Cervical Traction combined with Neural Mobilization for patients with cervical radiculopathy: A randomized controlled trial.

Abstract Background Although both neural mobilization (NM) and cervical traction (CT) are widely used interventions in cervical radiculopathy (CR), there is limited clinical data to support their use. Objective To evaluate the effects of CT, with or without the addition of NM, on pain, function, and disability in patients with CR. Design A randomized, double-blinded, placebo-controlled clinical trial. Methods 66 patients with CR were randomly allocated to: a group (n = 22) received CT combined with NM (CT+NM), a group (n = 22) received CT combined with sham NM (CT+shamNM) and a wait-list control (WLC) group (n = 22). The Neck Disability Index (NDI), the Patient-Specific Functional Scale, the Numeric Pain Rating Scale (NPRS), grip strength and cervical spine mobility were used as outcome measures. A two-way analysis of variance was used to evaluate differences between the three groups at baseline and at 4-week follow-up. Results Statistically and clinically significant between-group differences at 4-week follow-up were found between CT+NM and WLC groups in favor of CT+NM group in NDI scores (d=1.30), NRPS (d=1.94), and active cervical rotation towards the opposite arm (d=1.18) and between CT+NM and CT+shamNM groups in favor of CT+NM group in NRPS (d=1.21). No significant differences were observed between CT+shamNM and WLC groups in all outcome measures. Clinically significant within-group improvements were found only for the CT+NM group. Conclusion At 4-week follow-up, CT in combination with NM resulted in improved outcomes in pain, function and disability in patients with CR.