The Effect of Cervical Lateral Glide and Manual Cervical Traction Combined with Neural Mobilization on Patients with Cervical Radiculopathy

Khatwani, Pooja; Yadav, J. S.; Kalra, Sheetal

doi:10.5958/0973-5674.2015.00163.x

Cited by 5 publications

(30 citation statements)

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“…Fifty studies compared the intervention group to other interventions (nonoperative or operative), 4 studies compared the intervention group to placebo/sham, and 5 studies included a waitlist control group. Across the trials, there were 4108 participants (1589 males, 2123 females, and 396 sex not specified) and 39 trials were single centre31–71 and 20 were multicentre 41,72–91. Fourteen trials included participants with an acute duration of symptoms (≤3 mo),41,45,49,54–56,60,70,73,81,82,84,92 21 included participants with a chronic duration of symptoms (>3 mo),31–34,37,38,44,48,52,68,69,72,74–76,78,79,83,85–88,91,93 9 included participants with a mixture of acute and chronic symptoms,39,43,46,58,62,63,77,80,89,90 and 15 did not report symptom duration 35,36,42,47,50,51,57–59,64–67,71,88…”

Section: Resultsmentioning

confidence: 99%

Conservative Management of Cervical Radiculopathy

Plener

Csiernik²,

et al. 2023

The Clinical Journal of Pain

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Objective: The purpose of this systematic review was to assess the effectiveness and safety of conservative interventions compared with other interventions, placebo/sham interventions, or no intervention on disability, pain, function, quality of life, and psychological impact in adults with cervical radiculopathy (CR). Methods: We searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022 to identify studies that were randomized controlled trials, had at least one conservative treatment arm, and diagnosed participants with CR through confirmatory clinical examination and/or diagnostic tests. Studies were appraised using the Cochrane Risk of Bias 2 tool and the quality of the evidence was rated using the Grades of Recommendations, Assessment, Development, and Evaluation approach. Results: Of the 2561 records identified, 59 trials met our inclusion criteria (n = 4108 participants). Due to clinical and statistical heterogeneity, the findings were synthesized narratively. There is very-low certainty evidence supporting the use of acupuncture, prednisolone, cervical manipulation, and low-level laser therapy for pain and disability in the immediate to short-term, and thoracic manipulation and low-level laser therapy for improvements in cervical range of motion in the immediate term. There is low to very-low certainty evidence for multimodal interventions, providing inconclusive evidence for pain, disability, and range of motion. There is inconclusive evidence for pain reduction after conservative management compared with surgery, rated as very-low certainty. Discussion: There is a lack of high-quality evidence, limiting our ability to make any meaningful conclusions. As the number of people with CR is expected to increase, there is an urgent need for future research to help address these gaps.

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Section: Resultsmentioning

confidence: 99%

Conservative Management of Cervical Radiculopathy

Plener

Csiernik²,

et al. 2023

The Clinical Journal of Pain

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“…Of the 68 distinct trials, all but four included information on the inclusion of participants based on clinical symptoms 39,48,86,87. The most common symptom mentioned as an inclusion criterion in 47/68 studies was arm pain with or without another symptom such as numbness, paresthesia, or weakness13–25,27,28,30–34,36,37,41,43–45,47,49–52,58–61,64,67–71,73,81,82,84 and 34/68 studies included neck symptoms such as pain and limited range of motion (ROM) 13,16,25,28–30,32–37,40,41,44,46,51,52,54,56,60,62–64,67,68,73,75,78,79,81–84,88.…”

