Asian Journal of Pharmaceutical Research and Health Care

Open Access Open Access  Restricted Access Subscription Access

Study on the Effectiveness of Manual Mulligan Traction Compared to Intermittent Electrical Traction in Patients with Cervical Spondylosis


Affiliations
1 Department of PM&R, RMMC&H, Annamalai University, Annamalai Nagar – 608002, Tamilnadu, India
2 Department of PM&R, RMMC&H, Annamalai University, Annamalai Nagar – 608002, Tamilnadu, India, India
 

Cervical traction is a variety of practicing methods depending on the pathology being treated. The established effectiveness in cervical spondylosis of these different methods makes it a useful tool for physiotherapy practitioners. However, its role in cervical spondylosis is uncertain. Comparing manual Mulligan traction and intermittent electrical traction would provide information of great importance to the scientific community on the use of cervical traction in patients with cervical spondylosis. The purpose of the present study is to find out and compare the effectiveness of manual Mulligan traction versus intermittent electrical traction on pain, range of motion (ROM) and functional disability in patients with cervical spondylosis. A total of 30 subjects with cervical spondylosis were selected and screened for inclusion and exclusion criteria. Initially, the pain intensity was evaluated using the Numerical Pain Rating scale (NPRS). The active ROM of cervical extension and cervical Lt/Rt rotation was measured with inch tape and functional disability by using the scale of the neck disability index (NDI). Participants were then allocated into two A&B groups. Group A (N=15) was given manual Mulligan traction with interferential therapy (IFT) and isometric neck exercise, and group B (N=15) was given intermittent electrical traction with IFT and isometric neck exercise. Group A showed significant improvements in NPRS (Z=9.77, P=0.002), NDI (t=2.76, P=0.010), ROM of cervical extension (t=7.26, P=0.026) and cervical left rotation (t=2.31, P=0.029) when compared to group B, but the level of improvement in cervical right rotation was insignificant (t=1.89, P=0.07). Hence it is concluded that manual Mulligan traction and intermittent electrical traction are effective in reducing pain, improving cervical ROM and functional performance in cervical spondylosis. However the subject who received the manual Mulligan traction with IFT and isometric neck exercise showed better improvement in reducing pain, improving cervical ROM and functional performance than subject who received the intermittent electrical traction.

Keywords

Cervical Spondylosis, Interferential Therapy, Intermittent Electrical Traction, Manual Mulligan Traction, Neck Disability Index
User
Notifications
Font Size

  • Cote P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3): 267-73. https://doi.org/10.1016/j.pain.2004.09.004. PMid: 15561381.

  • Hassan Al-Shatoury HA, Galhom AA, Hommer DH (Chief Ed.). Cervical spondylosis. 2005.

  • Konstantinovic LM, Cutovic MR, Milovanovic AN, Jovic SJ, Dragin AS, Letic MD et al. Low-level laser therapy for acute neck pain with radiculopathy. a double-blind, placebo-controlled randomized study. Wiley Periodicals, Inc. Pain Medicine. 2010; 11:1169-78. https://doi.org/10.1111/j.1526-4637.2010.00907.x. PMid: 20704667.

  • Bergmann TF, Peterson DH. Chiropractic Technique, Principles and Procedures. Third edition: Copyright. 2011, 2002, 1993 by Mosby. P. 155-85.

  • René Fejer, Kirsten Ohm Kyvik, Jan Hartvigsen. The prevalence of neck pain in the world population: A systematic critical review of the literature. Eur Spine J. 2006; 15(6):834-48. https://doi.org/10.1007/s00586-004-0864-4. PMid: 15999284, PMCid: PMC3489448.

  • Van der Heijden GJ, Beurskens AJ, Koes BW, Assendelft WJ, de Vet HC, Bouter LM. The efficacy of traction for back and neck pain: A systematic, blinded review of randomized clinical trial methods. Phys. Ther. 1995; 75(2): 93-104. https://doi.org/10.1093/ptj/75.2.93. PMid: 7846138.

  • Cleland JA, Childs JD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in patients with neck pain: A randomized clinical trial. Man Ther. 2005; 10(2):127-35. https://doi.org/10.1016/j.math.2004.08.005. PMid: 15922233.

  • Deepak Kumar. Manual Mulligan concept: International Edition Paperback. Capri institute of manual therapy; 2nd ed; 2015. p. 19-20.

  • Susan L Michlovitz, Thomas P Nolan Jr. Modalities for Therapeutic Intervention (Contemporary Perspectives in Rehabilitation), Kindle Edition;Publisher: F.A. Davis Company; 4 ed, 2005. p.165-71.

  • Browder DA, Erhard RE, Piva SR. Intermittent cervical traction and thoracic manipulation in the management of mild cervical compressive myelopathy attributed to cervical herniated disc: A case series. J Orthop Sports Phys Ther. 2004; 34(11):701-12. https://doi.org/10.2519/jospt.2004.34.11.701. PMid: 15609490.

  • Reilly JP, Gersten JW, Clinkingbeard JR. Effect of pelvicfemoral position on vertebral separation produced by lumbar traction. Phys Ther. 1979; 59(3):282-86. https://doi.org/10.1093/ptj/59.3.282. PMid: 419172.

  • Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: A comparison of six methods.Pain. 1986; 27(1):117-26. https://doi.org/10.1016/03043959(86)90228-9.

  • Norkin, Cynthia C, White D Joyce. Measurement of joint motion: A guide to goniometry, Philadelphia: F.A. Davis; 3rd ed: 1995. p. 310-26.

  • Vernon HT, Mior SA. The neck disability index: A study of reliability and validity. J Manip Physiol Ther. 1991; 14:40915. https://doi.org/10.1037/t35122-000.

