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

Официальное название

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

Обзор

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.

Подробное описание

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.

Вмешательства

• Устройство traction (30 degree) head flexion
  Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30-degree head flexion) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, ne
• Другое Deep neck flexor strengthening exercise
  All patients are instructed to perform a home program involving chin-in exercises from a supine position, focusing on upper cervical spine extension and flexion. Participants will move their heads backwards and then return to the starting position, ensuring slow, controlled movements while palpating their necks to relax superficial neck muscles. The exercises will be done twice a week for six weeks, with each hold lasting 10 seconds, 15-second breaks between holds, and 10-15 repetitions in total
• Другое Sub occipital Release
  In a supine position with the head on a pillow, the patient is treated by a therapist seated at the head of the table. The therapist uses both hands (digits 2 to 5) to contact the base of the occiput, gently lifting the head anteriorly while allowing the dorsum of the hands to rest on the pillow. This technique involves cranial pulling as the patient's sub occipital muscles relax, with distraction maintained for up to 5 minutes as tissue slack becomes available. Once relaxation is achieved, the
• Другое Hold/Relax Stretch
  The therapy procedure involves positioning the patient supine and performing specific movements to address shoulder and neck tension. The therapist supports the occiput and rib area while guiding the neck into forward bending and lateral flexion, combined with right or left rotation, depending on the sequence. The patient is instructed to perform isometric contractions by elevating the shoulder against resistance for 10 seconds, followed by relaxation, with additional stretches held for 10 secon
• Другое Prone Cervical Unilateral Poster anterior Mobilization
  The patient is positioned prone with a pillow under their chest, and their head and neck are in a neutral position, while the therapist stands at the head. The therapist places both thumbs on the spinous process of the targeted vertebra and applies a gentle posterior to anterior force to assess pain, mobility, and end feel, gradually increasing the force for four to five repetitions.
• Устройство traction (foramen opening)
  Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (flexion, lateral bending and rotation according to pain) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through
• Устройство traction (30 degree) side bending)
  Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30 degree) side bending and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, ne

Первичные конечные точки

• assessment of pain intensity [Срок оценки: at baseline and after 6 weeks]

Вторичные конечные точки (3)

• Assessment of neck functional activities [Срок оценки: at baseline and after 6 weeks]
• assessment of H reflex for the median nerve [Срок оценки: at baseline and after 6 weeks]
• assessment of nerve root function [Срок оценки: at baseline and after 6 weeks]

Критерии участия

Критерии включения

• The patient's age will be ranged from 30 to 45 years old for both genders.
• The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
• 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).
• Sensory, reflex, and/ or motor changes in the upper limb

Критерии исключения

• History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
• Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
• 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.
• Systemic diseases such as autoimmune and metabolic diseases.
• History of steroid injection.
• Complete loss of sensation along the involved nerve root.
• bilateral radiating upper extremity
• Diabetic polyneuropathy.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Лечение

Центры проведения

Египет · 1 центр

• out-patient clinic, faculty of physical therapy, Horus university — Damietta

Идентификаторы

NCT: NCT07366983 · Nagy-Phd

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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