Effectiveness of craniocervical flexion training combined with cervical traction among patients with cervical spondylotic radiculopathy / 预防医学

Objective@# To evaluate the effectiveness of craniocervical flexion training using pressure biofeedback combined with cervical traction among patients with cervical spondylotic radiculopathy (CSR).@*Methods@#Sixty patients with CSR receiving treatment in Center of Rehabilitation, Zhejiang Hospital from January 2020 to December 2021 were enrolled and randomly assigned into the control and treatment groups, of 30 patients in each group. All patients were given cervical traction, and patients in the treatment group were given additional craniocervical flexion training using pressure biofeedback for successive four weeks. The effectiveness of craniocervical flexion training combined with cervical traction was evaluated using Visual Analogue Scale (VAS), Neck Disability Index (NDI) and the active range of motion (AROM) of cervical flexion, and the neck pain and cervical functions were compared between the two groups before and after treatments using repeated-measures analysis of variance.@* Results@# Fifteen men were included in the treatment group, with a mean age of (49.47±5.33) years, mean disease course of (5.53±2.89) months, and mean VAS score of (4.73±1.39) points, and there were no significant differences between the control and treatment groups in terms of gender, age, course of disease or VAS score (P>0.05). The VAS score and NDI were lower 4 weeks post-treatment than pretreatment in both the treatment [VAS score: (2.13±1.01) vs. (4.73±1.39); NDI: (12.17±2.12) vs. (20.20±3.78)] and control groups [VAS score: (2.93±1.11) vs. (4.90±1.21); NDI: (15.23±2.39) vs. (19.60±3.30)], and the AROM of cervical flexion was significantly higher 4 weeks post-treatment than pretreatment in both the treatment [(42.87°±2.99°) vs. (37.50°±2.80°)] and control groups [(41.80°±3.61°) vs. (38.07°±2.99°)]; there was an interaction between time and group, and a higher improvement for cervical functions was seen in the treatment group than in the control group (FVAS =5.119, P=0.027; FNDI=15.473, P<0.001; FAROM=11.443, P<0.001). @*Conclusion@#Craniocervical flexion training using pressure biofeedback combined with cervical traction may effectively alleviate the neck pain and increase the AROM among patients with CRS, which is more effective to improve patients' cervical functions than cervical traction alone.

Cervical traction: a simple step ahead in the prevention of postpartum hemorrhage

Background: Postpartum hemorrhage is the most common preventable cause of maternal mortality in developing countries. The present study aimed to examine the impact of cervical traction technique in reducing the amount of postpartum blood loss and rate of PPH.Methods: This was a case-control, pilot study conducted in a tertiary hospital between June 2017 to June 2018. A total of 200 singletons, low-risk pregnant females, undergoing normal vaginal delivery, were enrolled in this study. Subjects showing a high risk for PPH were excluded. Patients were randomized as case group (n=100) and control group (n=100). The case group received sustained traction for 90 seconds to anterior and posterior lip of the cervix with active management of the third stage of labor, whereas the control group received routine active management of the third stage of labor. All subjects were followed up for 6 hours post-delivery. The amount of blood loss, hematocrit and hemoglobin post-delivery were compared between both groups.Results: The mean blood loss (ml), decrease in hemoglobin (g/L) and decrease in hematocrit post-delivery in cases were significantly low compared to controls (207±37.6 versus 340±49, P<0.01), (0.78±0.2 versus 1.4±0.3, P=0.03) and (1.7±0.2 versus 3.5±0.2, P<0.01). PPH occurred in 7 of 200 (3.5%) patients. The difference in the number of PPH was not significant (5/100; 5% versus 2/100; 2% P=0.2). There were no complications reported due to cervical traction.Conclusions: Cervical traction is a simple and safe maneuver to reduce the amount of postpartum blood loss. Larger RCT is recommended to investigate the reduction in PPH rate.

