Servikal Radikülopatisi Olan Bireylerde Fizyoterapi Ve Rehabilitasyonun El Fonksiyonları Üzerindeki Etkisinin Araştırılması

Abstract

This study aimed to evaluate the sensorimotor changes and bilateral involvement patterns in the upper extremity associated with different nerve root levels in individuals with unilateral cervical radiculopathy (CR), and to examine the effects of a conventional physiotherapy program on these changes and the differential responses according to the level of involvement. The study included 58 participants diagnosed with CR at the C5, C6, and C7 levels or with non-specific neck pain (NSNP). All participants received structured conventional physiotherapy (hot pack, TENS, ultrasound, and cervical stabilization exercises) three times per week for 6 weeks. Assessments were conducted before and after treatment, focusing on the cervical region (pain, range of motion, disability), upper extremity (muscle strength, grip strength, sensation, hand dexterity, functional status), and emotional state (kinesiophobia, depression, anxiety). In addition, bilateral evaluations were performed to analyze changes in the unaffected extremity. At baseline, the C7 group demonstrated more pronounced impairments in hand function and median nerve sensory function, with the lowest muscle strength and hand dexterity scores. Following treatment, all groups showed significant improvements in muscle strength, grip strength, and sensory parameters (p<0.05); however, limited improvement was observed in certain motor and sensory parameters in the C6 and C7 groups. Median nerve sensory deficits and hand dexterity limitations persisted in the C7 group after treatment. All groups demonstrated improvements in DASH scores (p<0.05), though the C7 group showed a lesser degree of improvement. Emotional parameters also improved across all groups (p<0.05), except for kinesiophobia in the C7 group, which did not show significant change. In conclusion, patients with C7-level CR exhibited a more resistant clinical profile with pronounced bilateral involvement, highlighting the need to individualize physiotherapy approaches according to the radiculopathy level. In this context, four hypotheses were formulated and tested to investigate whether the effects of physiotherapy on hand functions, sensorimotor performance, functional status, emotional state, and kinesiophobia differ according to the level of cervical radiculopathy.