Review of a study- Cervical traction

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Fritz et al. (2014) did a fairly recent RCT on effectiveness of mechanical traction in patients presenting with cervical radiculopathy.

A previous study done by Raney showed that cervical traction was associated with more benefit if patients present with 3 or more of those 5 following factors: (1) Peripheralization with ROM of mobs of low cervical spine. (2) positive shoulder abduction sign [place 1 hand on the head and wait 30 second… if pain decrease, it’s (+)], (3) positive neck traction test, (4) positive ULNT, (5) 55 or older

Based on Raney study, Fritz et. al (2014) did a stratified RCT comparing 3 groups: (1) Exercise alone, (2) Exercise with mechanical traction, (3) Exercise + overdoor traction as home exercise program.

Results:
(1) Disability and pain significantly lower in the group with mechanical traction even after 6 and 12 months!
(2) Regardless of symptoms described by Raney, patients still could benefit from cervical traction

Limitation of this study:
(1) Couldn’t blind the therapist/ patient
(2) Number of treatments were up to 10 in 4 weeks
(3) High drop out… so low internal validity
(4) Selection bias… so low external validity

My thought on this:
A tool to consider for neck pain patients. (probably has more of a psychosocial effect)

Short term decrease of pain increases therapeutic alliance and decreases perceived threat. Also since it’s not blinded, the therapist beliefs will have an impact on the patient’s outcome…

 

Reference:
http://www.jospt.org/doi/pdf/10.2519/jospt.2014.5065