Effect of Cervical Traction From Different Angles With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 45
- 试验地点
- 1
- 主要终点
- assessment of pain intensity
研究概览
简要总结
This study will be conducted to examine
- The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis.
- The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes.
- The efficacy of mechanical traction from decompression angles with neural mobilization has a Numeric Pain Rating Scale.
- The efficacy of mechanical traction from decompression angles combined with neural mobilization on Neck Disability Index.
详细描述
Cervical radiculopathy is a condition characterized by pain, sensory and motor impairments, and slowed reflexes caused by the compression of cervical nerve roots, often stemming from cervical disc herniation. The etiology includes mechanical compression and chemical irritation, commonly due to foraminal stenosis. Cervical radiculopathy pain is a combination of nociceptive and neuropathic components, with various conservative treatments available, including immobilization and physical therapy, although evidence for their efficacy is limited. Neural mobilization especially when combined with cervical traction, shows promise in alleviating nerve-related pain and enhancing treatment adaptability. Techniques involving specific joint movements can enhance foraminal dimensions, thereby affecting nerve tension and circulation. This study uniquely examines the effects of head positions on foraminal opening and clinical outcomes, including H reflex and ultrasonography changes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 30 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The patient's age will be ranged from 30 to 45 years old for both genders.
- •The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
- •The patient's symptoms more than 3 months and positive provocative test for cervical radiculopathy (Spurling's test, shoulder abduction test, neck distraction test, and upper limb tension test 1 (Median nerve).
- •Sensory, reflex, and/ or motor changes in the upper limb
排除标准
- •History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
- •Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
- •Patients with neck pain for signs and symptoms of serious pathology, including suspected arterial insufficiency, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and fracture.
- •Systemic diseases such as autoimmune and metabolic diseases.
- •History of steroid injection.
- •Complete loss of sensation along the involved nerve root.
- •bilateral radiating upper extremity
- •Diabetic polyneuropathy.
研究组 & 干预措施
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
干预措施: Hold/Relax Stretch (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
干预措施: traction (30 degree) head flexion (Device)
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
干预措施: Deep neck flexor strengthening exercise (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
干预措施: Sub occipital Release (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
干预措施: Prone Cervical Unilateral Poster anterior Mobilization (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) side bending
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Deep neck flexor strengthening exercise (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) side bending
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Sub occipital Release (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) side bending
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Hold/Relax Stretch (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) side bending
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Prone Cervical Unilateral Poster anterior Mobilization (Other)
multimodal physical therapy program and traction with neural mobilization (30 degree) side bending
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: traction (30 degree) side bending) (Device)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Deep neck flexor strengthening exercise (Other)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Sub occipital Release (Other)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Hold/Relax Stretch (Other)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: Prone Cervical Unilateral Poster anterior Mobilization (Other)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)
Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
干预措施: traction (foramen opening) (Device)
结局指标
主要结局
assessment of pain intensity
时间窗: at baseline and after 6 weeks
Pain intensity was evaluated using the Numeric Pain Rating Scale (NPRS), a validated self-reported measure. Participants rated their pain on an 11-point scale from 0 (no pain) to 10 (worst pain imaginable), after receiving an explanation of the scale. NPRS scores were documented at baseline and scheduled follow-ups to track pain intensity changes during the intervention, with higher scores reflecting greater pain severity.
次要结局
- Assessment of neck functional activities(at baseline and after 6 weeks)
- assessment of H reflex for the median nerve(at baseline and after 6 weeks)
- assessment of nerve root function(at baseline and after 6 weeks)
研究者
Mohamed Nagy Elshafey
principal investigator
Cairo University