1. To evaluate the effectiveness of mulligan mobilization and stretching exercises in reducing pain in individuals with cervical radiculopathy. 2. To evaluate the effectiveness of mulligan mobilization and stretching exercises in reducing disability in individuals with cervical radiculopathy. 3. To evaluate the effectiveness of mulligan mobilization and stretching exercises at improving ranges in individuals with cervical radiculopathy.
Cervical Radiculopathy is a condition characterized by dysfunction of cervical spinal nerve roots which occurs as a result of compression or inflammatory pathology from a space occupying lesion such as a disc herniation, decreased disc height and degenerative changes of the uncovertebral joints anteriorly and zygoapophyseal joints posteriorly. Cervical radiculopathy constitutes 5%-36% of all radiculopathies. In general, rate of occurrence of cervical radiculopathy is 83/100,000 with an increased prevalence in the fifth decade of life (203/100,000).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
30
Group A will receive Mulligan mobilizations (SNAGs). Mulligan SNAGs mobilization technique was applied at level C4/5. Subjects were placed in sitting position and therapist stood behind the patient with therapist's thumbs on spinous process of particular vertebra. Mobilization was given by active movement followed by passive overpressure based on the movement restricted. The duration of treatment was three sets of ten repetitions each. Conventional treatment include the following: Subjects in both the groups were treated with hot pack (20 min), TENS (2 to 10 Hz), and manual traction along with deep neck flexor, and isometric neck strengthening.
Group B will receive stretching exercises. Subject was asked to lie supine on the plinth and the head was held at the edge of the plinth by the therapist. Then with one hand the therapist held the neck in cervical lateral flexion to the opposite side so as to achieve the stretching of the trapezius muscle. Myofascial release by applying sustained finger pressure for 5-10 s on the involved trapezius was given. A gentle myofascial stretching force was applied to take up slack and sustained until a release occurred. This protocol comprised four sets of 15 stretches with 3 min rest. Conventional treatment include the following: Subjects in both the groups were treated with hot pack (20 min), TENS (2 to 10 Hz), manual traction along with deep neck flexor, and isometric neck strengthening.
Leady Reading Hospital (LRH), Hayatabad Medical Complex (HMC)
Peshawar, KPK, Pakistan
RECRUITINGChange in Cervical Pain Intensity Measured by Numeric Pain Rating Scale (NPRS)
The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable") High test-retest reliability has been observed in both literate and illiterate patients with rheumatoid arthritis (r = 0.96 and 0.95, respectively) before and after medical consultation.
Time frame: 4 Weeks
Cervical Range of Motion by Inclinometer
An inclinometer is a device used to measure angles. It is commonly used in physiotherapy to measure the range of motion (ROM) of joints and very similar to a goniometer. The digital inclinometer demonstrated excellent reliability (ICC=0.75-0.86), except for the right lateral flexion (ICC=0.74) and left rotation (ICC=0.72).
Time frame: 4 Weeks
Cervical Disability by Neck Disability Index (NDI)
This questionnaire has been designed to give us information as to how your neck pain has affected your ability to manage in everyday life. Score: /50 Transform to percentage score x 100 = %points. It has 7 items for daily living, 2 for pain and 1 for concentration. Each item is rated from 0 to 5. Total score is presented in percentage. Higher score tells greater disability while 0 means no disability(16).Total score is 50. In cervical radiculopathy patients it has moderate test retest reliability ICC= 0.68 (22).The NDI has a fair to moderate test-retest reliability in patients with mechanical neck pain but also for patients with cervical radiculopathy. The NDI has a good construct validity.
Time frame: 4 Weeks
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