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Does Improvement Towards a Normal Cervical Sagittal Configuration Aid in the Management of Lumbosacral Radiculopathy

Not Applicable
Completed
Conditions
Cervical Lordosis Rehabilitation
Interventions
Other: Deneroll cervical extension traction
Other: Traditional treatment
Registration Number
NCT05553002
Lead Sponsor
Cairo University
Brief Summary

A randomized controlled study with six months follow-up will be conducted to investigate the effects of sagittal head posture correction on 3D spinal posture parameters, back and leg pain, disability, and S1 nerve root function in patients with chronic discogenic lumbosacral radiculopathy . Participants will include 80 patients between 40 and 55 years experiencing chronic discogenic lumbosacral radiculopathy with a definite hypolordotic cervical spine and forward head posture and will be randomly assigned a comparative treatment control group and a study group. Both groups will receive TENS therapy and hot packs, additionally, the study group will receive the Denneroll cervical traction orthotic.

Detailed Description

Despite the fact that there is some evidence of a link between low back pain and head posture , there is limited experimental data to support a cause-and-effect relationship and interventional outcomes. Accordingly, a prospective, randomized, controlled study will be conducted at a research laboratory of our university to investigate if cervical curve restoration and forward head posture correction will have short and long term effects on three dimensional spinal posture parameters as well as lumbar radiculopathy management outcomes such as symptoms, disability, and neurophysiological findings .In this study we will use an orthotic cervical traction termed the Denneroll to help restore normal sagittal spinal configuration based on principles of 3-point bending traction methods. Interventions will be applied at a frequency of 3 times per week for 10 weeks and groups will be followed for an additional 6-months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Absolute rotatory angle less than 25° and greater than 0.
  • Anterior head translation distance greater than 15mm
  • Confirmed chronic unilateral lumbosacral radiculopathy associated with L5-S1 lumbar disc prolapse .
  • Symptoms lasting longer than 3 months
Exclusion Criteria
  • Previous history of lumbosacral surgery.
  • Metabolic system disorder.
  • Peripheral neuropathy.
  • History of upper motor neuron lesion.
  • Spinal canal stenosis.
  • Rheumatoid arthritis.
  • Osteoporosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Deneroll cervical extension tractionDeneroll cervical extension tractionThe study group will receive 3-point bending cervical extension traction following the protocol of Deed Harrison . The duration of each session will start at approximately three minutes and increased one minute per session until reaching the goal of 20 minutes per session
Deneroll cervical extension tractionTraditional treatmentThe study group will receive 3-point bending cervical extension traction following the protocol of Deed Harrison . The duration of each session will start at approximately three minutes and increased one minute per session until reaching the goal of 20 minutes per session
Traditional treatmentTraditional treatmentThe participants will receive hot packs (15 minutes) and TENS therapy to control pain and eliminate the causal role of muscle spasms and/or tightness in changing the posture parameters.
Primary Outcome Measures
NameTimeMethod
The Change in cervical absolute rotatory anglewill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

Cervical absolute rotatory angle is formed by two lines intersecting from the posterior body margins of C2-C7 and forward head distance

The Change in anterior head translationwill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

anterior head translation is measured as the horizontal displacement of the posterior superior body corner of C2 vertebra relative to a vertical line extending superiorly from the posterior inferior body corner of C7..

Secondary Outcome Measures
NameTimeMethod
The change in 3D spinal posture parameterswill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

Rasterstereography sagittal plane parameters (lumbar angles, thoracic angles, and trunk inclination), the frontal plane parameters (trunk imbalance and lateral deviation) and the transversal plane parameters (vertebral surface rotation and pelvis torsion) will be selected to cover the posture profile in three planes

The change in pain intensitywill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

Measurement of pain will be performed by using a visual analogue scale (VAS). The subjects will be asked about the perception of pain using a 10-cm line with 0 (no pain) on one end and 10 (worst pain) on the other. subjects will be asked to place a mark along the line to denote their level of pain

The change in disability levelwill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

Disability will be measured using the Oswestry Disability Index. The total score is transferred onto a scale ranging from 0 to 100, where 0 indicates no disability and 100 indicates worst possible disability

The change in peak to peak amplitude of H reflexwill be measured at three intervals :pretreatment, 10 weeks post treatment, and at six months of follow-up

The H-reflex (or Hoffmann's reflex) is a reaction of muscles after electrical stimulation of sensory fibers (Ia afferents stemming from muscle spindles) in their innervating nerves

Trial Locations

Locations (1)

Cairo University

🇪🇬

Cairo, Egypt

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