Cervical traction combined with neural mobilization for patients with cervical radiculopathy: A randomized controlled trial. (2021)

PICO

Patient/Population

Cervical radiculopathy (CR).

(n=66)

Intervention

  • Neural mobilization (NM) + cervical traction (CT),

Comparison

  • Sham neural mobilization (SNM) + cervical traction (CT).

  • Wait-list control group (WLC)

Outcomes

  • Pain
  • Neck Disability

  • Grip strength

  • Cervical spine mobility, functionality, and active ROM

Translatability:   (3/3) Easy                                    

Comments: “ Combining CT with NM results in improved disability, pain intensity and function compared to either CT with sham NM or no treatment at 4-week follow-up. CT alone did not present clinically significant differences compared to no treatment.”

Limitations: No information regarding the potential psychosocial consequences of CR. Some concerns about the degree of the patients’ blinding to group allocation. No follow up beyond 4, no long term outcomes across all domains.

Appraisals:

PEDro Scale  – (9/10) Blind therapists: No.  (by Pedro – confirmed)

Risk of Bias – (4/4)  (by RobotReviewer)

Trustworthiness – The study contains no serious weaknesses. Based on this result you should conclude that the trustworthiness of the study is high (90%). This means there is a 10% chance that alternative explanations for the effect found are possible. The effect size was large and 95% CI was OK. (by CAT for RCTS)

Metrics and
Journal Details:
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BTB

Intervention

  • Neural mobilization + cervical traction

Dose

  • 12 15-min treatment sessions.

    10 sets of (work 60s/rest 30s) manual intermittent pain-free CT (from grade II to grade III and grade IV) + pain-free slider NM technique. Each set lasted 60s and was followed by a rest period of 30s.

Periodicity

  • 3 times per week for 4 weeks

Local/Technic:

  •  In a comfortable supine position.
    CT was performed simultaneously with a slider NM of the median nerve to
    mobilize the C6-T1 nerve roots. The slider NM technique included repeated passive flexion and extension motions of the elbow, wrist and finger joints of the involved upper limb and was given in a slow and oscillatory fashion.
    Treatment was progressed clinically targeting a progressively increasing pain-free intermittent CT load in neck flexion. In addition, the pain-free slider NM of the medial nerve was initially given in a neutral shoulder position, but progressively the angle of the shoulder joint was increased to 90  of abduction combined with shoulder external rotation to further facilitate nerve gliding and reduce the increased neural mechanosensitivity

    Citation:

    Savva, C., Korakakis, V., Efstathiou, M., & Karagiannis, C. (2021). Cervical traction combined with neural mobilization for patients with cervical radiculopathy: A randomized controlled trial. Journal of bodywork and movement therapies26, 279–289. https://doi.org/10.1016/j.jbmt.2020.08.019

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