PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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The Effects of Neural Mobilization with Joint Mobilization on Dysfunction, Pain, and Range of Motion in Cervical Radiculopathy Patients

신경가동술과 관절가동술이 경추 신경근병증 환자의 기능장애, 통증, 관절가동범위에 미치는 영향

  • Han, Ji-Hun (Department of Physical Therapy, Sahmyook University) ;
  • Song, Chang-Ho (Department of Physical Therapy, Sahmyook University)
  • 한지훈 (삼육대학교 물리치료학과) ;
  • 송창호 (삼육대학교 물리치료학과)
  • Received : 2021.11.12
  • Accepted : 2021.11.23
  • Published : 2021.12.31
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Abstract

Purpose: The study aimed to investigate the effects of neural mobilization with joint mobilization on dysfunction, pain, and range of motion in cervical radiculopathy patients. Methods: Forty-seven cervical radiculopathy patients were recruited for the study. The subjects were randomly allocated to three groups. Group A (n=16) received a neural mobilization with joint mobilization, Group B (n=15) received a neural mobilization (NM), Group C (n=16) received a joint mobilization (JM). All groups had five sets for a day, three days a week, for four weeks. All subjects were evaluated before and after intervention by their neck disability index (NDI), numeric pain rating scale (NPRS), and range of motion (ROM). Results: The results were as follows: First, the NDI was significantly decreased in all groups (p<0.05). Group A had more significantly decreased NDI than Group B and C (p<0.05). Secondly, the NPRS was significantly decreased in all groups (p<0.05). Group A had more significantly decreased cervical NPRS than Group B (p<0.05). Groups A and B were more effective at decreasing upper extremity NPRS than Group C (p<0.05). Thirdly, the ROM was significantly increased in all the groups (p<0.05). Group A had more significantly improved cervical rotation ROM than Group B (p<0.05). Significant short-term effects of the NM with JM on dysfunction, pain, and range of motion in cervical radiculopathy patients were recorded in this study. Conclusion: These findings gave some indications that it may be feasible to include NM with JM in interventions with cervical radiculopathy patients.