Variation of neck EMG and mechanical characteristics during the process of cervical traction / 医用生物力学

Objective To observe changes of surface electromyography (sEMG) in cervical traction under different loading weight and at different angles, and compare the muscle activity changes obtained by experiment with simulation results obtained by AnyBody cervical modeling, so as to verify the rationality of the simulation results. Methods Ten young volunteers with supine cervical traction were selected to test the sEMG signals of bilateral sternocleidomastoid (SCM) and upper trapezius (UT) muscles by using the JE-TB0810 surface EMG device. The average EMG (AEMG) and mean power frequency (MPF) were used to analyze the variation patterns of sEMG in cervical spine. Results The AEMG values of SCM and UT muscles increased as the loading weight and traction angles increasing, with a statistically significant difference (P0.05). The experimental results were consistent with muscle force activity characteristics of SCM and UT muscles by modeling and simulation of cervical traction. Conclusions The simulation results are reasonable. The traction weight should be loaded reasonably according to the excitation and fatigue of the cervical muscles in clinic. This can both reach the treatment effect and improve the patient’s comfort, which will provide an important reference for further development and improvement of the cervical traction device.

Cardiovascular and Respiratory Responses of Apparently Healthy Participants to Cervical Traction in Sitting Position Using Different Weights.

Background and Aim: Cervical Traction (CT) is a vital physiotherapeutic modality in the management of cervical musculoskeletal disorders. This study determined the cardio-respiratory responses to CT using different percentage body weights on Apparently Healthy Individuals (AHI). Materials and Methods: 163 consecutively recruited AHI that met the inclusion criteria were randomly assigned into three groups (A, B and C) that were subjected to CT weights of 7.5%, 10% and 15% of their total body weights respectively. Participants’ systolic (SBP) and diastolic (DBP) blood pressure, Pulse Rate (PR), Respiratory Rate (RR) and Inspiratory Capacity (IC) was recorded before and after traction. The side-effects reported by participants during and after traction were also recorded using a previously validated 8- item self-administered questionnaire. Data was analyzed using Paired t-test, Independent t-test, Chi square test and One-way ANOVA. Results: IC and PR significantly changed across the three groups post-traction. RR significantly changed in groups B and C post-traction but not in group A. SBP and DBP showed no significant differences in any of the group post-traction. The participant’s side effects of pain in the neck or arm, dizziness and shortness of breath were found to be significantly associated with cervical traction across the three groups, (p < 0.05; CI=0.00-0.00). Conclusion: CT alters the cardiovascular and respiratory system leading to side effects that increase with increased traction weight. Use of a minimum weight for CT is recommended.

Nonsurgical spinal decompression and common cervical traction compared / 中华物理医学与康复杂志

Objective To compare the effects of nonsurgical spinal decompression system (SDS) cervical traction and common cervical traction using surface electromyography (sEMG).Methods Twenty-two volunteers' sEMG signals were recorded before,during and after two modes of cervical traction:the conventional traction in sitting and SDS traction in supine.The interval between the two modes of traction was no shorter than 24 hours.The mean and peak amplitudes of their sEMG signals were observed before,during and after traction.The sEMG signals of the posterior cervical muscle while sitting or lying were compared at different stages of the traction.Results There was no statistically significant difference in sEMG signals between the subjects' right and left posterior cervical muscles.The sEMG signals decreased significantly during both traction trials.With common cervical traction the mean and peak amplitudes of the left posterior cervical muscle pre-and post-traction were higher than during traction,and the same as that of the right posterior cervical muscle.In the SDS trials the sEMG signals during traction and post-traction were significantly lower than those pre-traction.After traction the sEMG signals while sitting (common cervical traction) were significantly higher than those post-traction while lying (SDS cervical traction),and the sEMG signals post-traction while either lying or sitting were stronger than during traction while lying.The post-traction signals in sitting were stronger than those in lying.Conclusions Both nonsurgical SDS and common cervical traction can relax the posterior cervical muscles.The effect of nonsurgical SDS was better than that of common cervical traction.

