The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

The Effects of Manual Therapy on Pain, ROM and Disability of Cervical Radiculopathy

경추 신경근병증의 통증, 관절가동범위, 경부장애에 대한 도수치료의 효과

  • Jeon, Jae-Guk (Dept. of Physical Therapy, Seoul Wooridul Spine Hospital) ;
  • Kim, Hyun (Dept. of Physical Therapy, Seoul Wooridul Spine Hospital) ;
  • Park, Hyun-Sik (Dept. of Physical Therapy, Central Hospital) ;
  • Joo, Tae-Sung (Dept. of Physical Therapy, 21st Century Hospital) ;
  • An, Ik-Geun (Dept. of Physical Therapy, Godoil Hospital)
  • Received : 2013.12.15
  • Accepted : 2014.01.10
  • Published : 2014.06.30
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Abstract

Background: Cervical radiculopathy is the result of cervical nerve root pathology that may lead to chronic pain and disability. Although manual therapy interventions including cervical traction and neural mobilization have been advocated to decrease pain and disability caused by cervical radiculopathy, their analgesic effect has been questioned due to the low quality of research evidence. The purpose of this paper is to present the effect of manual therapy on pain, ROM, disability in a patient experiencing cervical radiculopathy. Methods: In this study, 30 participants who met the diagnostic criteria for cervical radiculopathy were randomized into two groups: group I (nerve mobilization group) & group II (Mckenzie exercise group). The experimental group was performed manual cervical traction and neural mobilization technique. The control group was performed manual cervical traction and cervical retraction, extension exercise. Assessments were performed to 30 participants before and after 4 weeks therapy. The components of assessments were pain intensity (PI), cervical rotation ROM (CR) and neck disability index (NDI). Results: After 4 weeks therapy, PI, CR and NDI were significantly reduced in both groups (p<.01). The PI, CR and NDI were no significantly reduced between group I and group II (p>.01). Conclusions: Manual therapy could reduce the symptoms of cervical radiculotpathy.

