Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of nerve mobilization with intermittent cervical segment traction on pain, range of motion, endurance, and disability of cervical radiculopathy

  • Yun, Young-Ho (Department of Physical Therapy, College of Medical Science, Konyang University) ;
  • Lee, Byoung-Kwon (Department of Physical Therapy, College of Medical Science, Konyang University) ;
  • Yi, Jae-Hoon (Department of Smart Rehabilitation Care, Pyeongtaek University) ;
  • Seo, Dong-Kwon (Department of Physical Therapy, College of Medical Science, Konyang University)
  • Received : 2020.09.02
  • Accepted : 2020.09.25
  • Published : 2020.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study aimed to evaluate the effects of the Kaltenborn-Evjenth concept of nerve mobilization combined with intermittent cervical segment traction (ICST) on pain, Neck Disability Index (NDI) scores, range of motion (ROM) and endurance in persons with cervical radiculopathy (CR). Design: Two-group pretest-posttest design. Methods: Thirty subjects participated in this study and were randomly assigned to two groups. The ICST group (n=15) was performed simultaneously with nerve mobilization and cervical traction for the segment with cervical pain at the same time. The intermittent cervical total traction (ICTT) group (n=15) performed nerve mobilization and cervical traction for the whole cervical area at the same time. In this study, outcome measures such as the Visual Analog Scale (VAS), NDI, ROM, endurance (cranio-cervical flexion test), and passive intervertebral motion performed before and 4 weeks after the experiment were compared to investigate the effects of each intervention. Results: In both groups, there were significant differences in the VAS, NDI scores, and endurance, and there were significant differences between the two groups except for endurance (p<0.05). In the ICST group, significant differences were found in all ROM, and in the ICTT group, significant differences were found in only extension, and there were significant differences between the two groups (p<0.05). Conclusions: The ICST group showed more improvement than the ICTT group in pain, NDI scores and ROM. Moreover, our findings show that the ICST could be used as a new strategy for manual therapy in persons with CR.

Keywords

References

  1. Larsson B, Sogaard K, Rosendal L. Work related neck-shoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Pract Res Clin Rheumatol 2007;21:447-63. https://doi.org/10.1016/j.berh.2007.02.015
  2. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician 2010;81:33-40.
  3. Thoomes EJ. Effectiveness of manual therapy for cervical radiculopathy, a review. Chiropr Man Therap 2016;24:45. https://doi.org/10.1186/s12998-016-0126-7
  4. Jellad A, Ben Salah Z, Boudokhane S, Migaou H, Bahri I, Rejeb N. The value of intermittent cervical traction in recent cervical radiculopathy. Ann Phys Rehabil Med 2009;52:638-52. https://doi.org/10.1016/j.rehab.2009.07.035
  5. Shacklock M. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. J Man Manip Ther 2008;16:23-4. https://doi.org/10.1179/106698108790818602
  6. Neto T, Freitas SR, Marques M, Gomes L, Andrade R, Oliveira R. Effects of lower body quadrant neural mobilization in healthy and low back pain populations: a systematic review and meta-analysis. Musculoskelet Sci Pract 2017;27:14-22. https://doi.org/10.1016/j.msksp.2016.11.014
  7. Hassan F, Osama M, Ghafoor A, Yaqoob MF. Effects of oscillatory mobilization as compared to sustained stretch mobilization in the management of cervical radiculopathy: a randomized controlled trial. J Back Musculoskelet Rehabil 2020;33:153-8. https://doi.org/10.3233/bmr-170914
  8. McCaffery M, Pasero C. Teaching patients to use a numerical pain-rating scale. Am J Nurs 1999;99:22.
  9. Herr KA, Spratt K, Mobily PR, Richardson G. Pain intensity assessment in older adults: use of experimental pain to compare psychometric properties and usability of selected pain scales with younger adults. Clin J Pain 2004;20:207-19. https://doi.org/10.1097/00002508-200407000-00002
  10. Song KJ, Choi BW, Choi BR, Seo GB. Cross-cultural adaptation and validation of the Korean version of the neck disability index. Spine 2010;35:E1045-9. https://doi.org/10.1097/BRS.0b013e3181df78e9
  11. Audette I, Dumas JP, Cote JN, De Serres SJ. Validity and between-day reliability of the cervical range of motion (CROM) device. J Orthop Sports Phys Ther 2010;40:318-23. https://doi.org/10.2519/jospt.2010.3180
  12. Falla DL, Campbell CD, Fagan AE, Thompson DC, Jull GA. Relationship between cranio-cervical flexion range of motion and pressure change during the cranio-cervical flexion test. Man Ther 2003;8:92-6. https://doi.org/10.1016/S1356-689X(03)00008-0
  13. Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine 2003;28:52-62. https://doi.org/10.1097/00007632-200301010-00014
  14. Savva C, Giakas G. The effect of cervical traction combined with neural mobilization on pain and disability in cervical radiculopathy. A case report. Man Ther 2013;18:443-6. https://doi.org/10.1016/j.math.2012.06.012
  15. Cleland JA, Whitman JM, Fritz JM, Palmer JA. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. J Orthop Sports Phys Ther 2005;35:802-11. https://doi.org/10.2519/jospt.2005.35.12.802
  16. Boyles R, Toy P, Mellon J Jr, Hayes M, Hammer B. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review. J Man Manip Ther 2011;19:135-42. https://doi.org/10.1179/2042618611Y.0000000011
  17. Nee RJ, Butler D. Management of peripheral neuropathic pain: integrating neurobiology, neurodynamics, and clinical evidence. Phys Ther Sport 2006;7:36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  18. Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther 2008;31:525-33. https://doi.org/10.1016/j.jmpt.2008.08.003
  19. Park WM, Kim K, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther 2014;19:527-33. https://doi.org/10.1016/j.math.2014.05.004