Effect of Silver Needle Thermo-conduction on Cervical Spondylosis of Vertebral Artery Type / 中国康复理论与实践

@#Objective To explore the effect of silver needle thermo-conduction on cervical spondylosis of vertebral artery type (CSA). Methods 82 patients with CSA were randomly divided into control group (n=41) and treatment group (n=41). The control group was treated with cervical traction combined with microwave diathermy, and the treatment group was treated with silver needle thermo-conduction combined with cervical traction. Both groups were evaluated with Evaluation Scale for Cervical Vertigo (ESCV) and transcranial Doppler before and 1 course after treatment. Results The ESCV score, the peak blood flow velocity of period of contraction of left vertebral artery, right vertebral artery and basilar artery in both groups were significantly higher after treatment than before (P<0.01), the treatment group was better than the control group after treatment (P<0.01). Conclusion Silver needle thermo-conduction combined with cervical traction therapy can accelerate the blood flow of patients with CSA and improve their clinical symptoms

Efeitos do tratamento da Classe II divisão 1 em pacientes dolicofaciais tratados segundo a Terapia Bioprogressiva (AEB cervical e arco base inferior), com ênfase no controle vertical / Treatment effects on Class II division 1 high angle patients treated according to the Bioprogressive therapy (cervical headgear and lower utility arch), with emphasis on vertical control

OBJETIVO: o presente estudo investigou o controle vertical e os efeitos do tratamento ortodôntico em pacientes dolicofaciais, empregando o AEB cervical e o arco base inferior. MÉTODOS: foi realizada a avaliação cefalométrica de 26 pacientes dolicofaciais com Classe II, divisão 1, idade média de 114 meses. O tratamento ortodôntico envolveu a utilização do AEB cervical na arcada superior e arco base na arcada inferior, até a obtenção da chave de oclusão normal dos molares, e finalizado segundo a Terapia Bioprogressiva, com duração média de 56 meses. Foram avaliados os valores de FMA, SN.GoGn, ANB, Fg-S, S-FPm, comprimento maxilar, comprimento mandibular, AFP (altura facial posterior), AFA (altura facial anterior), IAF (índice de altura facial), ângulo do plano oclusal, ângulo do plano palatino, QT (queixo total), LS (lábio superior) e ângulo Z. RESULTADOS: o tratamento promoveu estabilidade dos planos mandibular, oclusal e palatino. Ocorreu a correção anteroposterior das bases apicais, verificada pela redução significativa da grandeza ANB. A maxila apresentou um suave deslocamento anterior,com um suave aumento da dimensão anteroposterior.A mandíbula apresentou melhora de seu posicionamento em relação à base do crânio e sua dimensão anteroposterior aumentou significativamente. As alturas faciais posterior e anterior permaneceram em equilíbrio, não alterando significativamente o IAF. O perfil tegumentar apresentou melhora significativa. CONCLUSÃO: o tratamento realizado promoveu a correção das bases apicais, com controle dos planos horizontais e das alturas faciais, sendo efetivo no controle vertical.

OBJECTIVE: This study investigated vertical control and the effects of orthodontic treatment on dolichofacial patients, using cervical headgear (CHG) and lower utility arch. METHODS: Cephalometric assessment of 26 dolichofacial patients with Class II, division 1, and mean age of 114 months. Orthodontic treatment involved the use of cervical headgear (CHG) in the maxillary arch, lower utility arch in the mandibular arch until normal occlusion of the molars was obtained and finished in accordance with Bioprogressive therapy, with a mean duration of 56 months. The values of FMA, SN.GoGn, ANB, Fg-S, S-FPm, maxillary length, mandibular length, posterior facial height (PFH), anterior facial height (AFH), facial height index (FHI), occlusal plane angle (OPA), palatal plane angle (PPA), total chin (TC), upper lip (UL) and Z angle were evaluated. RESULTS: The results showed that treatment promoted stability of the mandibular, occlusal and palatal planes. Anteroposterior correction of the apical bases occurred, verified by the significant reduction in the variable ANB. The maxilla presented slight anterior displacement and increase in the anteroposterior dimension. The mandible presented improvement in its position in relation to the cranial base and its anteroposterior dimension increased significantly. The posterior and anterior facial heights remained in equilibrium, with no significant alteration in FHI. The tegumental profile presented significant improvement. CONCLUSION: The treatment performed produced correction of the apical basis with control of the horizontal planes and facial heights, and was effective for vertical control.

