Sustained Natural Apophyseal Glides and Mechanical Cervical Traction in the Management of Cervical Radiculopathy

NCT ID: NCT03362567

Last Updated: 2017-12-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 47 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-07-28
• Study Completion Date: 2017-04-15

Brief Summary

Sustained natural apophyseal glides (SNAGS), is a form of manual therapy, involved a combination of a sustained facet glide with active motion, followed by overpressure. Natural apophseal glides (NAGS), a modification of SNAGS, involves a mid to end-range facet joint mobilisation applied anterocranially or posterioanteriorly along the plane of treatment, combined with a small amount of manual traction which increases movement within the spine, and decreases symptomatic pain . A study reported that Natural Apophyseal Glides (NAGS) and Sustained Natural Apophyseal Glides (SNAGS) demonstrated significant effects in reducing pain and disability in subjects with chronic neck pain . This technique, SNAGS, is however an evolving manual therapy techniques which its effectiveness has not been thoroughly investigated in cervical radiculopathy treatment raised author's curiosity to compare and document efficacy of SNAGS with cervical traction in Nigeria since comparative studies evaluating SNAGS and manual cervical traction relative efficacies among Nigerians are yet to be documented if at all available. Consequently, the quest is to look for a quicker and a better way of relieving cervical radiculopathy in this environment . The more reason why we have to compare it with a conventional mechanical traction.

Detailed Description

This is a Quasi experimental study. Participants will be patients with radiculopathy receiving treatment at the Usman Danfodio University Teaching Hospital Sokoto Nigeria. Ethical approval will be obtained from Institute of Public Health of the Obafemi Awolowo University Ile-Ife, Nigeria, and a copy will be taken to the site of the study. The purpose and protocol for the study will be explained to the participants, after their informed consent have been obtained. The sample size will be determined using N= 4σ2 (Zcrit+Zpwr)2/ D2 where N is the total sample size, σ is the assumed SD of each group (assumed to be equal for the groups), which is assumed to be 16.63 from previous study; Zcrit is the standard normal deviate corresponding to the selected significance criterion, i.e 0.05(95% = 1,960), Zpwr is the standard normal deviate corresponding to the selected statistical power (i.e. 0.80 = 0.842), and D is the minimum expected difference among the three means, and D =18 from a previous study. Therefore, N obtained will be 41.22. Fifty two participants are proposed for this study (making 26 participants for each group) in order to give room for attrition. The 52 participants will be allocated to two groups (Groups A and B) using permuted block randomization. Subjects in group A will receive (i) Sustained Natural Apophyzeal Glides: Each subject in this group will be in sitting position facing the wall bar. The therapist will place on thumb reinforced over the spinous process of the implicated cervical vertebra. The therapist will then push upon the implicated spinous process. The pressure will be sustained for 60 seconds. Six repetitions will be carried out and maintained on each visit twice in a week for 6 weeks. Subjects in group B will receive over -the -door mechanical cervical traction in sitting position using position 10% of each patient's body weight for 15 minutes on each visit, twice in a week for 6 weeks. Pain intensity will be measured using visual analogue scale, cervical range of motions will be measured using inclinometer, functional disabilities will be measured using neck disabilities index questionnaires. The out come measures will be applied three times: pre-treatment, 3rd week and 6th week within the treatment period. The data obtained will be analysed using descriptive and inferential statistics.

Conditions

Cervical Radiculopathy

Keywords

Cervical Radiculopathy; Sustained Natural Apophyseal Glides; Mechanical Cervical Traction; Pain Intensity; Neck Disability

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

SNAGS Group

Subjects in SNAGS group were treated with application of sustained natural apophyseal glides, twice weekly for six weeks

Group Type: EXPERIMENTAL

Sustained Natural Apophyseal Glides

Intervention Type: OTHER

Subjects in SNAGS group were treated with sustained natural apophyseal glides, twice weekly for six weeks

Mechanical Cervical Traction

Intervention Type: OTHER

subjects in MCT received mechanical cervical traction, for 15 minutes each session twice in a week for six weeks

MCT Group

subjects in MCT received mechanical cervical traction, for 15 minutes each session twice in a week for six weeks

Group Type: EXPERIMENTAL

Sustained Natural Apophyseal Glides

Intervention Type: OTHER

Subjects in SNAGS group were treated with sustained natural apophyseal glides, twice weekly for six weeks

Mechanical Cervical Traction

Intervention Type: OTHER

subjects in MCT received mechanical cervical traction, for 15 minutes each session twice in a week for six weeks

Interventions

Sustained Natural Apophyseal Glides

Subjects in SNAGS group were treated with sustained natural apophyseal glides, twice weekly for six weeks

Intervention Type: OTHER

Mechanical Cervical Traction

subjects in MCT received mechanical cervical traction, for 15 minutes each session twice in a week for six weeks

Intervention Type: OTHER

Other Intervention Names

SNAGS; MCT

Eligibility Criteria

Inclusion Criteria

-

Exclusion Criteria

-

• Minimum Eligible Age: 25 Years
• Maximum Eligible Age: 75 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Obafemi Awolowo University

OTHER

Sponsor Role: lead

Responsible Party

Adesola Ojo Ojoawo

Dr and Senior Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Adesola O Ojoawo, Phd

Role: PRINCIPAL_INVESTIGATOR

Obafemi Awolowo University

References

Ali A, Shakil-Ur-Rehman S, Sibtain F. The efficacy of Sustained Natural Apophyseal Glides with and without Isometric Exercise Training in Non-specific Neck Pain. Pak J Med Sci. 2014 Jul;30(4):872-4.

Reference Type: BACKGROUND

PMID: 25097535 (View on PubMed)

Other Identifiers

IPHOAU/12/673

Identifier Type: -

Identifier Source: org_study_id