation against a sham VNS with no electrical stimulation, also combined with rehabilitation, to assess their effects on upper extremity motor function in stroke patients. The study is conducted with a triple-blind, randomized, sham-controlled design and aims to evaluate both safety and efficacy.

Researchers are evaluating a new way to provide preoperative information to patients who are candidates for spinal or urological surgery. This study is an interventional, randomized controlled trial conducted at multiple centers. It aims to compare a new multimedia-based method that objectively checks patient understanding against the standard informed consent process to see which better supports patient decision-making about surgery. Participants in the experimental group will receive detailed information through videos with surgical options, graphics, and animations. They will also have interviews with the surgeon and caregivers using 3D-printed models to guide shared decision-making. After deciding on surgery, patients will join educational programs to reinforce understanding before a final surgeon interview and signing of informed consent. The control group will receive the usual care, including a standard explanatory interview and consent signing. Throughout the study, participants will complete questionnaires assessing satisfaction, comprehension, mental health, pain, disability, urinary and sexual function, and legal outcomes at multiple time points: before surgery, at discharge, and at two and six months after surgery. The research team will monitor these measures to evaluate the impact of the new method on patient understanding and decision satisfaction over time.

This research aims to compare two manual therapy techniques, Active Release Technique and Strain-Counterstrain, in adults aged 18 to 45 years who experience non-specific neck pain. The study focuses on how these treatments affect pain levels, neck range of motion, the cranio-vertebral angle, and disability. Neck pain is a common problem worldwide and in Pakistan, often caused by muscle strain or poor posture, leading to discomfort and reduced quality of life. This trial seeks to provide insights into which technique may better improve symptoms and function in affected individuals. Participants will be randomly assigned to one of two groups. Group A will receive the Active Release Technique applied to the trapezius, levator scapulae, sternocleidomastoid, and suboccipital muscles for 15 minutes. Group B will receive the Strain-Counterstrain technique on the same muscles and for the same duration. Both groups will also receive hot packs, stretching of superficial neck muscles, and neck isometric exercises. Treatments will be given over four weeks, with assessments at the start and end of this period. During the study, participants will be evaluated for pain using the Numeric Pain Rating Scale, neck disability with the Neck Disability Index, neck posture by measuring the cranio-vertebral angle, and neck mobility with a goniometer. These measurements will be recorded at the beginning and after four weeks of treatment. The study will be conducted at Safi Teaching Hospital in Faisalabad, Pakistan, with ethical approval and informed consent. The findings aim to help improve clinical care for people with non-specific neck pain by identifying more effective manual therapy options.

Researchers are comparing the immediate effects of two types of exercises, motor imagery and motor control, on people with chronic neck pain. The study focuses on how these exercises influence pain levels, pressure pain threshold, neck position sense (cervical proprioception), and the ability to imagine movements (motor imagery). The goal is to better understand which exercise may help manage chronic neck pain symptoms. Participants will be randomly assigned to receive either a single session of motor imagery exercise based on the PETTLEP model or a single session of motor control exercise. Both interventions are studied as experimental approaches to see their acute impact on pain and motor functions related to chronic neck pain. During the study, participants will have their pain severity, pressure pain threshold, cervical proprioception, and motor imagery abilities measured before and immediately after the exercise session. This helps researchers evaluate the immediate changes caused by the interventions. The study enrolls adults aged 18 to 65 with chronic neck pain lasting at least 12 weeks and a specific pain intensity and cognitive function level.

Researchers are investigating the immediate effects of myofascial release therapy on neck pain, functional ability, and neck movement in people diagnosed with Text Neck Syndrome (TNS). TNS is a condition caused by prolonged forward head posture from excessive use of smartphones and other digital devices, especially among young adults. The study aims to explore how a single session of myofascial release might influence symptoms like neck pain and disability in this population. The treatment involves one session of standardized myofascial release techniques applied to the neck and upper back areas. A trained physiotherapist will perform four specific techniques: Single Arm Pull, Lateral Neck Shoulder Release, Thoracic Transverse Release, and Anterior Cervical Release. Each technique lasts about 90-120 seconds and is applied to both sides when appropriate. This study focuses on observing immediate changes before and after this therapy session. Participants will undergo assessments of neck pain intensity using the Numeric Rating Scale, functional disability using the modified Neck Disability Index, and cervical range of motion. These measurements will be taken right before and immediately after the intervention. The study includes volunteers aged 18 to 40 who use mobile devices for more than three hours daily and show symptoms of TNS. The findings will help inform future research and treatment approaches for posture-related neck problems.

