Effect of Manual Therapy on Sensory Features in Patients With Cervical Radiculopathy
Condition: Cervical Radiculopathy
MeSH terms: Radiculopathy
Study type: Interventional

Summary: 
      Background & Purpose: Cervical radiculopathy is a neurological disorder, which commonly
      results because of nerve compression. There are different types of physical therapy
      interventions that are used for cervical radiculopathy. The evidence of effectiveness of
      manual therapy in cervical radiculopathy is still limited. Short-term hypoalgesic effects
      after manual therapy was found in different musculoskeletal conditions. However, the
      effectiveness of manual therapy in patients with cervical radiculopathy hasn't been
      investigated yet. Therefore, the aim of study is to examine the short-term effect of manual
      therapy (mobilization) on the sensory features in patients with chronic cervical
      radiculopathy.
    

Detailed description: 
      Participants:

      The sample size was calculated using G*power 3.1(F test, analysis of variance [ANOVA]:
      repeated measure, within between interaction, and a priori: compute required sample size). A
      result of 10 participants (treatment group=5 and sham group=5) was used to calculate the
      effect size (ES) of 0.44 for the pressure pain threshold on the cervical spine after the
      intervention(immediate effect) between group. The power estimated for ANOVA for the two group
      with a significance of 0.05 revealed that a total sample size of 28 participants was
      necessary to obtain a power of 0.80. . a minimum of 14 needed to be recruited in this study
      Participants with unilateral neck pain and radiating symptoms to upper extremity of more than
      three months were recruited from King Abdul-Aziz Hospital and East Jeddah general hospital in
      Jeddah, Saudia Arabia All patients signed a consent form before they participate in the study
      after explaining all procedures to them. The study was approved by the Institutional Review
      Board (IRB) at the University of Dammam (IRB Number: PGS-20160-30-142) and was approved by
      ministry of health at Saudia Arabia (IRB number: H-02J-002). All electronic data pertinent to
      the patients were being saved in a secured laptop, whereas the paper document will be kept in
      a locked cabinet.

      Data analysis:

      All statistical analysis was performed using IBM SPSS version 20 (Armonk, NY: IBM Corp).
      Significance levels will be set at p ≤ 0.05. Mean and standard deviation will be calculated
      as descriptive statistics. One-way repeated measures analysis of variance (ANOVA) and post
      hoc comparison, if needed will calculate the differences in the outcome measures: Quantitive
      sensory testing (QST), pain intensity, and active CROM
    

Intervention name(s): manual therapy; Superficial soft tissue massage
Intervention type(s): Other; Other
Intervention description(s): Manual therapy: One of the following techniques was used for the treatment group based on the patients' response (i.e centralization and reduction of symptoms).
Cervical postero-anterior vertebral mobilization glides:
a central posteranterior (PA) or unilateral PA oscillatory pressure of grade III on the patient's most symptomatic level for 2 minute and 3 sets .
Cervical lateral vertebral glides :at grade III for 1 minute and 3 sets.
Strengthening Exercises:
for deep neck flexor muscles for 10 seconds and repeating it for 10 times.; 1. Superficial soft tissue massage: The researcher applied a superficial effleurage massage without moving the deeper tissue for 2 minutes for 3 sets
Strengthening Exercises:
for deep neck flexor muscles for 10 seconds and repeating it for 10 times
Other intervention name(s): mobilization; deep neck flexor exercise; deep neck flexor exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: triple-blind (The researcher was blinded to the outcome measures, whereas the assessor, who performed the outcome measures was blinded to the patient groups. The patient was blinded to treatment)
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Manual therapy; cervical radiculopathy; pressure pain threshold; physiotherapy