PTH 633 SOAP Note Template THERAPIST NAME: Grace Blankenhagen

Comparison of 2 Manual Therapy and Exercise Protocols for Cervical Radiculopathy

Abstract

STUDY DESIGN:

Participant- and assessor-blinded randomized clinical trial.

OBJECTIVES:

To compare a rehabilitation program thought to increase the size of the intervertebral foramen (IVF) of
the affected nerve root to a rehabilitation program that doesn't include any specific techniques thought to
increase the size of the IVF in patients presenting with cervical radiculopathy (CR).

BACKGROUND:

Clinical approaches for the treatment of CR commonly include exercises and manual therapy techniques
thought to increase the size of the IVF, but evidence regarding the effectiveness of these specific manual
therapy techniques is scarce.

METHODS:

Thirty-six participants with CR were randomly assigned either to a group that received a manual therapy
and exercise program aimed at increasing the size of the IVF of the affected nerve root (experimental
group, n=18) or to a group that received a manual therapy and exercise program without the specific goal
of increasing the size of the IVF of the affected level and side (comparison group, n=18). Primary (Neck
Disability Index) and secondary (shortened version of the Disabilities of the Arm, Shoulder and Hand
questionnaire [QuickDASH] and numeric pain-rating scale) outcomes were evaluated at baseline, at the
end of the 4-week program (week 4), and 4 weeks later (week 8). A mixed-model, 2-way analysis of
variance was used to analyze treatment effects.

RESULTS:

No significant group-by-time interaction or group effect was observed for Neck Disability Index,
QuickDASH, and numeric pain-rating scale scores (P.14) following the intervention. However, both
groups showed statistically and clinically significant improvement from baseline to week 4 and to week 8
in Neck Disability Index, QuickDASH, and numeric pain-rating scale scores (P<.05).

CONCLUSION:

Results suggest that manual therapy and exercises are effective in reducing pain and functional limitations
related to CR. The addition of techniques thought to increase the size of the IVF of the affected nerve root
yielded no significant additional benefits. Given the absence of a "no treatment" group, a spontaneous
resolution of symptoms cannot be excluded. However, the magnitude of improvement makes spontaneous
resolution unlikely. The trial was registered at ClinicalTrials.gov (NCT01500044).

Works Cited
PTH 633 SOAP Note Template THERAPIST NAME: Grace Blankenhagen

Langevin P, Desmeules F, Lamothe M, Robitaille S, Roy JS. Comparison of 2 manual therapy

and exercise protocols for cervical radiculopathy: a randomized clinical trial evaluating short-
term effects. J Orthop Sports Phys Ther. 2015;45(1):4-17. doi: 10.2519/jospt.2015.5211

Mulcahy JA. Physical therapists guide to cervical radicuolopathy. Move Forward PT. 2016.
Accessed at http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=805cbc55-
0daa-4b08-b4be-225a7cebfb68 on February 12, 2016.