Article

OBJECTIVE: To investigate the immediate and 1-year effects of a multimodal
program, with cervical lordosis and anterior head translation (AHT)
rehabilitation, on the intensity of pain, disability, and peripheral and central
nervous system function in patients with discogenic cervical radiculopathy (CR).
DESIGN: A randomized controlled trial with 1-year and 10-week follow-up. SETTING:
University research laboratory. PARTICIPANTS: Patients (N=60; 27 men) with
chronic discogenic CR, a defined hypolordotic cervical spine, and AHT posture
were randomly assigned to a control group (n=30; mean age, 43.9+/-6.2y) or an
intervention group (n=30; mean age, 41.5+/-3.7y). INTERVENTIONS: Both groups
received the multimodal program; in addition, the intervention group received the
Denneroll cervical traction device. MAIN OUTCOME MEASURES: AHT distance, cervical
lordosis, arm pain intensity, neck pain intensity, and disability (Neck
Disability Index [NDI]), dermatomal somatosensory evoked potentials (DSSEPs), and
central somatosensory conduction time (N13-N20). Measures were assessed at 3 time
intervals: baseline, 10 weeks, and 1-year follow-up. RESULTS: After 10 weeks of
treatment, between-group analysis showed equal improvement in arm pain intensity
(P=.40), neck pain intensity (P=.60), and latency of DSSEPs (P=.60) in both
intervention and control groups. However, also at 10 weeks, there were
significant differences between groups, favoring the intervention group for
cervical lordosis (P<.0005), AHT distance (P<.0005), amplitude of DSSEPs
(P<.0005), N13 to N20 conduction time (P<.0005), and NDI (P<.0005). Although at
1-year follow-up, between-group analysis identified a regression back to baseline
values for the control group. Thus, all variables were significantly different,
favoring the intervention group at 1-year follow-up: cervical lordosis (P<.0005),
AHT distance (P<.0005), latency and amplitude of DSSEPs (P<.0005), N13 to N20
conduction time (P<.0005), intensity of neck and arm pain, and NDI (P<.0005).
CONCLUSIONS: The addition of the Denneroll cervical orthotic device to a
multimodal program positively affected discogenic CR outcomes at long-term
follow-up. We speculate that improved cervical lordosis and reduced AHT
contributed to our findings.
CI - Copyright A(c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS