Cervical Traction, Passive Accessory Intervertebral Movements and Active Strength Training in Cervical Radiculopathy

Not Applicable

Completed

• Conditions: Cervical Radiculopathy
• Interventions: Other: Manual Cervical Traction; Other: Active Strength Training; Other: Passive Accessory Intervertebral Movements

• Registration Number: NCT05234268
• Lead Sponsor: Riphah International University

Brief Summary

To determine the effectiveness of Manual Cervical Traction, Passive Accessory Intervertebral Movements (PAIVMs) and Active strength training in the management of cervical radiculopathy. To compare the effectiveness of Manual Cervical Traction, Passive Accessory Intervertebral Movements (PAIVMs) and Active strength training in the management of cervical radiculopathy.

Detailed Description

Cervical radiculopathy is a clinical condition resulting from compression of cervical nerve roots near the spinal cord. Some factors that may increase the risk for developing cervical radiculopathy include age. The risk for cervical radiculopathy tends to increase with age. This study is based on three interventions (Manual Cervical traction, Passive Accessory Intervertebral Movements (PAIVMs) and Active Strength Training) individually on three separate but equal groups of participants. It will determine the most effective intervention and which intervention is superior to the other for treating cervical radiculopathy and to assist future practitioners and researchers.

Study Timeline

• Study Start: 2021-06-30
• Study First Submitted: 2022-02-01
• Study First Submitted QC: 2022-02-01
• Study First Posted: 2022-02-10
• Primary Completion: 2022-08-01
• Study Completion: 2022-08-05
• Status Verified: 2022-09
• Last Update Submitted: 2022-09-14
• Last Update Posted: 2022-09-16

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 51

Inclusion Criteria

• Diagnosed with cervical radiculopathy due to muscle tightness or spasm (Diagnosed by Spurling's Test)
• Having complaint more than 2 months

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Exclusion Criteria

• Past history of cervical surgery
• Past history of cervical trauma
• Any inflammatory disease
• Tumor or Carcinoma
• Disco genic/ disc herniation or stenosis cause of radiculopathy.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Manual Cervical Traction	Manual Cervical Traction	The patient is in supine lying. The head and neck of patient are held in the hands of the practitioner, and then a gentle traction of a pulling force is applied. Intermittent periods of traction can be applied, holding each position for about 10 seconds. Traction is usually applied at about 20-30 degrees of neck flexion.
Active Strength Training	Active Strength Training	The progression of exercises will be done using different colours of Thera-band indicating varied resistance
Passive Accessory Intervertebral Movements	Passive Accessory Intervertebral Movements	Patient lying in prone. Therapist stands to side of patient placing their pisiform/ulnar surface of hand over the selected spinous process (SP) with their wrist in full extension. Other hand placed on top of hand to reinforce. Therapist's shoulders should be directly above the SP with elbows slightly bent. Therapist uses their body weight to apply a PA force to the selected SP by leaning their body over their arms and performing rocking movements to provide oscillatory movements of the vertebra.

Primary Outcome Measures

Name	Time	Method
Pain Relief by Visual Analogue Scale (VAS)	4 weeks	A Visual Analogue Scale (VAS) is a measurement instrument that tries to measure a characteristic or attitude that is believed to range across a continuum of values and cannot easily be directly measured. It is often used in epidemiologic and clinical research to measure the intensity or frequency of various symptoms. The simplest VAS is a straight horizontal line of fixed length, usually 100 mm. The ends are defined as the extreme limits of the parameter to be measured (symptom, pain, health) orientated from the left (worst) to the right (best).
Activities of daily living by Neck Disability Index (NDI)	4 Weeks	This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Patient-completed, condition- specific, functional status questionnaire with 10 items including pain, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation.; Each section is scored on a 0 to 5 rating scale, in which zero means "no pain" and 5 means "Worst imaginable pain".
Cervical Compression Test by Spurling's Test	4 Weeks	The Spurling's test (also known as Maximal Cervical Compression Test and Foraminal Compression Test) is used during a musculoskeletal assessment of the cervical spine when looking for cervical nerve root compression causing Cervical Radiculopathy. There are different ways described in the literature to perform the Spurling's test. The version that provoked upper limb symptoms the best was with the neck in extension, lateral flexion and axial compression.

Secondary Outcome Measures

Name	Time	Method
Endurance of the deep flexors of the cervical spine by Cranio-cervical Flexion Test	4 week	The Craniocervical flexion test (CCFT) is a clinical test of neuromotor control including the activation and endurance of the deep flexors of the cervical spine. This test involves the subject performing a "yes" like nod which is the anatomical action of the Deep Cervical flexors, against a pressure biofeedback. The CCFT tests the neuromuscular control of the control of the deep cervical flexor muscles, the longus capitis, and colli. The test also assesses endurance of the deep cervical flexors and interaction of the deep cervical flexor muscles with the superficial flexors, i.e. the Sternocleidomastoid and the anterior scalene muscles. It can also be used as a clinical indicator of impaired activation of the deep cervical flexor muscles, to measure the muscle activity of the deep and superficial cervical muscles.
Cervical Range of motion by Goniometer	4 Weeks	A goniometer is an instrument which measures the available range of motion at a joint. Goniometer have different types; the most use is the universal standard goniometer, which is either made with plastic or metal tool. It consists of a stationary arm, a movable arm and a fulcrum.

Trial Locations

Locations (2)

Pakistan Railway General Hospital; 🇵🇰 Rawalpindi, Punjab, Pakistan

Quaid-e-Azam International Hospital; 🇵🇰 Rawalpindi, Punjab, Pakistan