Mobilization With Movement vs. Neural Mobilization on Nerve Root Function in Patients With Cervical Radiculopathy

Not Applicable

Completed

• Conditions: Cervical Radiculopathy at C7 Nerve Root; Disc Herniation; Cervical Radiculopathy at C5 Nerve Root; Cervical Radiculopathy; Cervical Radiculopathy at C6 Nerve Root
• Interventions: Other: Sustained natural apophyseal glides (SNAGS); Other: Neural mobilization; Other: Traditional physical therapy

• Registration Number: NCT05803954
• Lead Sponsor: Cairo University

Brief Summary

This study will be conducted to compare the effect of sustained natural apophyseal glides (SNAGS) versus neural mobilization on clinical outcomes such as 1- nerve root function in the form of: (A) peak to peak amplitude; (B) latency; (C) F wave. 2- pain pressure threshold (PPT) and 3- Neck disability index (NDI) in patients with cervical disc (C5-C6 and/or C6-C7) herniation.

Seventy two patients from both gender with cervical disc (C 5-C 6 and/or C 6- C7) herniation with both sensory and motor nerve affections will be recruited for this study following referral from an experienced neurologist and confirmed diagnosis by MRI. The patients' age will range between 20-50 years, body mass index (BMI) from 18 to 25 kg/cm2.

The patients will be assigned randomly by permuted block to three equal groups; group (A) will receive SNAGS in addition to traditional therapy, group (B) will receive neural mobilization in addition to traditional therapy and group (C) will receive traditional therapy.

peak to peak amplitude, nerve latency and F wave will be measured by electromyography, , pressure pain threshold will be measured by commander algometer. Neck disability will be measured by Arabic neck disability index.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-03-25
• Study First Submitted QC: 2023-03-27
• Study Start: 2023-03-31
• Study First Posted: 2023-04-07
• Status Verified: 2023-07
• Primary Completion: 2023-07-01
• Study Completion: 2023-07-01
• Last Update Submitted: 2023-07-05
• Last Update Posted: 2023-07-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 72

Inclusion Criteria

1. seventy patients with cervical disc (C 5-C 6 and/or C 6- C7) herniation with both sensory and motor nerve affections, referred from neurologist and confirmed diagnosis by MRI
2. Both sexes.
3. Age between 20-50 years.
4. Patients with neck pain radiating down to the arm.
5. Patients with positive findings for spurling test, Upper Limb Tension Test One (ULTTO), cervical distraction test and cervical rotation test towards the symptomatic side <60.
6. BMI from 18 to 25 kg/cm2
7. Existed active trigger points within middle trapezius and/ or cervical region.
8. Positive Pittsburgh sleep quality index' value >10, means moderate and/ or sever difficulty.

Exclusion Criteria

1. Patients experiencing primary shoulder or upper extremity problem of local origin
2. cardiovascular disorders and respiratory disorders,
3. pathological conditions involving cervical spine like vertebro basilar insufficiency and canal stenosis
4. osteophytes in cervical vertebrae
5. Patients who were undergoing treatment for neck pain with other means of physiotherapy at the time of the study
6. Cervical fractures, spinal surgery or other spinal pathologies (i.e. ankylosing spondylitis, spondylolisthesis)
7. Peripheral nerve lesions like neurotmesis and axonotmesis.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Group A (SNAGs group)	Traditional physical therapy	-
Group A (SNAGs group)	Sustained natural apophyseal glides (SNAGS)	-
Group B (Neural mobilization group)	Traditional physical therapy	-
Group B (Neural mobilization group)	Neural mobilization	-
Group C (traditional physical therapy)	Traditional physical therapy	-

Primary Outcome Measures

Name	Time	Method
F-wave parameters	Change over the course of the study, from baseline to the end of treatment program at 4 weeks	Evaluation of the spinal motoneuron excitability through the measurement of the F wave parameters
Somatosensory Evoked Potentials (SEPs) Latency and Amplitude	Change over the course of the study, from baseline to the end of treatment program at 4 weeks	SEPs are the electrical signals generated by the nervous system in response to somatosensory stimuli. SEPs are read on the skull with electroencephalography (EEG)
Pain pressure threshold by Pressure algometer	Change over the course of the study, from baseline to the end of treatment program at 4 weeks	An algometer will be used used to quantify pain intensity by pressure

Secondary Outcome Measures

Name	Time	Method
Neck disability Index	Change over the course of the study, from baseline to the end of treatment program at 4 weeks	Methods of assessment for such disability, especially those targeted at activities of daily living which are most affected by neck pain, questionnaire 10-item scaled entitled the Neck Disability Index (NDI)

Trial Locations

Locations (1)

Ismailia medical complex; 🇪🇬 Ismailia, Egypt