Effect of Cervical Traction With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

NCT07366983 | Not Yet Recruiting

• 1 other identifier: Nagy-Phd
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be conducted to examine

1. 1.The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis.
2. 2.The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes.
3. 3.The efficacy of mechanical traction from decompression angles with neural mobilization has a Numeric Pain Rating Scale.
4. 4.The efficacy of mechanical traction from decompression angles combined with neural mobilization on Neck Disability Index.

Conditions

Nerve Root Disorder; Cervical Radiculopathy; Traction; Neural Mobilization

Outcome Measures

Primary Outcomes (1)

• assessment of pain intensity

  Pain intensity was evaluated using the Numeric Pain Rating Scale (NPRS), a validated self-reported measure. Participants rated their pain on an 11-point scale from 0 (no pain) to 10 (worst pain imaginable), after receiving an explanation of the scale. NPRS scores were documented at baseline and scheduled follow-ups to track pain intensity changes during the intervention, with higher scores reflecting greater pain severity.

  at baseline and after 6 weeks

Secondary Outcomes (3)

• Assessment of neck functional activities

  at baseline and after 6 weeks

• assessment of H reflex for the median nerve

  at baseline and after 6 weeks

• assessment of nerve root function

  at baseline and after 6 weeks

Study Arms (3)

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion

EXPERIMENTAL

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks

Device: traction (30 degree) head flexion; Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization

multimodal physical therapy program and traction with neural mobilization (30 degree) side bending

ACTIVE COMPARATOR

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.

Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization; Device: traction (30 degree) side bending)

multimodal physical therapy program and traction with neural mobilization (foramen opening position)

ACTIVE COMPARATOR

Patients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.

Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization; Device: traction (foramen opening)

Interventions

Deep neck flexor strengthening exercise OTHER

All patients are instructed to perform a home program involving chin-in exercises from a supine position, focusing on upper cervical spine extension and flexion. Participants will move their heads backwards and then return to the starting position, ensuring slow, controlled movements while palpating their necks to relax superficial neck muscles. The exercises will be done twice a week for six weeks, with each hold lasting 10 seconds, 15-second breaks between holds, and 10-15 repetitions in total.

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion; multimodal physical therapy program and traction with neural mobilization (30 degree) side bending; multimodal physical therapy program and traction with neural mobilization (foramen opening position)

Hold/Relax Stretch OTHER

The therapy procedure involves positioning the patient supine and performing specific movements to address shoulder and neck tension. The therapist supports the occiput and rib area while guiding the neck into forward bending and lateral flexion, combined with right or left rotation, depending on the sequence. The patient is instructed to perform isometric contractions by elevating the shoulder against resistance for 10 seconds, followed by relaxation, with additional stretches held for 10 seconds. This process is repeated three to four times and includes a home stretching program, holding stretches for 30 to 60 seconds two to three times daily.

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion; multimodal physical therapy program and traction with neural mobilization (30 degree) side bending; multimodal physical therapy program and traction with neural mobilization (foramen opening position)

Prone Cervical Unilateral Poster anterior Mobilization OTHER

The patient is positioned prone with a pillow under their chest, and their head and neck are in a neutral position, while the therapist stands at the head. The therapist places both thumbs on the spinous process of the targeted vertebra and applies a gentle posterior to anterior force to assess pain, mobility, and end feel, gradually increasing the force for four to five repetitions.

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion; multimodal physical therapy program and traction with neural mobilization (30 degree) side bending; multimodal physical therapy program and traction with neural mobilization (foramen opening position)

traction (foramen opening) DEVICE

Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (flexion, lateral bending and rotation according to pain) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

multimodal physical therapy program and traction with neural mobilization (foramen opening position)

traction (30 degree) side bending) DEVICE

Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30 degree) side bending and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

multimodal physical therapy program and traction with neural mobilization (30 degree) side bending

traction (30 degree) head flexion DEVICE

Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30-degree head flexion) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion

Sub occipital Release OTHER

In a supine position with the head on a pillow, the patient is treated by a therapist seated at the head of the table. The therapist uses both hands (digits 2 to 5) to contact the base of the occiput, gently lifting the head anteriorly while allowing the dorsum of the hands to rest on the pillow. This technique involves cranial pulling as the patient's sub occipital muscles relax, with distraction maintained for up to 5 minutes as tissue slack becomes available. Once relaxation is achieved, the therapist positions the shoulder against the patient's forehead to enhance sub occipital distraction.

multimodal physical therapy program and traction with neural mobilization (30 degree) head flexion; multimodal physical therapy program and traction with neural mobilization (30 degree) side bending; multimodal physical therapy program and traction with neural mobilization (foramen opening position)

Eligibility Criteria

• Age: 30 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• The patient's age will be ranged from 30 to 45 years old for both genders.
• The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
• The patient's symptoms more than 3 months and positive provocative test for cervical radiculopathy (Spurling's test, shoulder abduction test, neck distraction test, and upper limb tension test 1 (Median nerve).
• Sensory, reflex, and/ or motor changes in the upper limb

You may not qualify if:

• History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
• Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
• Patients with neck pain for signs and symptoms of serious pathology, including suspected arterial insufficiency, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and fracture.
• Systemic diseases such as autoimmune and metabolic diseases.
• History of steroid injection.
• Complete loss of sensation along the involved nerve root.
• bilateral radiating upper extremity
• Diabetic polyneuropathy.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

out-patient clinic, faculty of physical therapy, Horus university

Damietta, Egypt

Location

MeSH Terms

Conditions

Radiculopathy

Interventions

Traction

Condition Hierarchy (Ancestors)

Peripheral Nervous System Diseases; Neuromuscular Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Orthopedic Procedures; Surgical Procedures, Operative

Central Study Contacts

Mohamed Nagy Abd ELfatah ELshafey, Assistant lecturer

CONTACT

01155273157; mnagy@horus.edu.eg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: principal investigator

Study Record Dates

• First Submitted: January 17, 2026
• First Posted: January 26, 2026
• Study Start: February 1, 2026
• Primary Completion: May 1, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: January 26, 2026

Record last verified: 2026-01

Locations

EG (1)