Effect of Cervical Traction With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

Cairo University (CU)

Status: Not yet enrolling

Conditions: Cervical Radiculopathy; Neural Mobilization; Traction; Nerve Root Disorder

Treatments: Device: traction (30 degree) side bending); Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Device: traction (foramen opening); Device: traction (30 degree) head flexion; Other: Prone Cervical Unilateral Poster anterior Mobilization; Other: Hold/Relax Stretch

Study type: Interventional

Funder types: Other

Identifiers

NCT07366983

Nagy-Phd

Details and patient eligibility

About

This study will be conducted to examine

1. The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis.
2. The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes.
3. The efficacy of mechanical traction from decompression angles with neural mobilization has a Numeric Pain Rating Scale.
4. The efficacy of mechanical traction from decompression angles combined with neural mobilization on Neck Disability Index.

Full description

Cervical radiculopathy is a condition characterized by pain, sensory and motor impairments, and slowed reflexes caused by the compression of cervical nerve roots, often stemming from cervical disc herniation. The etiology includes mechanical compression and chemical irritation, commonly due to foraminal stenosis. Cervical radiculopathy pain is a combination of nociceptive and neuropathic components, with various conservative treatments available, including immobilization and physical therapy, although evidence for their efficacy is limited. Neural mobilization especially when combined with cervical traction, shows promise in alleviating nerve-related pain and enhancing treatment adaptability. Techniques involving specific joint movements can enhance foraminal dimensions, thereby affecting nerve tension and circulation. This study uniquely examines the effects of head positions on foraminal opening and clinical outcomes, including H reflex and ultrasonography changes.

Enrollment: 45 estimated patients

Sex: All

Ages: 30 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. The patient's age will be ranged from 30 to 45 years old for both genders.
2. The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
3. The patient's symptoms more than 3 months and positive provocative test for cervical radiculopathy (Spurling's test, shoulder abduction test, neck distraction test, and upper limb tension test 1 (Median nerve).
4. Sensory, reflex, and/ or motor changes in the upper limb

Exclusion criteria

1. History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
2. Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
3. Patients with neck pain for signs and symptoms of serious pathology, including suspected arterial insufficiency, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and fracture.
4. Systemic diseases such as autoimmune and metabolic diseases.
5. History of steroid injection.
6. Complete loss of sensation along the involved nerve root.
7. bilateral radiating upper extremity
8. Diabetic polyneuropathy.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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45 participants in 3 patient groups

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion

Experimental group

Description:

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks

Treatment:

Other: Hold/Relax Stretch

Other: Prone Cervical Unilateral Poster anterior Mobilization

Device: traction (30 degree) head flexion

Other: Sub occipital Release

Other: Deep neck flexor strengthening exercise

multimodal physical therapy program and traction with neural mobilization (30 degree) side bending

Active Comparator group

Description:

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.

Treatment:

Other: Hold/Relax Stretch

Other: Prone Cervical Unilateral Poster anterior Mobilization

Other: Sub occipital Release

Other: Deep neck flexor strengthening exercise

Device: traction (30 degree) side bending)

multimodal physical therapy program and traction with neural mobilization (foramen opening position)

Active Comparator group

Description:

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.

Treatment:

Other: Hold/Relax Stretch

Other: Prone Cervical Unilateral Poster anterior Mobilization

Device: traction (foramen opening)

Other: Sub occipital Release

Other: Deep neck flexor strengthening exercise