Section: Resultsmentioning

confidence: 99%

“…Forty-five trials included red flag conditions as exclusion criteria such as previous trauma, infection, and malignancy,13–16,25,27–31,33,35–37,41,42,44,47–52,54–57,59,60,62,63,65,67–71,73–75,78,81,83,84,88 27 excluded participants who underwent previous cervical spine surgery,13–19,24,25,27,30–33,39,41,44,46,47,49,50,53,60,62,63,65,67–70,78,88 and three excluded participants who had an indication for surgery (ineffective nonsurgical treatment for three to six months, relapse of severe symptoms that impacted daily life, or progressive and severe neurological deficits) 38,53,79. Twelve trials excluded participants who had bilateral upper extremity symptoms27,28,46,50,58–60,62,63,65,86,88 and 40 trials excluded participants who had signs of cervical myelopathy/stenosis 13–18,20–24,27,28,30–36,38,40,45,46,48,49,54–59,62,63,65,67–70,76,78,81,82,84–86,88. Excluding participants with cervical myelopathy is important due to the severity and distinct patient symptoms that are experienced with this condition in comparison to CR 90…”

Section: Resultsmentioning

confidence: 99%

“…Of the 68 studies, 54 included at least two categories (clinical symptoms, clinical examination tests, and/or imaging), with 12 studies including participants based on clinical symptoms alone [74][75][76][77][78][79][80][81][82][83][84][85] and two including participants based on clinical examination findings alone. 86,87 Twenty-six trials required clinical symptoms in addition to Copyright r 2022 Wolters Kluwer Health, Inc. All rights reserved. positive clinical examination tests, 17-19,25,27,29,30,…”

Section: Inclusion Criteria Categories (Symptoms Physical Examination...mentioning

confidence: 99%

“…Of the 68 distinct trials, all but four included information on the inclusion of participants based on clinical symptoms. 39,48,86,87 The most common symptom mentioned as an inclusion criterion in 47/68 studies was arm pain with or without another symptom such as numbness, paresthesia, or weakness [13][14][15][16][17][18][19][20][21][22][23][24][25]27,28,[30][31][32][33][34]36,37,41,[43][44][45]47,[49][50][51][52][58][59][60][61]64,[67][68][69][70][71]73,81,82,84 and 34/68 studies included neck symptoms...…”

Section: Clinical Symptomsmentioning

confidence: 99%

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Eligibility Criteria of Participants in Randomized Controlled Trials Assessing Conservative Management of Cervical Radiculopathy: A Systematic Review

Plener

Silva-Oolup

et al. 2022

Spine

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Study Design. Systematic review. Objective. The aim of this study was to evaluate the inclusion and exclusion criteria for participants in randomized control trials (RCTs) assessing conservative management for cervical radiculopathy (CR), to determine if any consensus exists within the literature. Summary of Background Data. A 2012 systematic review identified a lack of uniformity for the eligibility criteria of participants in RCTs evaluating conservative interventions for CR. Since then, a large number of RCTs have been published, signaling the need for an updated evaluation of this topic. Materials and Methods. We electronically searched MEDLINE, CENTRAL, CINAHL, Embase, and PsycINFO from inception to June 15, 2022, to identify RCTs assessing conservative management of CR. Information extracted was analyzed to determine the level of homogeneity and/or heterogeneity of the inclusion and exclusion criteria across studies. Results. Seventy-six RCTs met our inclusion criteria with 68 distinct trials identified. The inclusion of arm pain with or without another symptom (i.e. numbness, paresthesia, or weakness) was required in 69.12% of trials, 50% of trials required participants to exhibit neck symptoms, and 73.53% of studies required some form of clinical examination findings, but inconsistencies existed for the number and type of tests used. Furthermore, 41.18% of trials included imaging, with 33.82% of trials requiring magnetic resonance imaging findings. The most common exclusion criteria included were the presence of red flags and cervical myelopathy in 66.18% and 58.82% of trials, respectively. Conclusions. Overall, there is still a lack of uniformity for the inclusion/exclusion criteria of trials assessing the conservative management of CR, with some improvements noted compared with the 2012 review. Based on the current literature assessing the diagnostic utility of clinical symptoms and confirmatory tests, we proposed inclusion criteria for trials assessing conservative interventions. Future research should aim to develop standardized classification criteria to improve consistency among studies.

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