McKenzie Exercises Along With Neurodynamic Mobilization Exercises in Patients With Cervical Radiculopathy

Riphah International University46 enrolled

Overview

This studt was conducted to determine the effects of McKenzie Exercises along with Neurodynamic Mobilization exercises on Pain, Range of Motion and Functional Disability in patients with Cervical Radiculopathy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Cervical Radiculopathy

Interventions

Neural Mobilization exercises:OTHER

The neural mobilization approach used in this group involved moving the median nerve for ten repetitions, each held for three seconds.

Standard TreatmentOTHER

Hot pack for 10 minutes. TENS for 10 minutes. Cervical traction for 15 minutes 7% of body weight with 4 seconds hold to progression to 7 seconds hold and 5 second rest. Superficial neck muscles (upper trapezius, Levator scapulae, Pect. Major) stretching for 3 times with 30 seconds hold and Neck isometrics 10 times with 6 seconds hold .

McKenzie ExercisesOTHER

First Week: The patient is lying supine with their head retracted or their chin tucked. For a little flexion, place a little pillow beneath the occiput. Patient pulls head and neck posteriorly, maintaining end position for 1 second, then relaxes. Second Week: Patient in sitting position. Progression with neck extension and chin tuck. Therapist applies overpressure at end of motion. Third Week: Patient in supine, head extended beyond couch edge. Therapist performs retraction and extension exercises with traction, maintaining traction through full range of motion. Fourth Week: Patient in sitting. Progression with combined movements: retraction with lateral flexion, neck rotation, and final combination of retraction and neck flexion with overpressure. 3-4 sets and 10-15 repititions.

Eligibility

Sex: ALLMin age: 35 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age limit 35-50 Years. * Both male and female participants. * Median nerve related symptoms. * Participants presenting with unilateral C5-C7 cervical radiculopathy associated with a posterolateral cervical disc bulge were included in the study. * Ipsilateral neck rotation, Spurling's test, median nerve neurodynamic testing, and ULNTT were considered positive if they reproduced unilateral C5-C7 radicular arm pain and negative if they did not. * Pain reported as greater than 4-9/10 on the NPRS, persisting for more than 3 months. * Neck Disability Index score 20-80. * Participants demonstrating moderate restriction in cervical range of motion, defined as flexion \<40°, extension \<50°, lateral flexion \<35°, and rotation \<70°, were included. Exclusion Criteria: * A cervical spine fracture. * Spondylolisthesis, subluxation, and cervical instability * Radicular symptoms in both upper extremities. * TB, cancer, heart illness, osteoporosis. * Prolapsed intervertebral disc, neurological problems, any trauma or localized infection in the neck area. * Upper motor neuron disease, cervical stenosis, and bone and joint metabolic diseases. * Hyperelasticity and Thoracic outlet syndrome * Hyper lordotic if exceeds than normal angle * Psychiatric conditions including sadness and phobia/obsession. * Individuals who have had cervical spine surgery within a year.

Locations (1)

Sehat Medical Complex

Lahore, Punjab Province, Pakistan

Outcomes

Primary Outcomes

Neck Disability Index

The Neck Disability Index (NDI) is a self-administered tool that is employed to evaluate the functional impairment in people with neck pains. The instrument consists of ten questions which refer to daily activities; every question will be rated out of 0-5 scale, and finally there will be a total mark out of 0 -50. High scores indicate an increased amount of disability hence making NDI useful in assessing the impact of neck discomfort on the quality of life of patients and guide therapeutic decision making. When used in measuring functional disability in cervical radiculopathy, the NDI demonstrates strong levels of reliability. The psychometric integrity of the instrument is also supported by internal consistency where a Cronbach alpha of between approximately 0.80 and 0.90 is shown. 0-4: Minimal Disability, 5-14: Mild Disability, 15-24: Moderate Disability, 25-34: Severe Disability, 35-50: Complete Disability

Time frame: From enrollment to the end of treatment at 4 weeks

Numeric Pain Rating Scale

The Numerical Pain Rating Scale (NPRS) is used to assess a patient's level of pain, ranging from 0 to 10, whereas 0 denotes "no pain" and 10 represents the "worst imaginable pain." It is widely used tool in both clinical and research settings. The National Pain Research Scale (NPRS) has good test-retest reliability as revealed by the correlation coefficients of 0.95 to 0.96 and thus validates the reliability and consistency of the pain intensity measures.

Time frame: From enrollment to the end of treatment at 4 weeks

ROM Cervical Spine (Flexion)

Changes in cervical spine flexion ROM at baseline and 4th week of intervention was measured using goniometer

Time frame: From enrollment to the end of treatment at 4 weeks

ROM Cervical Spine (Extension)

Changes in cervical spine flexion ROM at baseline and 4th week of intervention was measured using goniometer.

Time frame: From enrollment to the end of treatment at 4 weeks.

ROM Cervical Spine (Lateral Flexion)

Data from ClinicalTrials.gov

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