Effectiveness of craniocervical flexion training combined with cervical traction among patients with cervical spondylotic radiculopathy
LIU Yang1, LIN Jian1, LI Hailong1, JI Yichao1, HU Rongrong2, LI Feifei2
1. Center of Rehabilitation, Zhejiang Hospital, Hangzhou, Zhejiang 310013, China; 2. Zhejiang Traditional Chinese Medical University, Hangzhou, Zhejiang 310053, China
Abstract：Objective To evaluate the effectiveness of craniocervical flexion training using pressure biofeedback combined with cervical traction among patients with cervical spondylotic radiculopathy (CSR). Methods Sixty patients with CSR receiving treatment in Center of Rehabilitation, Zhejiang Hospital from January 2020 to December 2021 were enrolled and randomly assigned into the control and treatment groups, of 30 patients in each group. All patients were given cervical traction, and patients in the treatment group were given additional craniocervical flexion training using pressure biofeedback for successive four weeks. The effectiveness of craniocervical flexion training combined with cervical traction was evaluated using Visual Analogue Scale (VAS), Neck Disability Index (NDI) and the active range of motion (AROM) of cervical flexion, and the neck pain and cervical functions were compared between the two groups before and after treatments using repeated-measures analysis of variance. Results Fifteen men were included in the treatment group, with a mean age of (49.47±5.33) years, mean disease course of (5.53±2.89) months, and mean VAS score of (4.73±1.39) points, and there were no significant differences between the control and treatment groups in terms of gender, age, course of disease or VAS score (P>0.05). The VAS score and NDI were lower 4 weeks post-treatment than pretreatment in both the treatment [VAS score: (2.13±1.01) vs. (4.73±1.39); NDI: (12.17±2.12) vs. (20.20±3.78)] and control groups [VAS score: (2.93±1.11) vs. (4.90±1.21); NDI: (15.23±2.39) vs. (19.60±3.30)], and the AROM of cervical flexion was significantly higher 4 weeks post-treatment than pretreatment in both the treatment [(42.87°±2.99°) vs. (37.50°±2.80°)] and control groups [(41.80°±3.61°) vs. (38.07°±2.99°)]; there was an interaction between time and group, and a higher improvement for cervical functions was seen in the treatment group than in the control group (FVAS =5.119, P=0.027; FNDI=15.473, P<0.001; FAROM=11.443, P<0.001). Conclusion Craniocervical flexion training using pressure biofeedback combined with cervical traction may effectively alleviate the neck pain and increase the AROM among patients with CRS, which is more effective to improve patients' cervical functions than cervical traction alone.
刘阳, 林坚, 李海龙, 季一超, 胡镕镕, 李斐斐. 神经根型颈椎病患者颅颈屈曲训练联合颈椎牵引干预效果评价[J]. 预防医学, 2023, 35(2): 104-107.
LIU Yang, LIN Jian, LI Hailong, JI Yichao, HU Rongrong, LI Feifei. Effectiveness of craniocervical flexion training combined with cervical traction among patients with cervical spondylotic radiculopathy. Preventive Medicine, 2023, 35(2): 104-107.
[1] 神经根型颈椎病诊疗规范化研究专家组.神经根型颈椎病诊疗规范化的专家共识[J].中华外科杂志,2015,53(11):812-814. [2] BLOMGREN J,STRANDELL E,JULL G,et al.Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain:a systematic review[J/OL].BMC Musculoskelet Disord,2018,19(1)[2023-01-15].https://doi.org/10.1186/s12891-018-2324-z. [3] TSIRINGAKIS G,DIMITRIADIS Z,TRIANTAFYLLOY E,et al.Motor control training of deep neck flexors with pressure biofeedback improves pain and disability in patients with neck pain:a systematic review and meta-analysis[J/OL].Musculoskelet Sci Pract,2020,50[2023-01-15].https://doi.org/10.1016/j.msksp.2020.102220. [4] 李增春,陈德玉,吴德升,等.第三届全国颈椎病专题座谈会纪要[J].中华外科学杂志,2008,46(23):1796-1799. [5] 麻国尧,汪芳俊,魏威,等.不同角度牵引治疗颈椎病的生物力学研究[J].中华全科医学,2015,13(8):1223-1225. [6] FURUE M,EBATA T,IKOMA A,et al.Verbalizing extremes of the visual analogue scale for pruritus:a consensus statement[J].Acta Derm Venereol,2013,93(2):214-215. [7] VERNON H,MIOR S.The Neck Disability Index:a study of reliability and validity[J].J Manipulative Physiol Ther,1991,14(7):409-415. [8] JULL G A,FALLA D,VICENZINO B,et al.The effect of therapeutic exercise on activation of the deep cervical fexor muscles in people with chronic neck pain[J].Man Ther,2009,14(6):696-701. [9] CHILDS J D,CLELAND J A,ELLIOTT J M,et al.Neck pain:Clinical practice guidelines linked to the International Classification of Functioning,Disability,and Health from the Orthopedic Section of the American Physical Therapy Association[J].J Orthop Sports Phys Ther,2008,38(9):A1-A34. [10] FRITZ J M,THACKERAY A,BRENNAN G P,et al.Exercise only,exercise with mechanical traction,or exercise with over-door traction for patients with cervical radiculopathy,with or without consideration of status on a previously described subgrouping rule:a randomized clinical trial[J].J Orthop Sports Phys Ther,2014,44(2):45-57. [11] 赖梦婷,周梦林,蔡树河.颈椎牵引治疗神经根型颈椎病的研究近况[J].按摩与康复医学,2018,9(2):6-8. [12] YOUNG I A,MICHENER L A,CLELAND J A,et al.Manual therapy,exercise,and traction for patients with cervical radiculopathy:a randomized clinical trial[J].Phys Ther,2009,89(7):632-642. [13] AKKAN H,GELECEK N.The effect of stabilization exercise training on pain and functional status in patients with cervical radiculopathy[J].J Back Musculoskelet Rehabil,2018,31(2):247-252.