Keywords

References

  1. 김호봉, 김선엽, 김영민. 도수치료기법들 간의 평가와 치료 개념에 대한 비교. 대한정형도수치료학회지. 2005;11(1):49-64.
  2. 박현식. 신경역동적 기법과 자가 신경 운동법이 수근관증후군 환자에게 미치는 영향. 대한정형도수치료학회지. 2010;16(2):48-52.
  3. 서현규, 정연우, 김경태. 관절가동술과 멕켄지 운동이 경부 가동범위와 압통에 미치는 영향. 대한정형도수치료학회지. 2008;14(1):1-14.
  4. Abdulwahab SS, Sabbahi M. Neck retractions, cervical root decompression, and radicular pain. J Orthop Sports Phys Ther. 2000;30:4-9. https://doi.org/10.2519/jospt.2000.30.1.4
  5. Beneciuk JM, Bishop MD, George SZ. Effects of upper extremity neural mobilization on thermal pain sensitivity: A sham-controlled study in asymptomatic participants. J Orthop Sports Phys Ther. 2009;39(6):428-438. https://doi.org/10.2519/jospt.2009.2954
  6. Christos Savva, Giannis Giakas. The effect of cervical traction combined with neural mobilization on pain and disability in cervical radiculopathy. Man Ther. 2013:18;443-446. https://doi.org/10.1016/j.math.2012.06.012
  7. Cleland JA, Fritz JM, Whitman JM, et al. Predictors of short-term outcome in people with a clinical diagnosis of cervical radiculopathy. Phys Ther. 2007;87:1619-1632. https://doi.org/10.2522/ptj.20060287
  8. Cleland JA, Whitman JM, Fritz JM, et al. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: A case series. J Orthop Sports Phys Ther. 2005;35:802-811. https://doi.org/10.2519/jospt.2005.35.12.802
  9. Coppieters MW, Butler DS. Do sliders slide and tensioners tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther. 2008;13(3):213-221. https://doi.org/10.1016/j.math.2006.12.008
  10. Constantoyannis C, Konstantinou D, Kourtopoulos H, et al. Intermittent cervical traction for cervical radiculopathy caused by large-volume herniated disks. J Manipulative Physiol Thera. 2002;25(3):188-192. https://doi.org/10.1067/mmt.2001.123356
  11. Costello M. Treatment of a patient with cervical radiculopathy using thoracic spine thrust manipulation, soft tissue mobilization, and exercise. J Man Manip Ther. 2008;16:129-135. https://doi.org/10.1179/jmt.2008.16.3.129
  12. Czervionke LF, Daniels DL, Ho PSP, et al. Cervical neural foramina: correlative anatomic and MR imaging study. Radiology. 1988;169(3):753-759. https://doi.org/10.1148/radiology.169.3.3186997
  13. Diniz KT, Miranda RM, Ribeiro CD, et al. Neural mobilization effects in posterior myofascial chain flexibility and in head posture. Neurobiologia. 2010;73(3):53-57.
  14. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81(1):33-40.
  15. Jellad A, Salah ZB, Boodokdane S, et al. The value of intermittent cervical traction in recent cervical radiculopathy. Ann Phys Rehabil Med. 2009;52(9):638-652. https://doi.org/10.1016/j.rehab.2009.07.035
  16. Joghataei MT, Arab AM, Khaksar H. The effect of cervical traction combined with conventional therapy on grip strength on patients with cervical radiculopathy. Clin Rehabil. 2004;18(8):879-887. https://doi.org/10.1191/0269215504cr828oa
  17. Kuijper BB, Tans JTJ, Schimsheimer RJ, et al. Degenerative cervicalradiculopathy: diagnosis and conservative treatment. A review. European Journal of Neurology. 2009;16(1):15-20. https://doi.org/10.1111/j.1468-1331.2008.02365.x
  18. Liu J, Ebraheim NA, Sanford CG, et al. Quantitative changes in the cervical neural foramen resulting from axial traction: in vivo imaging study. The Spine Journal. 2008;8(4):619-623. https://doi.org/10.1016/j.spinee.2007.04.016
  19. Malanga G. The diagnosis and treatment of cervical radiculopathy. Med Sci in Sports Exerc. 1997;29:236-245.
  20. Nardin RA, Patel MR, Gudas TF, et al. Electromyography and magnetic resonance imaging in the evaluation of radiculopathy. Muscle Nerve. 1999;22:151-155. https://doi.org/10.1002/(SICI)1097-4598(199902)22:2<151::AID-MUS2>3.0.CO;2-B
  21. Nee RJ, Butler D. Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics and clinical evidence. Phys Ther Sport. 2006;7(3):36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  22. Persson LC, Carlsson JY. Headache in patients with neck-shoulder-arm pain of cervical radicular origin. Headache. 1999;39:218-224. https://doi.org/10.1046/j.1526-4610.1999.3903218.x
  23. Radhakrishan K, Litchy W, O''Fallon W, et al. Epidemiology of cervical radiculopathy: A population-based study from Rochester. Minnesota. 1976 through 1990. Brain. 1994;117:325-335. https://doi.org/10.1093/brain/117.2.325
  24. Rubinstein SM, Pool JJM, van Tulder MW, et al. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. Eur Spine J. 2007;16(3):307-319. https://doi.org/10.1007/s00586-006-0225-6
  25. Rydevik BL, Pedowitz RA, Hargens AR, et al. Effects of acute, graded compression on spinal nerve root function and structure: An experimental study of the pig cauda equine. Spine. 1991;16:487-493. https://doi.org/10.1097/00007632-199105000-00001
  26. Song KJ, Choi BW, Choi BR, et al. Cross-cultural adaptation and validation of the Korean version of the neck disability index. Spine(Phila Pa 1976). 2010;35(20):E1045-1049. https://doi.org/10.1097/BRS.0b013e3181df78e9
  27. Takasaki H, Hall T, Jull G, et al. The influence of cervical traction, compression, and spurling test on cervical intervertebral foramen size. Spine. 2009;34(16):1658-1662. https://doi.org/10.1097/BRS.0b013e3181a9c304
  28. Wainner RS, Fritz JM, Irrgang JJ, et al. Reliability and diagnostic accuracy of the clinical examination and patient selfreport measures for cervical radiculopathy. Spine. 2003;28:52-62. https://doi.org/10.1097/00007632-200301010-00014
  29. Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther. 2000;30:728-744. https://doi.org/10.2519/jospt.2000.30.12.728
  30. Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: A case series. J Orthop Sports Phys Ther. 2006;36:152-159. https://doi.org/10.2519/jospt.2006.36.3.152
  31. Walsh TT. Upper limb neural tension testing and mobilization. Fact, fiction, and a practical approach. J Hand Ther. 2005;18(2):241-258. https://doi.org/10.1197/j.jht.2005.02.010