The addition of a sagittal cervical posture corrective orthotic device to a multimodal rehabilitation program improves short and long term outcomes in patients with discogenic cervical radiculopathy

Publication date: Available online 27 August 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ibrahim M. Moustafa, Aliaa A. Diab, Shimaa Taha, Deed E. Harrison
ObjectiveTo investigate the immediate and 1-year effects of a multimodal program, with cervical lordosis and anterior head translation (AHT) rehabilitation, on the severity of pain, disability, peripheral and central nervous system function in patients with discogenic cervical radiculopathy (DCR).DesignA randomized controlled study with a 1-year and 10-week follow-up.SettingUniversity research laboratory.Participants40 (27 males) patients with chronic DCR, a defined hypolordotic cervical spine and AHT posture were randomly assigned to the control (43.9 ± 6.2 years of age) or an intervention group (41.5 ± 3.7 years of age).InterventionsBoth groups received the multimodal program; additionally, the intervention group received the denneroll cervical traction device.Main Outcome MeasuresAHT, cervical lordosis, arm pain, neck pain and disability (NDI), dermatomal somatosensory evoked potentials (DSSEP's) and central somatosensory conduction time (N13-N20). Measures were assessed at three time intervals: baseline, 10 weeks, and 1 year follow up.ResultsAfter 10 weeks of treatment, between group analysis, showed equal improvements for both the intervention and control groups in arm pain intensity (p=0.4), neck pain intensity (p=0.6), and latency of DSSEP's (p=0.6). However, also at 10 weeks, there were significant differences between groups favoring the intervention group for cervical lordosis (p˂0.0005), AHT (p˂0.0005), amplitude of DSSEP's (p˂0.0005), N13-N20 (p˂0.0005), and NDI (p˂0.0005). Whereas, at the 1 year follow-up, between group analysis identified a regression back to baseline values for the control group. Thus, all variables were significantly different favoring the intervention group at 1-year follow up period: cervical lordosis (P˂0.0005), AHT (P˂0.0005), latency and amplitude of DSSEP's (P˂0.0005), N13-N20 (P˂0.0005), severity of neck and arm pain, and NDI (P˂0.0005) in favor of the denneroll group.ConclusionThe addition of the denneroll cervical orthotic to a multimodal program positively affected DCR outcomes at long term follow up. We speculate the improved cervical lordosis and reduced AHT contributed to our findings.



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