The Efficacy of Cervical Lordosis Rehabilitation for Nerve Root Function and Pain in Cervical Spondylotic Radiculopathy
Condition: Cervical Lordosis Rehabilitation
MeSH terms: Lordosis; Radiculopathy; Swayback
Study type: Interventional

Summary: 
      To test the hypothesis that improvement of cervical lordosis (CL) in cervical spondylotic
      radiculopathy (CSR) will improve clinical features in a population suffering from CSR. Thirty
      chronic lower CSR patients with CL < 25° will be included. Patients will be assigned randomly
      into two equal groups, study and control . Both groups will receive neck stretching and
      exercises and infrared; additionally the study group will receive cervical extension
      traction. Treatments will be applied 3 time per week for 10 weeks after which groups will be
      followed for 3-months and 2-years. Amplitude of dermatomal somatosensory evoked potentials
      (DSSEPS), Cervical lordosis, and pain scales (NRS) will be measured.
    

Detailed description: 
      Previous studies testing the effects of 3-point bending types of cervical traction, have not
      clarified exactly what impact the sagittal cervical curve correction has on nerve root
      function and pain responses associated with improving an abnormal cervical lordosis in
      cervical spondylotic patients. The present randomized controlled trial will be undertaken to
      investigate the neurophysiological and pain response outcomes of 3-point bending (2-way)
      traction compared to standard care in patient cases with lower cervical spine CSR, chronic
      pain, and with a verified hypo-lordosis of the cervical spine. The primary hypothesis of this
      study will be that cervical lordosis restoration will have short- and long-term effects on
      DSSEPs and pain outcomes in CSR patients.
    

Intervention name(s): Stretching exercises; Two way traction
Intervention type(s): Other; Other
Intervention description(s): Exercises will be performed in the following order: 1) stretching towards lateral flexion for the upper part of the trapezius; 2) ipsilateral flexion and rotation for the scalene; 3) and flexion for the extensor muscles. Each maneuver will be held for 30 seconds as this is an optimum time to not create alteration in the evoked protentional. Each stretch will be repeated 3 times; During the traction, the head halter will be fixed posteriorly to cause slight distraction, retraction, and slight extension and at the same time a front anterior strap had weight will be applied over a pulley that allows transverse traction load to be applied to the apex of the participants cervical curve alteration. Weights will start at 15 lbs. (6.8 Kg) on the anterior strap and will increase over consecutive visits to patient tolerance or a maximum of 35 lbs. (15.9 Kg).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Parallel Assignment A prospective, double blinded, parallel-group, randomized clinical trial will be conducted at one of our university's research departments,
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cervical spine; Lordosis; Dermatomal; Traction