Browse > Article

Effects of Cervical traction and Muscle Energy Technique on Pain, Neck Disability Index, Function, Range of Motion in Patients with Cervical Radiculopathy  

Hong, Jin-gi (Dept. of Physical Therapy, Graduate School of Korea National University of Transportation)
Kim, Young-min (Dept. of Physical Therapy, Korea National University of Transportation)
Publication Information
The Journal of Korean Academy of Orthopedic Manual Physical Therapy / v.27, no.3, 2021 , pp. 57-67 More about this Journal
Abstract
Background: This study examined the effects of the muscle energy technique and cervical traction after applying conservative physical therapy in patients with cervical radiculopathy. Methods: Patients were randomly divided into two groups muscle energy technique (8 subjects) and cervical traction (8 subjects). Each group performed their exercise 70 minutes per day, three times week for four weeks. Pain intensity was measured with a visual analogue scale (VAS). Function was measured with the neck disability index (NDI). Cervical range of motion (ROM) was measured with a cervical range of motion (CROM) goniometer. Results: After four weeks of therapy, VAS (p<.05) and NDI (p<.05) significantly decreased, and ROM significantly increased in both groups (p<.05). There were also significant differences between the two groups for these three measures (p<.05). Conclusion: The muscle energy technique and cervical traction are more effective than cervical traction alone in reducing VAS and NDI and increasing ROM in patients with cervical radiculopathy.
Keywords
Cervical radiculopathy; Cervical traction; Muscle energy technique; NDI; VAS;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Magnusson SP, Simonsen EB, Aagaard P, et al. Mechanical and physiological responses to stretching with and without preisometric contraction in human skeletal muscle. Arch Phys Med Rehabil. 1996;77(4):373-378. https://doi.org/10.1016/S0003-9993(96)90087-8   DOI
2 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   DOI
3 Phadke A, Bedekar N, Shyam A, et al. Effect of muscle energy technique and static stretching on pain and functional disability in patients with mechanical neck pain: A randomized controlled trial. Hong Kong Physiother J. 2016;35:5-11. https://doi.org/10.1016/j.hkpj.2015.12.002   DOI
4 Revel M. Whiplash injury of the neck from concepts to facts. Ann Readapt Med Phys, 2003;46(3):158-170. https://doi.org/10.1016/s0168-6054(03)00053-9   DOI
5 Jeon JG, Kim MJ. Effects of myofacial release and Mulligan technique on pain and disability for cervicogenic headache patients. The Journal of Korean Orthopedic Manual Physical Therapy. 2012;18(2):87-93.
6 Moustafa IM, Diab AA. Multimodal treatment pro- gram comparing 2 different traction approaches for patients with discogenic cervical radiculopathy: A randomized controlled trial. J Chiropr Med. 2014;13(3):157-167. https://doi.org/10.1016/j.jcm.2014.07.003   DOI
7 Nagrale AV, Glynn P, Joshi A, et al. The efficacy of an integrated neuromuscular inhibition technique on upper trapezius trigger points in subjects with non-specific neck pain: A randomized controlled trial. J Man Manip Ther. 2010;18(1):37-43. https://doi.org/10.1179/106698110X12595770849605   DOI
8 Song KJ, Choi BW, Kim SJ, et al. Cross-cultural Adaptation and Validation of the Korean Version of the Neck Disability Index. The Korean Fracture Society, 2009;44(3):350-359. https://doi.org/10.4055/jkoa.2009.44.3.350   DOI
9 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. J Orthop Sports Phys Ther. 2014;44(2):45-57. https://www.jospt.org/doi/10.2519/jospt.2014.5065   DOI
