Manual Physical Therapy, Cervical Traction, and Strengthening Exercises in Patients With Cervical Radiculopathy: A Case Series

Cleland, Joshua A.; Whitman, Julie M.; Fritz, Julie M.; Palmer, Jessica

doi:10.2519/jospt.2005.35.12.802

Cited by 107 publications

(40 citation statements)

References 33 publications

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“…While preliminary reports suggest that a multimodal treatment program consisting of manual therapy and exercise may result in positive outcomes for patients with CR, [6][7][8][9][10] efforts to successfully add cervical traction to a multimodal treatment program remain elusive. A study by Ragonese 11 concluded that when treating patients with a diagnosis of CR, an approach that combines manual therapy (including cervical traction) and therapeutic exercise appears to be superior to either intervention alone.…”

Section: Introductionmentioning

confidence: 99%

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

Moustafa

Diab

2014

Journal of Chiropractic Medicine

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Objective: The purpose of this study was to investigate the immediate and long-term effects of a 1-year multimodal program with the addition of 2 different traction approaches on the pain, function, disability, and nerve root function in patients with discogenic cervical radiculopathy (CR). This study also attempted to identify the optimal traction angle based on the maximum recovery of the peak-to-peak amplitude of the flexor carpi radialis (FCR) H-reflex. Methods: This randomized clinical trial with one-year follow-up included a total of 216 (101 female) patients with unilateral lower discogenic CR were randomly assigned to 1 of 3 groups. The standard care group (C) received the multimodal program (pain relief methods, muscle strengthening, and thoracic spine manipulation). The ventroflexion traction group (A) received the same multimodal program as group C, with added traditional ventroflexion traction. The novel traction group (B) received the same multimodal program as group C in addition to a flexor carpi radialis (FCR) H-reflex-based traction method. Primary outcomes were the Neck Disability Index (NDI) and secondary outcomes included neck pain, arm pain, and the amplitude and latency of the H-reflex. Patients were assessed at 3 intervals (pre-treatment, 4 weeks post-treatment, and the 1-year follow-up). Results: The mixed linear model with repeated measures indicated a significant group × time effect in favor of the novel cervical traction group (B) for measures of NDI (F = 412.6, P b .0005), neck pain (F = 108.9, P b .0005), arm pain (F = 91.3, P b .0005), H-reflex amplitude (F = 207.7, P b .0005), and H-reflex latency (F = 58.9 P b .0005). We found that the extension position of cervical spine (5°extension) was the position that achieved the maximum improvement in the novel cervical traction method. Conclusions: This preliminary study showed that a multimodal program with a novel cervical traction method added improved NDI, neck pain, arm pain, and the amplitude and latency of FCR H-reflex for a group of patients with chronic discogenic CR.

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Section: Introductionmentioning

confidence: 99%

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

Moustafa

Diab

2014

Journal of Chiropractic Medicine

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“…3 While individuals with cervical radiculopathy often report neck pain, they most frequently seek treatment due to arm pain. [3][4][5] Individuals with whiplash associated disorders who demonstrate signs of irritation of the brachial plexus and subsequent neck and arm pain reported more severe symptoms and achieved worse outcomes than those without brachial plexus irritation. 6 Some authors have suggested that patients with neck and arm pain should be treated more expeditiously in order to avoid the further negative impact on mental health status associated with chronic symptoms.…”

