This study will be conducted to investigate the effect of sensory motor training for neck muscles on hand grip strength in post-menopausal fibromyalgia neck pain.

Fibromyalgia is a chronic disease accompanied by widespread body pain, heightened tenderness in specific anatomical regions, fatigue, sleep disorders, and irritable bowel syndrome.

Prevalence of fibromyalgia is approximately 2-4% in the general population. It predominantly affects 80-90% of women and typically peaks between the ages of 50 and 60.

Post-menopausal fibromyalgia may be attributed to hormonal changes, particularly the decline in estrogen, which plays a role in pain modulation, mood regulation and sleep quality. This hormonal shift, combined with age-related changes in the central nervous system, altered cortisol levels, increased prevalence of psychological comorbidities such as anxiety and depression may contribute to the development or worsening of fibromyalgia symptoms in post-menopausal women.

Neck pain affects about 70-90% of fibromyalgia patients. It can lead to muscle tension, nerve compression, and altered neuromuscular control, particularly affecting the cervical spine and upper limb function. These changes may impair motor output and reduce hand grip strength.

Improving hand grip strength can contribute to better quality of life, functional independence, and may reduce reliance on medication.

Sensory motor training is an emerging rehabilitation approach designed to improve the interaction between sensory input and motor output. It enhances proprioception, coordination, and motor control, which are often impaired in patients with fibromyalgia due to central sensitization and neuromuscular dysfunction.

Sensory motor neck training using laser pointer technique enhances cervical proprioception and motor control in patients with neck pain by providing visual feedback to guide accurate head movements.

So, this study will be conducted to provide new evidences and information about the effect of sensory motor training on hand grip strength in post-menopausal fibromyalgia neck pain to manage this problem upon them and add new information to the field of physical therapy.

Inclusion Criteria:

• Fifty post-menopausal women clinically diagnosed with fibromyalgia neck pain for more than 3 months.
• Their age will be ranged from 50-60 years old.
• Their body mass index (BMI) will be less than 30 kg/m².
• Their hand grip strength is less than 20 kg for dominant hand as measured by hand-held dynamometer.
• Their neck pain score is ≥ 4 as measured by the visual analogue scale (VAS).
• The right hand is the dominant for all of them.

Exclusion Criteria:

• Participants will be excluded from the study if they have:
• Recent cervical trauma or surgery.
• Neurological disorders.
• Diabetes mellitus.