10 Uysal SC, Tuzun EH, Eker L, et al. Effectiveness of the muscle energy technique on respiratory muscle strength and endurance in patients with fibromyalgia. J Back Musculoskelet Rehabil, 2019;32(3):411-419. https://doi.org/10.3233/BMR-181287   DOI
11 Hogg-Johnson S, van der Velde G, Carroll LJ, et 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. J Manipulative Physiol Ther. 2009;32(2):S46-S60. https://doi.org/10.1016/j.jmpt.2008.11.010   DOI
12 Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: A review. The Musculoskeletal Journal of Hospital for Special Surgery. 2011;7(3):265-272. https://doi.org/10.1007/s11420-011-9218-z   DOI
13 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. J Manipulative Physiol Ther, 2007;30(3):215-227. https://doi.org/10.1016/j.jmpt.2007.01.014   DOI
14 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://www.jospt.org/doi/10.2519/jospt.2009.2954   DOI
15 Romeo A, Vanti C, Boldrini V, et al. Cervical radiculopathy: effectiveness of adding traction to physical therapy-a systematic review and meta-analysis of randomized controlled trials. Phys Ther, 2018;98(4):231-242. https://doi.org/10.1093/physth/pzy001   DOI
16 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. J Manipulative Physiol Ther. 2009;32(2):S87-S96. https://doi.org/10.1016/j.jmpt.2008.11.013   DOI
17 Cha SJ, Im CG, Kim KJ. Study on relationship between meridian muscles and modern manual therapy centered on positional release therapy and muscle energy techniques. Journal of Physiology & Pathology in Korean Medicine. 2012;26(5):630-640.
18 Chae YW. The measurement of forward head posture and pressure pain threshold in neck muscle. The Journal of Korean Society of Physical Therapy. 2002;14(1):117-124. https://doi.org/1003/JNL.JAKO200220417581008
19 Chaitow L. Muscle Energy Techniques 3rd ed. Seoul: Koonja. 2008.
20 Eubanks JD. Cervical radiculopathy: Nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81(1):33-40.
21 Wagner DR, Tatsugawa K, Parker D, et al. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High altitude medicine & biology, 2007;8(1):27-31. https://doi.org/10.1089/ham.2006.0814   DOI
22 Bogduk N. On the definitions and physiology of back pain, referred pain, and radicular pain. Pain. 2009;147(1):17-19. https://doi.org/10.1016/j.pain.2009.08.020   DOI
23 Rubinstein SM, Pool JJ, Van Tulder MW. 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   DOI
24 Savva C, Giakas G, Efstathiou M, et al. Effectiveness of neural mobilization with intermittent cervical traction in the management of cervical radiculopathy: A randomized controlled trial. Int J Osteopath Med. 2016;21:19-28. https://doi.org/10.1016/j.ijosm.2016.04.002   DOI
25 Thoomes EJ, Scholten-Peeters GG, de Boer AJ, et al. Lack of uniform diagnostic criteria for cervical radiculopathy in conservative intervention studies: A systematic review. Eur Spine J, 2012;21(8):1459-1470. https://doi.org/10.1007/s00586-012-2297-9   DOI
26 Vernon H. The Neck Disability Index: state-of-the-art, 1991-2008. J Manipulative Physiol Ther. 2008;31(7):491-502. https://doi.org/10.1016/j.jmpt.2008.08.006   DOI
27 Wainner RS, Gill H. Diagnosis and nonoperative management of cervical radiculopathy. J Orthop Sports Phys Ther. 2000a;30(12):728-744. https://doi.org/10.2519/jospt.2000.30.12.728   DOI
28 Iyer S, Kim HJ. Cervical radiculopathy. Current reviews in musculoskeletal medicine. 2016;9(3):272-280. https://doi.org/10.1007/s12178-016-9349-4   DOI
29 Joo D, Kim Y, Jeong D. The effects of compound program of muscle energy technique and therapeutic massage on patient with chronic low back pain. Res On Phys Fit. 2007;29:87-98.