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References

  1. Abbed KM, Coumans J-VCE. Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation. Neurosurgery. 2007;60(suppl_1):S1-28-S21-34. https://doi.org/10.1227/01. NEU.0000215386.05760.6D
  2. Anandkumar S. The effect of sustained natural apophyseal glide (snag) combined with neurodynamics in the management of a patient with cervical radiculopathy: a case report. Physiotherapy Theory and Practice. 2015;31(2):140-145. https://doi.org/10.3109/09593985.2014.971922
  3. Beneciuk JM, Bishop MD, George SZ. Effects of upper extremity neural mobilization on thermal pain sensitivity: a sham-controlled study in asymptomatic participants. Journal of Orthopaedic & Sports Physical Therapy. 2009;39(6):428-438. https://doi.org/10.2519/jospt.2009.2954
  4. Bogduk N. The anatomy and pathophysiology of neck pain. Physical Medicine and Rehabilitation Clinics. 2003; 14(3):455-472.
  5. Boyles R, Toy P, Mellon J, et al. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review. Journal of Manual & Manipulative Therapy. 2011;19(3):135-142. https://doi.org/10.1179/2042618611Y.0000000011
  6. Carette S, Fehlings MG. Cervical radiculopathy. New England Journal of Medicine. 2005;353(4):392-399. https://doi.org/10.1056/NEJMcp043887
  7. Carragee EJ, Hurwitz EL, Cheng I, et al. Treatment of neck pain: injections and surgical interventions: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics. 2009; 32(2):S176-S193.
  8. Carroll LJ, Hogg-Johnson S, van der Velde G, et al. Course and prognostic factors for neck pain in the general population: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics. 2009;32(2):S87-S96.
  9. Cleland JA, Fritz JM, Whitman JM, et al. Predictors of short-term outcome in people with a clinical diagnosis of cervical radiculopathy. Physical Therapy. 2007;87(12): 1619-1632. https://doi.org/10.2522/ptj.20060287
  10. Cleland JA, Whitman JM, Fritz JM, et al. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2005;35(12):802-811. https://doi.org/10.2519/jospt.2005.35.12.802
  11. Coppieters MW, Butler DS. Do 'sliders' slide and 'tensioners' tension? An analysis of neurodynamic techniques and considerations regarding their application. Manual Therapy. 2008;13(3):213-221. https://doi.org/10.1016/j.math.2006.12.008
  12. Costello M. Treatment of a patient with cervical radiculopathy using thoracic spine thrust manipulation, soft tissue mobilization, and exercise. Journal of Manual & Manipulative Therapy. 2008;16(3):129-135. https://doi.org/10.1179/jmt.2008.16.3.129
  13. Cote P, Kristman V, Vidmar M, et al. The prevalence and incidence of work absenteeism involving neck pain. European Spine Journal. 2008;17(Suppl 1):192-198. https://doi.org/10.1007/s00586-008-0636-7
  14. Ellis RF, Hing WA. Neural mobilization: a systematic review of randomized controlled trials with an analysis of therapeutic efficacy. Journal of Manual & Manipulative Therapy. 2008;16(1):8-22. https://doi.org/10.1179/106698108790818594
  15. Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. American Family Physician. 2010;81(1):33-40.
  16. Farrar JT, Young Jr JP, LaMoreaux L, et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149-158. https://doi.org/10.1016/S0304-3959(01)00349-9
  17. Fritz JM, Thackeray A, Brennan GP, et al. Exercise only, exercise with mechanical traction, or exercise with over-door traction for patients with cervical radiculopathy, with or without consideration of status on a previously described subgrouping rule: a randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2014;44(2):45-57. https://doi.org/10.2519/jospt.2014.5065
  18. Goupille P, Mulleman D, Valat J. Radiculopathy associated with disc herniation. Annals of the Rheumatic Diseases. 2006;65(2):141-143. https://doi.org/10.1136/ard.2005.039669
  19. Hogg-Johnson S, van d er Velde G, Carroll LJ, e t al. The burden and determinants of neck pain in the general population: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics. 2009;32(2):S46-S60. https://doi.org/10.1016/j.jmpt.2008.11.010
  20. Hurwitz EL, Carragee EJ, van der Velde G, et al. Treatment of neck pain: noninvasive interventions: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Journal of Manipulative and Physiological Therapeutics. 2009;32(2):S141-S175. https://doi.org/10.1016/j.jmpt.2008.11.017
  21. Kuijper B, Tans JTJ, Schimsheimer RJ, et al. Degenerative cervical radiculopathy: 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
  22. Loew M, Heichel TO, Lehner B. Intraarticular lesions in primary frozen shoulder after manipulation under general anesthesia. Journal of Shoulder and Elbow Surgery. 2005;14(1):16-21. https://doi.org/10.1016/j.jse.2004.04.004
  23. Nee RJ, Butler D. Management of peripheral neuropathic pain: Integrating neurobiology, neurodynamics, and clinical evidence. Physical Therapy in Sport. 2006;7(1):36-49. https://doi.org/10.1016/j.ptsp.2005.10.002
  24. Nikolaidis I, Fouyas IP, Sandercock PA, et al. Surgery for cervical radiculopathy or myelopathy. Cochrane Database of Systematic Reviews. 2010;(1).
  25. Ragonese J. A randomized trial comparing manual physical therapy to therapeutic exercises, to a combination of therapies, for the treatment of cervical radiculopathy. Orthopaedic Physical Therapy Practice. 2009;21(3): 71-76.
  26. Rubinstein SM, Pool JJ, Van Tulder MW, et al. A systematic review of the diagnostic accuracy of provocative tests of the neck for diagnosing cervical radiculopathy. European Spine Journal. 2007;16(3):307-319. https://doi.org/10.1007/s00586-006-0225-6
  27. Sandow E. Case studies in cervicothoracic spine function evaluation and treatment of two dancers with mechanical neck pain. Journal of Dance Medicine & Science. 2011;15(1):37-44.
  28. Savva C, Giakas G. The effect of cervical traction combined with neural mobilization on pain and disability in cervical radiculopathy. A case report. Manual Therapy. 2013;18(5):443-446. https://doi.org/10.1016/j.math.2012.06.012
  29. Smania N, Corato E, Fiaschi A, et al. Repetitive magnetic stimulation a novel therapeutic approach for myofascial pain syndrome. Journal of Neurology. 2005;252(3):307-314. https://doi.org/10.1007/s00415-005-0642-1
  30. Van Middelkoop M, Rubinstein SM, Ostelo R, et al. Surgery versus conservative care for neck pain: a systematic review. European Spine Journal. 2013;22(1):87-95. https://doi.org/10.1007/s00586-012-2553-z
  31. Vernon H, Humphreys K, Hagino C. Chronic mechanical neck pain in adults treated by manual therapy: a systematic review of change scores in randomized clinical trials. Journal of Manipulative and Physiological Therapeutics. 2007;30(3):215-227. https://doi.org/10.1016/j.jmpt.2007.01.014
  32. Vernon H, Mior S. The neck disability index: a study of reliability and validity. Journal of Manipulative and Physiological Therapeutics. 1991;14(7):409-415.
  33. Wainner RS, Fritz JM, Irrgang JJ, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003;28(1):52-62. https://doi.org/10.1097/00007632-200301010-00014
  34. Waldrop MA. Diagnosis and treatment of cervical radiculopathy using a clinical prediction rule and a multimodal intervention approach: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2006;36(3): 152-159. https://doi.org/10.2519/jospt.2006.36.3.152
  35. Young IA, Michener LA, Cleland JA, et al. Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Physical Therapy. 2009;89(7):632-642. https://doi.org/10.2522/ptj.20080283