Background
Cervical radiculopathy is a relatively common and disabling condition involving local pain in the neck region and pain that radiates into the upper limb. Recent data suggest that cervical traction may effectively reduce disability and pain, with a dose-response relationship. The main aim of this study was therefore to evaluate the mid-term effect of an intensive cervical traction protocol for patients with cervical radiculopathy on disability, and to compare the effects with those reported by non-intensive protocols in the literature.
Methods
We conducted a prospective open observational study of 36 patients referred by their general practitioner for symptoms suggestive of cervical radiculopathy. All patients underwent the same treatment: a 30-minute cervical traction protocol, twice a day, for five consecutive days. The main objective was the evaluation of disability at 3 months. We evaluated at baseline (D1), the end of the protocol (D5) and at mid-term (M3) disability, cervical pain, radiating pain, pain on motor imagery, presence of neuropathic pain and medication consumption. The primary outcome was the proportion of patients for whom the Neck Disability Index improved by more than the minimum clinically important difference of 7 points by M3.
Results
Thirty-six patients were included in this study. The Neck Disability Index improved by more than the minimum clinically important difference in 48.3% at M3. Mean Neck Disability Index (p < .001), mean cervical VAS (p < .001), mean radiating VAS (p < .001), and mean VAS for imagined lateral flexion and rotation (p < .002) improved significantly from D1 to D5 and from D1 to M3. Consumption of medication reduced at each time point. The proportion of patients with neuropathic pain reduced from 61.1% at D1 to 33.3% at D5 and 48.3% at M3.
Conclusion
Disability reduced by more than the minimum clinically important difference in almost half of the participants following the intensive traction protocol. These results are encouraging and suggest that this complex condition can be treated with relatively simple methods.
Introduction : les chutes chez les personnes âgées fragiles hospitalisées sont un phénomène majeur et préoccupant au quotidien. Contexte : les chaussages inadéquats, fréquemment observés au sein de cette population, constituent l’un des principaux facteurs de risques. Plusieurs hôpitaux utilisent des chaussettes antidérapantes comme moyen préventif. Dans le contexte de la médecine basée sur les preuves, il semble nécessaire de vérifier l’existence de données probantes concernant leur efficacité. Objectif : cet article vise à statuer sur l’efficacité préventive des chaussettes antidérapantes. Méthode : cinq bases de données ont été investiguées (PubMed, PEDro, Cochrane, ScienceDirect et Google Scholar). Les critères d’éligibilité (PICO) incluent les patients âgés hospitalisés. Résultats : sept études ont été incluses. Les chaussettes antidérapantes montrent un effet préventif pour diminuer les récidives de chutes ( p = 0.009) ou la prévalence des chutes en lien avec l’incontinence urinaire. Discussion : plusieurs études concluent sur la plus-value des chaussettes antidérapantes comparativement aux chaussettes classiques ou aux pantoufles. Les limites inhérentes aux études sélectionnées sont considérées dans l’élaboration des conclusions. Conclusion : un chaussage considéré comme sécuritaire par les thérapeutes et sécurisant par le patient constitue l’option la plus recommandée actuellement. Des études cliniques complémentaires sont nécessaires pour étayer notre conclusion.
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