30 Wang WT, Olson SL, Campbell AH, et al. Effectiveness of physical therapy for patients with neck pain: An individualized approach using a clinical decision-making algorithm. Arch Phys Med Rehabil, 2003;82(3):203-218. https://doi.org/10.1097/01.PHM.0000052700.48757.CF   DOI
31 Palmer KT, Smedley J. Work relatedness of chronic neck pain with physical findings-a systematic review. Scand J Work Environ Health. 2007;165-191. https://doi.org/10.5271/sjweh.1134   DOI
32 Cote P, Cassidy JD, Carroll L. The epidemiology of neck pain: What we have learned from our population-based studies. J Can Chiropr Assoc. 2003;47(4):284-290. https://www.doi.org/0008-3194/2003/284-290/$2.00/©JCCA2003
33 Wei X, Wang S, Li J, et al. Complementary and alternative medicine for the management of cervical radiculopathy: An overview of systematic reviews. Journal of Evidence Based Alternative Medicines in Pain Management. 2015:1-10. https://doi.org/10.1155/2015/793649   DOI
34 Young IA, Michener LA, Cleland JA, et al. Manual therapy, exercise, and traction for patients with cervical radiculopathy: A randomized clinical trial. Phys Ther. 2009;89(7):632-642. https://doi.org/10.2522/ptj.20080283   DOI
35 Kim DG, Chung SH, Jung HB. The effects of neural mobilization on cervical radiculopathy patients' pain, disability, ROM, and deep flexor endurance. J Back Musculoskelet Rehabil. 2017;30(5):951-959. https://doi.org/10.3233/BMR-140191   DOI
36 Kim HJ, Nemani VM, Piyaskulkaew C, et al. Cervical radiculopathy: Incidence and treatment of 1,420 consecutive cases. Asian Spine J. 2016;10(2):231-237. https://doi.org/10.4184/asj.2016.10.2.231   DOI
37 Kim SH, Kim MJ. The effect of cervical traction on pain & symptom for patients with cervical pain. The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2001;7(1):67-75. https://doi.org/1003/JNL.JAKO200127362747485
38 Garcia-Perez-Juana D, Fernandez-de-Las-Penas C, Arias-Buria JL, et al. Changes in cervicocephalic kinesthetic sensibility, widespread pressure pain sensitivity, and neck pain after cervical thrust manipulation in patients with chronic mechanical neck pain: A randomized clinical trial. J Manipulative Physiol Ther, 2018;41(7):551-560. https://doi.org/10.1016/ j.jmpt.2018.02.004   DOI
39 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   DOI
40 Broekema A, Kuilen J, Lesman-Leegte, et al. Study protocol for a randomised controlled multicentre study. Saxion. 2017;7(1):1-9. https://doi.org/10.1136/bmjopen-2016-012829   DOI
41 Cote P, Kristman V, Vidmar M, et al. The prevalence and incidence of work absenteeism involving neck pain. Eur Spine J. 2008;17:192-198. https://doi.org/10.1007/s00586-008-0636-7   DOI
42 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(3):447-463. https://doi.org/10.1016/j.berh.2007.02.015   DOI
43 Kleinman N, Patel AA, Benson C, et al. Economic burden of back and neck pain: Effect of a neuropathic component. Population health management. 2014;17(4):224-232. https://doi.org/10.1089/pop.2013.0071   DOI
44 Kuijper B, Tans JTJ, Schimsheimer RJ, et al. Degenerative cervical radiculopathy: Diagnosis and conservative treatment. A review. Eur J Neurol. 2009;16(1):15-20. https://doi .org/10.1111/j.1468-1331.2008.02365.x   DOI
45 Lari AY, Okhovatian F, sadat Naimi S, et al. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females. Man Ther. 2016;21:204-209. https://doi.org/10.1016/j.math.2015.08.004   DOI
46 Lee SM. The effect of Pilates on Craniovertebral Angle, Cervical Range of Motion, neck and shoulder region pain and muscle fatigue on Forward Head Posture. Pusan National University. Master Thesis. 2012.
47 Thoomes E. Effectiveness of manual therapy for cervical radiculopathy, a review. Chiropractic & Manual Therapies, 2016;24(1):1-11. https://doi.org/10.1186/s12998-016-0126-7   DOI
48 Lee EW, Shin WS, Jung KS, et al. Reliability and validity of the neck disability index in neck pain patient. Korean Research Society of Physical Therapy. 2007;14(3):97-106.