Effect of Neck vs. Combined Neck-Lumbar Mobilization on Pain and Motion in Cervical Disc Herniation

Fenerbahce University

Status: Completed

Conditions: Cervical Disc Herniation

Treatments: Other: Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)

Study type: Interventional

Funder types: Other

Identifiers

NCT06858605

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Details and patient eligibility

About

Background To assess the effectiveness of Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) applied to cervical-only mobilization versus both lumbar and cervical regions on pain intensity and range of motion (ROM) in individuals with cervical disc herniation, Methods: Thirty three participants were enrolled in the study. The patients were randomly assigned to two groups. Group A received cervical-only KEOMT while Group B received combined lumbar and cervical KEOMT, Interventions were administered three times a week for four weeks. Pain was measured using the Visual Analog Scale (VAS), ROM was assessed for flexion and lateral flexion, and Neck Pain and Disability Index (NPDI) and Short-Form 36 Health Survey (SF-36) were used for evaluation.

Enrollment: 33 patients

Sex: All

Ages: 25 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosed with cervical disc herniation at least 8 weeks but not more than 5 years prior.
• Cervical disc herniation verified by magnetic resonance imaging (MRI) at 1 or 2 segmental levels, consistent with clinical findings.
• Neck Disability Index (NDI) score greater than 5.
• No use of analgesic medication other than the prescribed treatment before or during the study period.

Exclusion criteria

• History of myelopathy, whiplash-associated disorder, generalized myalgia, malignant tumor, or inflammatory disease.
• Painful back problems or neurological symptoms within the past year.
• Psychiatric disorders or drug abuse.
• Contraindications to physical therapy or inability to return to work or perform physical therapy due to other diseases or disabilities.
• Inability to communicate effectively.
• Participation in any additional interventions outside the prescribed treatment during the study period.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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33 participants in 2 patient groups

Group A (Cervical mobilization group)

Experimental group

Description:

Cervical mobilizations were performed with patients in a supine position. This setup facilitated accurate application of manual therapy techniques. Techniques included Grade 1 mobilizations (pain relief) and Grade 2 mobilizations (soft tissue relaxation). The concave-convex rule guided gliding and translatory movements for optimizing joint mechanics. Manual traction and segmental mobilization were performed with patients in a supine position. The KEOMT included cervical segmental traction and cervical segmental mobilization-flexion and gliding therapy in grade 3. The Convex/Concave Rule was consistently applied in all cases.

Treatment:

Other: Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)

Group B (Combined cervical and lumbar mobilization group)

Experimental group

Description:

For segmental flexion mobilization, the patient is positioned on their side with their hips and knees flexed. The therapist places one hand on the vertebrae, positioning the fingers on either the transverse or spinous processes, and the other hand on the sacrum in a similar manner. To facilitate movement, the therapist's chest makes contact with the patient's knees, allowing the pelvis to be guided in a caudal or ventral direction. This technique can be effectively adapted for both cervical and lumbar regions, maintaining consistent application across various spinal segments. For segmental traction, the patient also lies on their side, with their knees flexed toward the abdomen. The therapist hooks their fingers over the proximal transverse processes or the soft tissues in the paravertebral region and applies traction by pulling in opposite directions.

Treatment:

Other: Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)