Cervical radiculopathy: A new traction method versus ventroflexion traction :A randomized controlled 1-year follow-up study

The other two groups (A&B) received conventional treatment in addition to intermittent mechanical cervical traction; the group (A) received the traditional ventroflexion tractionfor 20 minutes, three times per week for four weeks. During the ventroflexion traction the patient was lying supine on a softly padded table with a pillow under the knees for relaxation. The position of the head during traction was adjusted by using a goniometer at 24 degree flexion without rotation or side flexion. the traction force was started at 9.1 kg (20 Ib) or 10% of the patient's body weight (whichever was less) and increased approximately 0.91 to 2.27 kg (2-5 Ib) every visit, depending on centralization or reduction of symptoms. The maximum force used was 15.91 kg (35 Ib). The on/off cycle was set at 50/10. The group (B), which received the flexor carpi radialis H- reflex based traction method for 20 minutes, three times per week for four weeks, followed the same procedures of traditional traction with only exception that the optimal head posture was selected according to findings of H reflex. flexor carpi radialis H- reflex amplitude was recorded after the patient maintained the end range of 24 degree head flexion, mid position, 15 degree backward extension and 5 degree backward extension for 20 minutes. The electrophysiological findings represented in peak to peak amplitudes were compared with the findings recorded during comfortable neutral positions. The idea behind this technique is that postural modification can cause amplitude inhibition, indicating more compression of the impinged nerve root, or recovery, indicating decompression of the root. The peak to peak amplitudes was selected as compression –decompression indicator as it is a more sensitive predictor of normal physiologic changes than is latency, which need more long time to be changed .