Concurrent Treatment for Patients With Cervical Radiculopathy

Study Overview
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Brief Summary
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This study evaluates the effectiveness of two treatment interventions in patients with cervical radiculopathy. One group will receive a concurrent approach using traction and neuromobilizations. The other group will receive the sequential approach of traction and neuromobilizations

Detailed Description
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Physical therapists routinely use cervical traction and manual therapy in patients with cervical radiculopathy. The standard of care is a sequential approach in which the patients receive interventions successively. This study will provide the standard of care approach for one group while the other group receives the concurrent approach in which the patient will have neuromobilizations while they are receiving mechanical traction. Both groups will also receive exercise and manual therapy to the cervical and thoracic spine.

Official Title
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The Concurrent Use of Intermittent Cervical Traction and Neuromobilization Techniques in Patients With Cervical Radiculopathy

Conditions
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Spinal Nerve Root Disorder Nos

Intervention / Treatment
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* Other: concurrent traction and neuromobilization technique
* Other: sequential traction and neuromobilization technique
* Other: active exercise program
* Other: manual therapy to cervical and thoracic spine


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Participants that test positive on at least 3 out of 4 special tests. Participants will score at least 10 on the Neck Disability Index Participants will score at least 2 on the numeric pain rating scale Exclusion Criteria: Do not test positive on at least 3 of 4 special tests. Signs of cervical trauma Cervical myelopathy Active pregnancy Medical red flags (fracture, tumor, long term steroid use, rheumatoid arthritis, and osteoporosis) Evidence of vascular compromise Cervical spine surgery Recent injections in the past six weeks

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Two groups receiving interventions
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Concurrent traction<br>Concurrent traction and neuromobilization technique at each scheduled session Active exercise program (4-5 exercises) at each session Manual therapy to cervical and thoracic spine at each session | Other: concurrent traction and neuromobilization technique<br>* participant will be on a mechanical traction machine with an on:off cycle. During the on cycle, the primary researcher will be performing a neuromobilization technique on the symptomatic arm. Patients will also receive exercise and manual therapy<br>* Other names: Neurmobilization technique;Other: active exercise program<br>* Participants will have 4-5 exercises to perform at each session<br>Other: manual therapy to cervical and thoracic spine<br>* Lateral glides to cervical spine and thoracic manipulations<br>|
| Active Comparator: Sequential traction<br>Sequential traction and neuromobilization technique at each scheduled session Active exercise program (4-5 exercises) at each session Manual therapy to cervical and thoracic spine at each session | Other: sequential traction and neuromobilization technique<br>* Participants will receive neuromobilzation techniques followed by supine cervical traction<br>* Other names: Sequential traction;Other: active exercise program<br>* Participants will have 4-5 exercises to perform at each session<br>Other: manual therapy to cervical and thoracic spine<br>* Lateral glides to cervical spine and thoracic manipulations<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes in pain | Measured using the Numeric pain rating scale. Minimum score is 0 and maximum score is 10. 0 describes no pain and 10 describes worst pain imaginable. | after 4 weeks of intervention | 
| changes in function | Measured using the Neck Disability Index. The Neck Disability Index has a minimum score of 0 and maximum score of 50. It is typically expressed as a percentage by multiplying the score by 2. Higher scores represent greater disability. | After 4 weeks of intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference in treatment time between the groups | average minutes in treatment in each group | 4 weeks of intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cervical radiculopathy, neck pain, neuromobilizations