BACKGROUND: To date, optimal strategies for the management of patients with cervical radiculopathy remain elusive. Preliminary evidence suggests that a multimodal treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy. However, limited evidence exists to support the use of mechanical cervical traction in patients with cervical radiculopathy. OBJECTIVE: The purpose of this study was to examine the effects of manual therapy and exercise, with or without the addition of cervical traction, on pain, function, and disability in patients with cervical radiculopathy. DESIGN: This study was a multicenter randomized clinical trial. SETTING: The study was conducted in orthopedic physical therapy clinics. PATIENTS: Patients diagnosed with cervical radiculopathy (N=81) were randomly assigned to 1 of 2 groups: a group that received manual therapy, exercise, and intermittent cervical traction (MTEXTraction group) and a group that received manual therapy, exercise, and sham intermittent cervical traction (MTEX group). INTERVENTION: Patients were treated, on average, 2 times per week for an average of 4.2 weeks. MEASUREMENTS: Outcome measurements were collected at baseline and at 2 weeks and 4 weeks using the Numeric Pain Rating Scale (NPRS), the Patient-Specific Functional Scale (PSFS), and the Neck Disability Index (NDI). RESULTS: There were no significant differences between the groups for any of the primary or secondary outcome measures at 2 weeks or 4 weeks. The effect size between groups for each of the primary outcomes was small (NDI=1.5, 95% confidence interval [CI]=-6.8 to 3.8; PSFS=0.29, 95% CI=-1.8 to 1.2; and NPRS=0.52, 95% CI=-1.8 to 1.2). LIMITATIONS: The use of a nonvalidated clinical prediction rule to diagnose cervical radiculopathy and the lack of a control group without treatment were limitations of this study. CONCLUSIONS: The results suggest that the addition of mechanical cervical traction to a multimodal treatment program of manual therapy and exercise yields no significant additional benefit to pain, function, or disability in patients with cervical radiculopathy.
RCT Entities:
BACKGROUND: To date, optimal strategies for the management of patients with cervical radiculopathy remain elusive. Preliminary evidence suggests that a multimodal treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy. However, limited evidence exists to support the use of mechanical cervical traction in patients with cervical radiculopathy. OBJECTIVE: The purpose of this study was to examine the effects of manual therapy and exercise, with or without the addition of cervical traction, on pain, function, and disability in patients with cervical radiculopathy. DESIGN: This study was a multicenter randomized clinical trial. SETTING: The study was conducted in orthopedic physical therapy clinics. PATIENTS: Patients diagnosed with cervical radiculopathy (N=81) were randomly assigned to 1 of 2 groups: a group that received manual therapy, exercise, and intermittent cervical traction (MTEXTraction group) and a group that received manual therapy, exercise, and sham intermittent cervical traction (MTEX group). INTERVENTION: Patients were treated, on average, 2 times per week for an average of 4.2 weeks. MEASUREMENTS: Outcome measurements were collected at baseline and at 2 weeks and 4 weeks using the Numeric Pain Rating Scale (NPRS), the Patient-Specific Functional Scale (PSFS), and the Neck Disability Index (NDI). RESULTS: There were no significant differences between the groups for any of the primary or secondary outcome measures at 2 weeks or 4 weeks. The effect size between groups for each of the primary outcomes was small (NDI=1.5, 95% confidence interval [CI]=-6.8 to 3.8; PSFS=0.29, 95% CI=-1.8 to 1.2; and NPRS=0.52, 95% CI=-1.8 to 1.2). LIMITATIONS: The use of a nonvalidated clinical prediction rule to diagnose cervical radiculopathy and the lack of a control group without treatment were limitations of this study. CONCLUSIONS: The results suggest that the addition of mechanical cervical traction to a multimodal treatment program of manual therapy and exercise yields no significant additional benefit to pain, function, or disability in patients with cervical radiculopathy.
Authors: Per Kjaer; Alice Kongsted; Jan Hartvigsen; Alexander Isenberg-Jørgensen; Berit Schiøttz-Christensen; Bolette Søborg; Charlotte Krog; Christian Martin Møller; Christine Marie Bækø Halling; Henrik Hein Lauridsen; Inge Ris Hansen; Jesper Nørregaard; Karsten Juhl Jørgensen; Lars Valentin Hansen; Marie Jakobsen; Martin Bach Jensen; Martin Melbye; Peter Duel; Steffan W Christensen; Tina Myung Povlsen Journal: Eur Spine J Date: 2017-05-18 Impact factor: 3.134
Authors: Ian D Coulter; Cindy Crawford; Howard Vernon; Eric L Hurwitz; Raheleh Khorsan; Marika Suttorp Booth; Patricia M Herman Journal: Pain Physician Date: 2019-03 Impact factor: 4.965
Authors: Pierre Côté; Jessica J Wong; Deborah Sutton; Heather M Shearer; Silvano Mior; Kristi Randhawa; Arthur Ameis; Linda J Carroll; Margareta Nordin; Hainan Yu; Gail M Lindsay; Danielle Southerst; Sharanya Varatharajan; Craig Jacobs; Maja Stupar; Anne Taylor-Vaisey; Gabrielle van der Velde; Douglas P Gross; Robert J Brison; Mike Paulden; Carlo Ammendolia; J David Cassidy; Patrick Loisel; Shawn Marshall; Richard N Bohay; John Stapleton; Michel Lacerte; Murray Krahn; Roger Salhany Journal: Eur Spine J Date: 2016-03-16 Impact factor: 3.134