Monitor and Correct the Deviation of Cervical Traction for Patients with Chronic Neck Pain -- The Influence on Clinical Outcomes

偏移監控下之頸椎牽引對於慢性頸痛患者療效上之影響

鄒志敏(Chih-Min Tsou) ； 張婷方(Ting-Fang Chang) ； 陳曉宜(Shiau-Yee Chen) ； 張堯舜(Yao-Shun Chang) ； 王惠中(Hui-Chung Wang)

《物理治療》 42卷2期 (2017/06) Pp. 170-171

https://doi.org/10.6215/FJPT.2017.73.P23

摘要

Background and Purpose: Intermittent cervical traction (ICT) has been widely used as part of a comprehensive outpatient rehabilitation program for neck pain although its effectiveness remains limited or inconclusive. In clinic, tilting of head or trunk during ICT in sitting position is common, which may influence the therapeutic effect of cervical traction. In this study, we explored the therapeutic effects of correcting the deviation of traction angle during ICT in sitting position. Methods: Thirty-three subjects with chronic neck pain from a university-affiliated medical center were assigned to the experimental or control group. The experimental group (n = 11; mean age: 46.7 ± 11 years) received ICT that corrects the deviation of traction angle (＞5° away from middle line) 3 times per week for 2 weeks. The control group (n = 22; mean age: 47.3 ± 1.2 years) received ICT without correcting the deviation of traction angle throughout the intervention period. We measured the outcomes of pain in VAS, cervical range of movement (CROM) by inclinometers, and disability of neck in NDI (neck disability index) before and after interventions. Results: VAS was significantly reduced in both control group (-2.1 ± 1.7, p ＜ 0.0005) and experimental group (-2.6 ± 1.7, p = 0.003) after 2 weeks of intervention, but no significant difference in the amount of reduction between groups (p = 0.433). CROM of flexion, side-flexion and rotation of were increased in both groups, but no significant differences in the amount of increment between groups (p ＞ 0.05). Moreover, there was no significant improvement in NDI after interventions in both groups (p ＞ 0.05). Conclusions: Monitoring and correcting the deviation of traction angle which is larger than 5° during ICT did not show extra benefit in improving pain (VAS), CROM, and NDI for patients with chronic neck pain, comparing to conventional traction-without-correction approach. Further studies are needed to explore the issue of intervention program duration and threshold of correction during ICT. Clinical Relevance: A 5° deviation of traction angle during ICT may not significantly interfere the effect for traction in patients with chronic neck pain.