The effectiveness of tensioning neural mobilization of brachial plexus in patients with chronic cervical radiculopathy: a randomized clinical trial

• Published in: Physiotherapy quarterly 2021, Vol.29 (1), p.12-16
• Main Authors: Omer Ibrahim, Asmaa, Abdelazeem Fayaz, Nadia, Hazim Abdelazeem, Ahmed, Abdelaty Hassan, Karima
• Format: Article
• Language: English
• Subjects: Biomechanics; Bone surgery; Brachial plexus; chronic cervical radiculopathy; Clinical trials; mechanosensitivity; Nervous system; neural mobilization; Pain; Patients; Physical education; Physical therapy; Tension tests
• ISSN: 2544-4395; 2544-4395
• DOI: 10.5114/pq.2020.96419

Introduction Tensioning neural mobilization (NM) is accomplished through increasing the distance between nerve bed ends via elongation. NM techniques have different biomechanical effects on the nervous system. Evidence for their use in treating certain upper-quarter conditions like cervicobrachial pain is limited. The study was to determine tensioning NM efficacy on unilateral chronic cervical radiculopathy regarding mechanosensitivity of the affected nerve roots and intensity of neck and arm pain. Methods Forty participants with chronic unilateral cervical radiculopathy were randomly assigned to group A (n = 20), receiving traditional physical therapy (manual traction and infrared irradiation), and group B (n = 20), receiving traditional physical therapy in addition to tensioning NM of brachial plexus. Mechanosensitivity of the affected brachial nerve roots and intensity of neck and arm pain were evaluated at baseline and after a 3-week program with the upper limb tension test-1 and visual analogue scale. The normal (Z) test, paired and unpaired t-test, Wilcoxon signed-rank test, and Wilcoxon rank-sum test (Mann-Whitney) were used in data analysis. Results There were significant within-group differences in both groups regarding mechanosensitivity and pain intensity (mechanosensitivity: p = 0.001 for group A, p = 0.001 for group B; pain: p < 0.01 for group A, p < 0.01 for group B). There was no statistically significant between-group difference regarding mechanosensitivity (p = 0.07) or pain intensity (p = 0.838). Conclusions The addition of tensioning NM to traditional physical therapy had no significant benefits, although both groups showed decreased post-treatment mechanosensitivity and pain intensity.