Section: Introductionmentioning

confidence: 99%

The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial

Costello

Puentedura

Cleland

et al. 2016

Journal of Manual & Manipulative Therapy

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Study design: Randomized clinical trial. Objectives: To investigate the immediate effects of soft tissue mobilization (STM) versus therapeutic ultrasound (US) in patients with neck and arm pain who demonstrate neural mechanical sensitivity. Background: While experts have suggested that individuals with neck and arm pain associated with neural tissue mechanical sensitivity may benefit from STM, there has been little research to investigate this hypothesis. Methods: Twenty-three patients with neck and arm pain and a positive upper limb neurodynamic test (ULNT) were randomly assigned to receive STM or therapeutic US during a single session. Outcome measures were collected immediately before and after treatment, and at 2-4 day follow-up. Primary outcomes were the Global Rating of Change (GROC), range of motion (ROM) during the ULNT, and pain rating during the ULNT. Secondary measures included the Neck Disability Index (NDI), Patient-Specific Functional Scale (PSFS), Numeric Pain Rating Scale (NPRS), and active range of shoulder abduction motion combined with the wrist neutral or wrist extension. Results: A greater proportion of patients in the STM group reported a significant improvement on the GROC immediately after treatment (P50.003, STM575%, US59%), and at 2-4 day follow-up (P50.027, STM558%, US59%). Patients who received STM demonstrated greater improvements in ROM during ULNT (P50.026), PSFS (P50.007), and shoulder active ROM combined with wrist extension (P50.028). Improvements in Numeric Pain Rating Scale and pain during the ULNT were observed only in the STM group. There was no difference between groups for the NDI or shoulder abduction ROM with wrist neutral. Conclusion: Patients with neck and arm pain demonstrated greater improvements in ULNT ROM, GROC, and PSFS, and pain following STM than after receiving therapeutic US. Level of evidence: Therapy, level 1b.

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“…Many studies reveals that Intermittent Cervical Traction for Cervical Radiculopathy found to be effective in reduction of pain and disability. 12,13,14 ; however, no standard parameters have been reported. It is speculated that improvements in symptoms are due to distraction of articular surfaces by traction which unloads the components of the spine by stretching muscles, ligaments and functional units.…”

Section: 5mentioning

confidence: 99%

Effectiveness of Autogenic Drainage Versus Postural Drainage on Oxygen Saturation in Patients with Chronic Bronchitis with 15 Minutes Post Therapy

Kiran

.S²,

Mastanaiah

et al. 2014

International Journal of Physiotherapy

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Background: Cervical Traction and Neural Mobilization both have been individually advocated for treatment of Cervical radiculopathy due to their various effects. But the combined effect of these techniques applied simultaneously has not been explored in studies. Hence the purpose is to find the effect of simultaneous application of cervical traction and neural mobilization on improvement in neck pain, radicular symptoms and neck disability in subjects with Cervical Radiculopathy.Methods: An experimental study design, 60 subjects with Unilateral Cervical Radiculopathy and ULTT1 positive for median nerve bias, randomized 20 subjects each into three groups-Group A, B and C respectively. Group A received both Cervical Traction and Neural Mobilization. The Group B received only Mechanical Cervical Traction. The Group C received only Neural Mobilization. The duration of intervention was given 3 treatment sessions per week for four weeks. Outcome measures such as Numerical Pain Rating Scale, Global Rating of Change Scale, Neck Disability Index were measured before, at the end of 2nd and 4th week post treatment. Results: Comparison of post intervention means at 2nd and 4 th week of treatment there is a statistically significant (p<0.05) difference in improvement in outcome measures between three groups. Group A subjects shown greater percentage of improvement than Group B and Group C. Conclusion:The present study concludes that simultaneous application of mechanical cervical traction with neural mobilization is more effective in improving pain, functional disability and severity of radicular symptoms than mechanical cervical traction and neural mobilization alone for subjects with Unilateral Cervical Radiculopathy.

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Manual Physical Therapy, Cervical Traction, and Strengthening Exercises in Patients With Cervical Radiculopathy: A Case Series

Cited by 107 publications

References 33 publications

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

Multimodal Treatment Program Comparing 2 Different Traction Approaches for Patients With Discogenic Cervical Radiculopathy: A Randomized Controlled Trial

The immediate effects of soft tissue mobilization versus therapeutic ultrasound for patients with neck and arm pain with evidence of neural mechanosensitivity: a randomized clinical trial

Effectiveness of Autogenic Drainage Versus Postural Drainage on Oxygen Saturation in Patients with Chronic Bronchitis with 15 Minutes Post Therapy

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