Manual Therapy, Exercise, and Traction for Patients With Cervical Radiculopathy: A Randomized Clinical Trial

被引:97
|
作者
Young, Ian A. [1 ]
Michener, Lori A. [1 ]
Cleland, Joshua A. [2 ,3 ,4 ]
Aguilera, Arnold J. [5 ]
Snyder, Alison R. [6 ]
机构
[1] Virginia Commonwealth Univ, Dept Phys Therapy, Richmond, VA USA
[2] Franklin Pierce Univ, Dept Phys Therapy, Concord, NH USA
[3] Concord Hosp, Rehabil Serv, Concord, NH USA
[4] Regis Univ, Manual Therapy Fellowship Program, Denver, CO USA
[5] Neurol Associates, Fredericksburg, VA USA
[6] AT Still Univ, Athlet Training Program, Mesa, AZ USA
来源
PHYSICAL THERAPY | 2009年 / 89卷 / 07期
关键词
NECK DISABILITY INDEX; SPINE MANIPULATION THERAPY; GLIDE TREATMENT TECHNIQUE; FEAR-AVOIDANCE BELIEFS; CASE SERIES; ARM PAIN; THORACIC MANIPULATION; LATERAL EPICONDYLITIS; ARTERY DISSECTION; FUNCTIONAL SCALE;
D O I
10.2522/ptj.20080283
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background. To date, optimal strategies for the management of patients with cervical radiculopathy remain elusive. Preliminary evidence suggests that a multimodal treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy. However, limited evidence exists to Support the use of mechanical cervical traction in patients with cervical radiculopathy. Objective. The purpose of this study was to examine the effects of manual therapy and exercise, with or without the addition of cervical traction, on pain, function, and disability in patients with cervical radiculopathy. Design. This study was a multicenter randomized clinical trial. Setting. The study was conducted in orthopedic physical therapy clinics. T Patients. Patients diagnosed with cervical radiculopathy (N=81) were randomly assigned to I of 2 groups: a group that received manual therapy, exercise, and intermittent cervical traction (MTEXTraction group) and a group that received manual therapy, exercise, and sham intermittent cervical traction (MTEX group). Intervention. Patients were treated, on average, 2 times per week for an average of 4.2 weeks. Measurements. Outcome measurements were collected at baseline and at 2 weeks and 4 weeks using the Numeric Pain Rating Scale (NPRS), the Patient-Specific Functional Scale (PSFS), and the Neck Disability Index (NDI). Results. There were no significant differences between the groups for an), of the primary or secondary Outcome measures at 2 weeks or 4 weeks. The effect size between groups for each of the primary outcomes was small (NDI = 1.5, 95% confidence interval [CI] = -6.8 to 3.8; PSFS = 0.29, 95% Cl = -1.8 to 1.2; and NPRS = 0.52, 95% Cl = -1.8 to 1.2). Limitations. The use of a nonvalidated clinical prediction rule to diagnose cervical radiculopathy and the lack of a control group without treatment were limitations of this study. Conclusions. The results suggest that the addition of mechanical cervical traction to a multimodal treatment program of manual therapy and exercise yields no significant additional benefit to pain, function, or disability in patients with cervical radiculopathy.
引用
收藏
页码:632 / 642
页数:11
相关论文
共 50 条
  • [1] Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial
    Alshami, Ali M.
    Bamhair, Duaa A.
    TRIALS, 2021, 22 (01)
  • [2] Comparison of 2 Manual Therapy and Exercise Protocols for Cervical Radiculopathy: A Randomized Clinical Trial Evaluating Short-Term Effects
    Langevin, Pierre
    Desmeules, Francois
    Lamothe, Melanie
    Robitaille, Simon
    Roy, Jean-Sebastien
    JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, 2015, 45 (01) : 4 - 17
  • [3] Cervical traction combined with neural mobilization for patients with cervical radiculopathy: A randomized controlled trial
    Savva, Christos
    Korakakis, Vasileios
    Efstathiou, Michalis
    Karagiannis, Christos
    JOURNAL OF BODYWORK AND MOVEMENT THERAPIES, 2021, 26 : 279 - 289
  • [4] 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
    Fritz, Julie M.
    Thackeray, Anne
    Brennan, Gerard P.
    Childs, John D.
    JOURNAL OF ORTHOPAEDIC & SPORTS PHYSICAL THERAPY, 2014, 44 (02) : 45 - 57
  • [5] Effect of cervical traction on cervicogenic headache in patients with cervical radiculopathy: a preliminary randomized controlled trial
    Jellad, Anis
    Kalai, Amine
    Chaabeni, Amr
    Ben Nasrallah, Cyrine
    Nsir, Atef Ben
    Jguirim, Mahbouba
    Sriha, Asma Belguith
    Frih, Zohra Ben Salah
    Bedoui, Mohamed Hedi
    BMC MUSCULOSKELETAL DISORDERS, 2024, 25 (01)
  • [6] Effectiveness of neural mobilization with intermittent cervical traction in the management of cervical radiculopathy: A randomized controlled trial
    Savva, Christos
    Giakas, Giannis
    Efstathiou, Michalis
    Karagiannis, Christos
    Mamais, Ioannis
    INTERNATIONAL JOURNAL OF OSTEOPATHIC MEDICINE, 2016, 21 : 19 - 28
  • [7] Simultaneous versus consecutive administration of cervical traction and neural mobilization in patients with cervical radiculopathy: A randomized controlled trial
    Masood, Tahir
    Afridi, Sabah
    Malik, Arshad Nawaz
    Osama, Muhammad
    Amir, Muhammad
    NEUROLOGY ASIA, 2024, 29 (01) : 167 - 174
  • [8] Effect of Arthroplasty vs Fusion for Patients With Cervical Radiculopathy A Randomized Clinical Trial
    Johansen, Tonje Okkenhaug
    Sundseth, Jarle
    Fredriksli, Oddrun Anita
    Andresen, Hege
    Zwart, John-Anker
    Kolstad, Frode
    Pripp, Are Hugo
    Gulati, Sasha
    Nygaard, Oystein Petter
    JAMA NETWORK OPEN, 2021, 4 (08)
  • [9] Effectiveness of manual therapy for cervical radiculopathy, a review
    Thoomes E.J.
    Chiropractic & Manual Therapies, 24 (1)
  • [10] Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial
    Wibault, Johanna
    Oberg, Birgitta
    Dedering, Asa
    Lofgren, Hakan
    Zsigmond, Peter
    Peolsson, Anneli
    JOURNAL OF NEUROSURGERY-SPINE, 2018, 28 (01) : 1 - 9