Assessment of Upper Extremity Proprioception in Patients With Cervical Radiculopathy

Cervical radicular pain is a neuropathic pain syndrome characterized by dermatomal distribution resulting from irritation of the cervical spinal nerve roots. The most common underlying causes are cervical disc herniation and cervical spinal stenosis. Motor, sensory, or reflex disturbances may accompany the condition, and it is most frequently observed in individuals aged 50-54 years. Proprioception is a sensorimotor function that enables the perception of joint position and movement through the processing of afferent inputs originating from joints, muscles, and tendons within the central nervous system. Proprioceptive inputs from the cervical spine integrate with visual and vestibular information to play a critical role in head-trunk orientation, postural control, and upper-extremity movement coordination. Although there is currently no gold-standard method for assessing active joint position sense-the quantifiable component of proprioception-tools such as manual and digital goniometers, inclinometers, and laser pointers are commonly used. However, these techniques measure joint position sense in a single plane and typically at a single joint. Recent studies, however, support the use of assessment methods that capture multisensory spatial representation of the entire limb and reflect the complexity of daily functional movements by incorporating multiplanar and multi-joint measurements. The PRO-Reach method developed by Ager et al. enables such multi-planar and multi-joint assessment without requiring computerized interfaces or robotic devices. Numerous studies have demonstrated impaired cervical proprioception in cervicogenic conditions such as chronic neck pain and cervical spondylosis. The aim of the present study is to investigate the extent of upper-extremity proprioceptive impairment in patients with cervical radiculopathy. Cervical muscle fatigue or alterations in cervical sensory input may reduce the accuracy of upper-extremity joint positioning, thereby negatively affecting upper-extremity proprioception