Article

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.
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. 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.

Langue : ANGLAIS