The effect of cervical manual traction on the length of the cervical spine in asymptomatic individuals

Before initiating the procedures, all individuals were familiarized with manual cervical traction in order to reduce errors in the positioning and execution of the technique. They were given fixed appointments in a preset schedule for the execution of the radiological examination and the manual cervical traction. For the examination, an initial supine position was adopted on the stretcher of the x-ray device (DC-15KB, 500 mA, Toshiba; Toquio, Japan). The participants were instructed to leave cervical region exposed without the presence of any metallic material which might hamper the execution of the technique. The cervical spine was positioned with the anterior arc of the jaw at 90° in relation to the surface of the table, confirmed by means of a goniometer (Carci). Each participant was instructed to relax his shoulders in order to allow adequate visualization of the neck and to keep the body in a static and relaxed position until the radiological procedure and the cervical manual traction were finished. For this procedure, the physiotherapist was stationed at the head of stretcher, grasping the participant’s jaw with his right hand and positioning his left hand under the occipital region, with the first and the third fingers in contact with the mastoid process of each side, respectively. After correct positioning of the patient, the radiology technician located the beam cone of incidence, calibrated it to 50 Kilowatts (kV) of penetration with a 0.8 second exposure time at 300 milliamps (totaling 24 mAs). The radiation was directed at the center of the fourth cervical vertebra, on the left lateral of the neck at a constant distance of 80 cm, resulting in simple radiographs of the lateral profile in a standard size of 24 x 30 cm. After the technician confirmed the unimpeded visibility of the vertebrae in the images, the physiotherapist began performing cervical manual traction. To accomplish this, a longitudinal force of distraction between the head and the trunk was applied for 120 seconds, as stipulated previously. After this procedure, in order to record the effects of manual traction, another series of radiographs was executed. After this initial procedural session, the participants were randomized using sealed opaque envelopes into two groups: the control group and the intervention. Each participant of the intervention group received 10 sessions of manual traction (01 session/day) for a period of 10 days. Each session consisted of the following: having the patient in the position of dorsal decubitus, the physiotherapist applied three rounds of manual traction for 120 seconds each, with an interval of 30 seconds between each round. The control group was instructed not to vary from their normal daily activities (DAs) for 10 days from beginnig of manual traction in the other group. The day following the completion of the sessions, a final radiological procedure was performed with both groups