Researchers are investigating how smartphone addiction affects neck posture, muscle function, balance, and tongue pressure in people with Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS). The study compares these individuals with a healthy control group to understand the added impact of smartphone use on posture and function beyond the effects of these diseases. Only patients with stable disease activity are included to focus on biomechanical effects without interference from active inflammation. The study involves three groups of 37 participants each: those with RA, those with AS, and healthy controls. Each participant will undergo a single session of assessments that include questionnaires on smartphone use and neck disability, measurements of neck posture (craniovertebral angle), neck muscle strength, balance tests, pressure pain thresholds, and tongue pressure. These evaluations are conducted in a specific order by a physiotherapist without any treatment or follow-up. Participants will provide information about their health, habits, and smartphone use, followed by physical tests measuring posture, muscle strength, balance, pain sensitivity, and tongue function. The main outcome measured is smartphone addiction level, with additional assessments of neck disability and physical function. Data will be analyzed to explore relationships between smartphone addiction and physical parameters across the three groups. The study aims to complete these assessments in one visit, focusing on understanding how technology use affects physical health in RA and AS.

Researchers are comparing three types of nerve blocks used for managing pain after shoulder arthroscopic surgeries. The study focuses on anterior glenoid nerve block, pericapsular nerve group (PENG) block, and interscalene brachial plexus (ISB) block. These blocks help reduce postoperative pain, improve patient comfort, speed up rehabilitation, and potentially shorten hospital stays. ISB blocks are well known as the standard method, while the PENG block is a newer technique that may provide pain relief with fewer side effects and quicker movement recovery. Participants will be randomly assigned to receive one of the three nerve blocks: the interscalene brachial plexus block, the anterior glenoid nerve block, or the pericapsular nerve group (PENG) block. All blocks are applied using ultrasound guidance during shoulder arthroscopic surgery. The study is double-blinded, meaning neither patients nor doctors know which block is given to ensure unbiased results. During the study, researchers will monitor the time until patients need their first rescue pain medication within 24 hours after surgery. They will also track total opioid use, pain levels, hospital stay duration, time to freely move the operated shoulder, and patient satisfaction. These measures help assess each block's effectiveness and safety. The entire study includes follow-up up to one week after surgery to observe recovery progress and potential complications.

Researchers are investigating upper-extremity proprioception impairment in patients experiencing radicular neuropathic symptoms caused by cervical disc herniation. This study focuses on the specific subgroup of cervical radiculopathy, which has not been systematically examined before, aiming to better understand the relationship between proprioceptive deficits and clinical outcomes such as pain and functional status. The study compares patients aged 18 to 65 years with cervical radiculopathy to a healthy control group matched by age, sex, and body mass index. Proprioception is assessed using the PRO-Reach method, which measures multisensory spatial representation of the entire upper limb through multiplanar and multi-joint evaluations without the need for computerized or robotic devices. Participants undergo baseline assessments including the Upper Limb Proprioception Reaching Test (PRO-Reach), pain rating scales (Numeric Rating Scale and DN-4 Questionnaire), quality of life evaluation (SHORT FORM-12), handgrip strength testing, and disability questionnaires (Quick Disabilities of the Arm, Shoulder and Hand Questionnaire). These measures help researchers evaluate sensory-motor function and its impact. The study involves healthy volunteers and patients, with data collection focused on initial measurements before any treatments, and participation is expected to last during the baseline assessment period.

This research aims to assess Associative Peripheral Stimulation (APS), a non-invasive therapy combining electrical muscle stimulation with voluntary movement, for helping people recover upper limb function during the acute phase after a stroke. The focus is on reducing motor impairment in patients who have recently experienced ischemic or hemorrhagic stroke and are showing weakness or paralysis in their upper extremity. Participants are randomly assigned to one of two groups: one receiving APS paired with rehabilitative exercises, and a control group receiving random peripheral stimulation paired with similar exercises. The study is conducted under triple masking to ensure unbiased results and compares outcomes over a 5-week and 3-month period. Throughout the study, participants undergo assessments including measurements of upper limb range of motion and the Fugl-Meyer Assessment for upper extremity function. Additional evaluations such as the Action Research Arm Test are also used. The study tracks progress at 5 weeks and 3 months to monitor motor recovery and function improvement, aiming to provide insight into APS's potential role in stroke rehabilitation.