The Clinical Research of Cervical Spondylotic Radiculopathy Treated with Intervertebral Foramen Block and Brachial Plexus Traction-like Technique / 浙江中医药大学学报

[Objective]To explore the clinical effect of cervical spondylotic radiculopathy treated with intervertebral foramen block and brachial plexus traction-like technique.[Methods]54 cases of cervical spondylotic radiculopathy were randomly divided into two groups,i.e.control group(cervical traction and brachial plexus traction-like technique) and treatment group(added with intervertebral foramen block).[Results]The cure rate and effective rate were 66.67% and 92.59% in treatment group,and 25.93% and 78.78% in control group,respectively.Clincal efficacy is significantly better in treatment group than that in control one(P

The effects of cervical traction on the soleus H reflex amplitude in man / 体力科学

The purpose of this study was to investigate the effects of cervical traction on the soleus H reflex amplitude. Young healthy men were recruited as the subjects. In experiment 1, cervical traction under three conditions, i. e. at an intensity of 3 kgf, 6 kgf or 9 kgf was applied to the subjects in the experimental group for a duration of 1 minute in the second minute of each trial. In experiment 2, cervical traction at an intensity of 3 kgf for a duration of 1 minute, 2 minutes, or 3 minutes was applied to the subjects in the experimental group. Cervical traction was not applied to the subjects in the control group. The soleus H reflex amplitude was measured before, during, and after cervical traction.<BR>The H reflex amplitudes under the 9kgf condition were largest and positive for every block, whereas those under the 3 kgf condition were smallest among the three experimental conditions employed. Significantly smaller H reflex amplitude compared to that in the control was observed under the 3 kgf condition.<BR>In experiment 2, the H reflex amplitudes under every experimental condition employed were smaller than that in the control. However, the differences in degree of depression of the soleus H reflex amplitudes among the three duration conditions were not significant.<BR>This study shows that cervical traction at an intensity of 3kgf depresses the gain of the soleus H reflex pathway. The cause of this depression may be an “after-effect” or flexor reflex afferents. A difference in the duration of cervical traction didn't result in any difference in the soleus H reflex amplitude.

The rotatory manipulation during cervical traction for painful neck movement.

Thirty-nine female patients with chronic (1-24 months) painful and limited neck movements were divided into two groups: a controlled group (n = 17) and a manipulated group (n = 22). In the controlled group, a non-steroidal anti-inflammatory drug (NSAID) named Voltaren® was prescribed for the patients to take three times a day for three weeks. In the manipulated group, patients were treated with Voltaren® plus ratatory manipulation during cervical traction. All patients were screened to exclude pathologic neurological signs by physical examination and cervical roentgenograms. Patients in the manipulated group were put on an intermittent traction machine with 20 degrees flexion of the neck and ratatory manipulation of the cervical spine was carried out while a pull of 25 kilograms (kg) was exerted. Patients were manipulated twice weekly for six sessions (3 weeks). In the manipulated group, results showed a marked reduction of pain (5levels on a visual analygue scale). Degrees of active range of motion (ROM) of neck in all directions improved significantly (p < 0.001) before and/after the first treatment and/after the last treatment (mean + SD): flexion and extension = 108.13+14.48/114.81+12.62/125.40+10.04; lateral flexion to the left and right = 67.86+13.72/73.77+10.18/80.50+10.37; rotation to the left lateral flexors of the cervical spine were also significantly increased from the beginning (P<0.01): 3.92+1.79/4.74+1.80 kg in flexors, 6.97+2.67/8.28+2.05 kg in extensors, 4.28+1.52/5.38+1.35 kg in the left lateral flexors and 4.31+1.51/5.27+1.25 kg in the right lateral flexors. About five sessions (twice a week) should improve the condition. No significant change occurred in the controlled group.

Removal of Huge Cervical Intraspinal Fragment Demonstrated Only by CT Scan

Cervical traction has been widely used as an essential method for the treatment of cervical fracture-dislocation. This report, however, was a case in which hazardous effect of traction due to unreduced huge fragment was demonstrated only by cervical CT scan. Surprisingly plain X-rays could not demonstrated this condition. It was apparent that skeletal traction resulted in further injury of the spinal cord. Surgical removal of unreduced huge fragment was accomplished completely and interbody fusion was followed. Postoperative CT findings showed complete removal of fragment and decompression of the spinal cord as well as gratifying interbody fusion. CT scanning is imperative to evaluate the cervical fracture-dislocation and blind skeletal traction may be hazardous.