Effects of Cervical Traction With and Without EMG Biofeedback in Patients With Cervical Radiculopathy
Condition: Cervical Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      Cervical radiculopathy is a neurological condition which is caused by underlying
      musculoskeletal disorders including herniated disc and degenerative changes in cervical spine
      that results in narrowing or stenosis of intervertebral foramen. This narrowing leads to
      compression of nerve root at the respective foramen. The compressed nerve root produces
      symptoms like numbness, tingling, pain and motor weakness in neck and upper extremity. These
      symptoms appear at the dermatome and myotome distribution of the affected nerve root. Mostly
      the cervical radiculopathy is present unilaterally but in severe cases it can appear
      bilaterally where bony spurs are found at various levels and nerve root in under compression
      on both sides.
    

Detailed description: 
      Cervical radiculopathy is a neurological condition which is caused by underlying
      musculoskeletal disorders including herniated disc and degenerative changes in cervical spine
      that results in narrowing or stenosis of intervertebral foramen. This narrowing leads to
      compression of nerve root at the respective foramen. The compressed nerve root produces
      symptoms like numbness, tingling, pain and motor weakness in neck and upper extremity. These
      symptoms appear at the dermatome and myotome distribution of the affected nerve root. Mostly
      the cervical radiculopathy is present unilaterally but in severe cases it can appear
      bilaterally where bony spurs are found at various levels and nerve root in under compression
      on both sides.

      The annual incidence rate of cervical radiculopathy is reported to be 107.3 per 100,000 of
      men and 63.5 per 100,000 of women. So accordingly, the condition is more common in males than
      females.

      Although no definitive treatment plan for cervical radiculopathy has been developed, there is
      a general consensus in the literature that using manual therapy techniques in conjunction
      with therapeutic exercise is effective in terms of increasing function and active range of
      motion (AROM). The focus will most likely be on reducing pain and disability. Recent
      researches have shown that exercise therapy has the highest beneficial outcomes.

      Treatment options for rehabilitation plan includes: Education and advice, Manual Therapy -
      PAIVMs (Passive Accessory Intervertebral Movements) / PPIVMs (Passive Physiological
      Intervertebral Movements) / NAGs (Natural Apophyseal Glides) / SNAGs (Sustained Natural
      Apophyseal Glides),Exercise Therapy - AROM, stretching and strengthening and Postural
      re-education Cervical traction and electromyography (EMG) biofeedback have been administered
      by many physiotherapists and positive outcomes are revealed. Traction not only relives nerve
      root compression but also helps in managing acute pain instantly whereas EMG biofeedback is
      used to generate an electrical feedback signal in response to muscle activation and helps
      patients to learn a more effective way of using their weak muscles
    

Intervention name(s): cervical traction with EMG biofeedback; cervical traction and conventional physical therapy
Intervention type(s): Other; Other
Intervention description(s): Continuous traction for 15-20 minutes in sitting position on average at an angle of 15-25 degrees of cervical flexion or in the most pain-free position.
Ask the patient to assume sitting position on a comfortable chair. Place surface electrodes of EMG biofeedback at the level of C5-6 Para spinal muscles to pick up the activity of the muscles and convert it to vis-ual and auditory impulses produced from the device. Tell the patient to try to relax the tension of the neck muscles as much as he can by lowering the visual and auditory impulses from the device; Continuous traction for 15-20 minutes in sitting position on average at an angle of 15-25 degrees of cervical flexion or in the most pain-free position
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: cervical traction; Range of motion; pain; EMG biofeedback; disability