Purpose:
To predict neck pain patients that are likely to improve with cervical traction and exercise.
Rule:
Age > 55
Positive shoulder abduction test
Positive upper limb tension test A
Symptom peripheralisation with central posterior–anterior motion testing at lower cervical (C4–7) spine
Positive neck distraction test
Interpretation:
Treatment given: 2-3 times a week for 3 weeks
Traction
Angle of pull: 24 degrees if patient had full Cx flexion; otherwise it was set at 15 degrees
The on/off cycle was set to 60 secs of pull force and 20 secs of relaxation force. Traction force during the off time was set to 50% of pull force.
Initial pull force was set at 10–12 pounds then incrementally adjusted to ‘‘moderately strong to strong’’ feel without increasing symptoms.
Maximum pull force for the studay was 40lbs and average pull force was 23.2 lbs±5.6 lbs (range 12–38 lbs).
Each session lasted approximately 15 min.
Exercises
Position: Sitting with natural lumbar lordosis.
Action: Retract and adduct scapulas and gently elongate Cx spine to achieve natural upright position
Repetitions: Hold minimum 10 secs and perform 2x per hour
Position: Supine
Action: Slow controlled cranio-cervical flexion with minimal effort and without contracting large superficial neck muscles
Repetitions: Hold for minimum 10 secs and perform 10x twice daily
Reference:
Raney NH, et al. Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. Eur Spine J. 2009; 18(3): 382-91.
