Manual Cervical Traction and Natural Apophyseal Glides for Cervical Radiculopathy Patients
Condition: Cervical Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      Cervical Radiculopathy is a clinical disorder of nerve root, and often is due to compressive
      or inflammatory pathology. There are number of different procedures which have been suggested
      for decreasing pain and disability in patients but manual therapy has been validated the
      effective technique. The objective of current research was to assess the comparative
      effectiveness of the Manual Cervical Traction and the Natural Apophyseal Glides on pain and
      disability among Cervical Radiculopathy patients.

      A parallel design, randomized controlled trial was performed on 72 patients in physiotherapy
      department, Mayo Hospital Lahore. Participants were randomly allocated into two groups after
      baseline testing. Group A received natural apophyseal glides and baseline treatment and group
      B received manual cervical traction and baseline treatment. Treatment period was of 3 weeks
      with 3 weekly sessions on alternate basis. Assessment was done before treatment at baseline
      and then by second and third week using numeric pain rating scale and neck disability index.
      SPSS version 25 was used to analyzed the data.
    

Detailed description: 
      72 patients who fulfill the inclusion criteria were enrolled in this study. Written informed
      consent was taken from every subject participating in this study. Allocation of subjects in
      two groups has been done by random number table as per CONSORT guidelines 2010. Group A was
      treated with Natural Apophyseal Glides and group B with Manual Cervical Traction. Both groups
      received the conventional therapy along with the manual techniques. The conventional therapy
      included hot pack, Neck range of motion exercises, neck strengthening and stabilization
      exercises. The hot pack is a form of thermo therapywas applied for 10 to 15 minutes and was
      applied at each visit during 3 sessions per week for total 3 weeks. The strengthening and
      stabilization exercises are form of therapeutics exercise are prescribed at 15 to 20 times
      per session for total 3 weeks. Intensity of exercise may rise gradually according to patient
      tolerance and muscular strength.The conventional or baseline therapy remained same throughout
      the study.

      Group A received conventional therapy and NAGS with 2-3 hertz (less than 6 repetitions) in 3
      sets for 3 weeks. Group B received MCT along with traditional therapy. Treatment frequency
      was 3 sessions per week for total three weeks duration. MCT applied was intermittent type
      traction.8 to 10 kg force was applied at an angle of 20 to 25 degree from horizontal. 5sets
      of cervical traction are performed. In every set traction is given for 1 minute with rest
      period of 20 seconds. The total time of session was 10 minute.Pain intensity was measured by
      Numeric Pain Rating Scale. Functional ability was appraised by Neck Disability Index. All the
      information was collected by using standardized questionnaire of NPRS and NDI. Confounding
      variables are controlled by randomization and restriction methods. All treatment was given by
      single handed to control the biasness.Proforma of the patients which dropout during study was
      filled through intention to treat analysis method which was set as 15%.
    

Intervention name(s): Natural apophyseal glides; Cervical manual traction
Intervention type(s): Other; Other
Intervention description(s): Patients received conventional therapy and NAGS with 2-3 hertz (less than 6 repetitions) in 3 sets for 3 weeks. The conventional therapy included hot pack, Neck range of motion exercises, neck strengthening and stabilization exercises. The hot pack is a form of thermo therapywas applied for 10 to 15 minutes and was applied at each visit during 3 sessions per week for total 3 weeks. The strengthening and stabilization exercises are form of therapeutics exercise are prescribed at 15 to 20 times per session for total 3 weeks. Intensity of exercise may rise gradually according to patient tolerance and muscular strength.; Patients received cervical manual traction (CMT) along with traditional therapy. Treatment frequency was 3 sessions per week for total three weeks duration. CMT applied was intermittent type traction.8 to 10 kg force was applied at an angle of 20 to 25 degree from horizontal. 5sets of cervical traction are performed. In every set traction is given for 1 minute with rest period of 20 seconds. The total time of traction session was 10 minute. The conventional therapy included hot pack, Neck range of motion exercises, neck strengthening and stabilization exercises. The hot pack is a form of thermo therapywas applied for 10 to 15 minutes and was applied at each visit during 3 sessions per week for total 3 weeks. The strengthening and stabilization exercises are form of therapeutics exercise are prescribed at 15 to 20 times per session for total 3 weeks. Intensity of exercise may rise gradually according to patient tolerance and muscular strength.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Single center, parallel group randomized controlled trial of 72 participants.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cervical radiculopathy; manual traction; neck pain