  • Jari Ylinen, Esa-Pekka Takala,Matti Nykänen, Arja Häkkinen, Timo Pohjolainen, Sirkka-Liisa Karppi et al. Active neck muscle training in the treatment of chronic neck pain in women-A randomized controlled trial. JAMA. 2003; 289(19):2509-16. https://doi.org/10.1001/jama.289.19.2509. PMid: 12759322.

  • Anna MacDowall, Yohan Robinson, Martin Skeppholm, Claes Olerud. Anxiety and depression affect pain drawings in cervical degenerative disc diseas. Ups J Med Sci. 2017; 122(2):99-107. https://doi.org/10.1080/03009734.2017.131 9441. PMid: 28503982, PMCid: PMC5441379.

  • RoseBist PK, Anil Kumar Peethambaran ,Gowri Anil Peethambar. Cervical spondylosis: Analysis of clinical and radiological correlation. International Surgery Journal. 2018; 5(2):491-95. https://doi.org/10.18203/2349-2902.isj20180338.

  • Brown G, Park K, Bicknell RT. Management of Occupational shoulder injuries in primary care. J Musculoskelet Disord Treat. 2005; 1:002. https://doi.org/10.23937/2572-3243.1510 002.

  • Khan K, Yasmeen S, Ishaque F, Imdad F, Lal W, Sheikh S, et al. Effectiveness of manual traction and other physiotherapy treatment in the management of painful cervical radiculopathy. International Journal of Physiotherapy. 2016; 3(3):286-90. https://doi.org/10.15621/ijphy/2016/v3i3/100829.

  • Kavitha Kiritkumar Bosmia, Jayashree Raju Kotwal. Comparison between the effectiveness of Manual Mulligan traction and intermittent electric traction in cervical spondylosis. Journal of Nursing and Health Science. 2015; 4(5):59-64.

  • Defrin R, Ariel E, Peretz C. Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment. Pain. 2005; 115(1-2):152-60. https://doi.org/10.1016/j.pain.2005.02.018. PMid: 15836978.

  • Sato A, Schmidt RF. Somatosympathetic reflexes: Afferent fibers, central pathways, discharge characteristics. Physiol Rev. 1973; 53(4):916-47. https://doi.org/10.1152/physrev.1973.53.4.916. PMid: 4355517.

  • Gross AR, Paquin JP, Dupont G, Blanchette S, Lalonde P, Cristie T, et al. Exercises for mechanical neck disorders: A Cochrane review update. Man Ther. 2016; 24:25-45. https://doi.org/10.1016/j.math.2016.04.005. PMid: 27317503.

  • Dusunceli Y, Ozturk C, Atamaz F, Hepguler S, Durmaz B. Efficacy of neck stabilization exercises for neck pain: A randomized controlled study. Rehabil Med. 2009; 41(8):626-31. https://doi.org/10.2340/16501977-0392. PMid: 19565156.


Abstract Views: 398

PDF Views: 196




  • Study on the Effectiveness of Manual Mulligan Traction Compared to Intermittent Electrical Traction in Patients with Cervical Spondylosis

Abstract Views: 398  |  PDF Views: 196

Authors

Arul Pragassame S.
Department of PM&R, RMMC&H, Annamalai University, Annamalai Nagar – 608002, Tamilnadu, India
Mohandas Kurup V. K.
Department of PM&R, RMMC&H, Annamalai University, Annamalai Nagar – 608002, Tamilnadu, India
Sivashanmugam V.
Department of PM&R, RMMC&H, Annamalai University, Annamalai Nagar – 608002, Tamilnadu, India, India

Abstract


Cervical traction is a variety of practicing methods depending on the pathology being treated. The established effectiveness in cervical spondylosis of these different methods makes it a useful tool for physiotherapy practitioners. However, its role in cervical spondylosis is uncertain. Comparing manual Mulligan traction and intermittent electrical traction would provide information of great importance to the scientific community on the use of cervical traction in patients with cervical spondylosis. The purpose of the present study is to find out and compare the effectiveness of manual Mulligan traction versus intermittent electrical traction on pain, range of motion (ROM) and functional disability in patients with cervical spondylosis. A total of 30 subjects with cervical spondylosis were selected and screened for inclusion and exclusion criteria. Initially, the pain intensity was evaluated using the Numerical Pain Rating scale (NPRS). The active ROM of cervical extension and cervical Lt/Rt rotation was measured with inch tape and functional disability by using the scale of the neck disability index (NDI). Participants were then allocated into two A&B groups. Group A (N=15) was given manual Mulligan traction with interferential therapy (IFT) and isometric neck exercise, and group B (N=15) was given intermittent electrical traction with IFT and isometric neck exercise. Group A showed significant improvements in NPRS (Z=9.77, P=0.002), NDI (t=2.76, P=0.010), ROM of cervical extension (t=7.26, P=0.026) and cervical left rotation (t=2.31, P=0.029) when compared to group B, but the level of improvement in cervical right rotation was insignificant (t=1.89, P=0.07). Hence it is concluded that manual Mulligan traction and intermittent electrical traction are effective in reducing pain, improving cervical ROM and functional performance in cervical spondylosis. However the subject who received the manual Mulligan traction with IFT and isometric neck exercise showed better improvement in reducing pain, improving cervical ROM and functional performance than subject who received the intermittent electrical traction.

Keywords


Cervical Spondylosis, Interferential Therapy, Intermittent Electrical Traction, Manual Mulligan Traction, Neck Disability Index

References





DOI: https://doi.org/10.18311/ajprhc%2F2019%2F23866