606 - Manual Therapy and Segmental Stabilization in the Treatment of Cervica...

#606 Manual Therapy and Segmental Stabilization in the Treatment of Cervical Radiculopathy

Non-operative Care and Injection Therapies

Poster Presented by: R. Aquaroli

Author(s):

R. Aquaroli (1)
E. Camacho (1)
E. Ito (1)
T. Bueno (1)
L. Marchi (2)

(1) Equilibrio Fit&Fisio, São Paulo, Brazil
(2) Instituto de Patologia da Coluna, São Paulo, Brazil

Abstract

Introduction: It is well described that the cervical radiculopathy (CR) is one of the diseases most affecting the cervical spine, causing ipsilateral radicular symptoms at the upper limb. Thus, in conservative care it can be aimed to restore mechanical and physiological function of the nervous system through neural mobilization techniques, in addition to activation of deep neck flexor muscles with cervical segmental stabilization, with the manipulation and joint mobilization, which objective to improve mobility in important areas on cervical biomechanics. The objective of this work is to describe a multimodal conservative treatment to enhance outcomes in patients diagnosed with RC.

Methods: The sample consisted of 11 patients with a diagnosis of CR (age range 21 to 59 y/o; 3 female and 8 male). The subjects were evaluated and rated their neck pain VAS (Visual Analogue Scale), responded to Functional Development of the Neck Pain and Disability Scale (NPDS) and had their goniometry shoulder abduction measured. The intervention method used was composed of neural mobilization, intermittent cervical traction, pompages, stretching, myofascial techniques, inhibiting, manipulative techniques of correction and stabilization exercises cervical segment. After 12 weeks of treatment, subjects underwent a new evaluation process.

Results: Before the intervention process, individuals reported average pain of 7 (±1.48) in VAS, and after treatment this score dropped to 1.18 (± 1.99) (p<0.01). Pretreatment average NPDS score average was 36 (±10.95) decreasing to 11.45 (±9.8) (p<0.01) after 12 weeks. Range of motion of the ipsilateral upper limb increased from average 9.2° (± 8.2) to 137° (± 24.4) (p<0.01). Just one patient did not achieve the expected result, was reevaluated by the surgeon and underwent surgery for decompression of neural structures and arthrodesis of level involved.

Conclusion: This proposed treatment was effective for reducing pain and disability in a series of cases of individuals with a diagnosis of cervical radiculopathy. While we cannot definitively testify cause and effect in a series of cases, this study allows for the development of the initial hypothesis that the approach may have scientific merit. Future studies and methodologies applied to randomized clinical trials should be performed to evaluate the efficiency of the methods and techniques used in this research for selected patients with cervical radiculopathy.