Comparison of the effects of constant force and gradual increased force of intermittent cervical traction in cervical radiculopathy
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Abstract
Cervical radiculopathy is a common disorder of the nerve root and is a pathologic process, which has been defined as pain in the distribution of a specific cervical nerve root. Mechanical cervical traction is one of the physical therapy interventions that has been proposed in the management of cervical radiculopathy. An important element that affects the efficiency of the cervical traction is using force or weight, which can be set as appropriate. Many studies have presented the effectiveness of intermittent cervical traction, but rarely mentioned about the efficiency or the reasonable force being used. Therefore, this study aimed to compare the therapeutic effect between constant force and gradual increased force of intermittent cervical traction on pain and the self-evaluated disability of cervical radiculopathy patients. Sixty-four cervical radiculopathy patients were randomly screened; eleven did not comply with the inclusion criteria and withdrew. The remaining 53 patients were divided into two groups. Group I (n=24) received constant force, and Group II (n=29) received gradual increased force of intermittent cervical traction. All patients were treated with superficial heat, a neck retraction exercise program to consistently practice at home every day, together with instructions on the correct neck posture and principles of ergonomics in activities of daily living. For Group II, the gradual increased force was required to be recorded and the increase of the force was discontinued in the event of pain or other forms of discomfort. Each patient reported responsiveness within a period of seven visits. The results of the first and last visits were collected with a visual analog scale (VAS) and the neck disability index (NDI). The findings showed that both groups experienced a significant (p-value < 0.01) improvement of pain (VAS) and disability (NDI). A comparison of the improvement, or the reduction of pre and post-treatment between both groups, found that Group II experienced a greater reduction than Group I for both evaluations with a significant difference (p-value < 0.01). This included the results of the gradual increased force (Group II) that found 48.27% of the patients had to discontinue at the fourth visit with the force 15.18 ± 0.98% of the total body weight (TBW). The mean duration of the physical therapy of Group I was 6.46 ± 1.06 visits and Group II was 5.66 ± 1.49 visits. It could be concluded that using gradual increased force of intermittent cervical traction displayed significant effective results for the treatment of pain and self-evaluated disability in a short period of time. This should be applied along with neck retraction exercises and postural education.
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