COMPARATIVE ASSESSMENT OF NEURAL GLIDING AND NEURAL TENSIONING TECHNIQUES COMBINED WITH CERVICAL TRACTION ON PAIN AND NECK DISABILITY AMONG PATIENTS WITH CERVICAL RADICULOPATHY
Keywords:
Cervical radiculopathy; neural gliding; neural tensioning; cervical traction; Neck Disability Index; Visual Analogue ScaleAbstract
Background: Cervical radiculopathy is diagnosed when pain and sensory disturbances originating from a compressed or irritated cervical nerve root radiate into the arm, often with associated disability. Most conservative treatments involve neural mobilization or neural tensioning (at times in conjunction with cervical traction); and there have been few trials to compare neural gliding with neural tensioning where both are used in combination with traction.
Objective: To compare the effects of neural gliding plus cervical traction and neural tensioning plus cervical traction on pain intensity and neck disability.
Methods: This randomized controlled trial was conducted in a tertiary care hospital in Multan, Pakistan involving 36 adults (35–55 years) that were allocated by sealed opaque envelopes in two groups each (Group A – neural gliding and mechanical cervical traction, n = 18 and Group B – neural tensioning and mechanical cervical traction, n = 18). Four times a week, treatment was provided for four weeks. The Visual Analogue Scale (VAS) for pain and disability questionnaires (Neck Disability Index [NDI]) were completed prior and following the program. Nonparametric tests were used.
Results: All those participating in the trial finished the trial. Both groups showed significant reductions in pain and disability scores compared to baseline (p < 0.001). Mean VAS reduction was respectively 3.35 points in Group A vs. 2.52 points in Group B and posttreatment VAS scores were different between the two groups (U = 80.000, p = 0.009, d = 1.00). There were no significant between group differences in post-treatment NDI scores (U = 134.500, p = 0.383, d = 0.44), and mean NDI reductions were 11.94 points in Group A and 7.11 points in Group B.
Conclusion: Both the groupings were effective. Hence, neural gliding and traction resulted in greater pain relief, but there were no significant differences in disability outcomes, thus gliding should be incorporated for pain reduction as primary clinical objectivity.
