Cervical Disc Herniation
Conditions
Keywords
Intervertebral Disc Displacement, Musculoskeletal Manipulations, Range of Motion, Articular, Neck pain
Brief summary
Background To assess the effectiveness of Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) applied to cervical-only mobilization versus both lumbar and cervical regions on pain intensity and range of motion (ROM) in individuals with cervical disc herniation, Methods: Thirty three participants were enrolled in the study. The patients were randomly assigned to two groups. Group A received cervical-only KEOMT while Group B received combined lumbar and cervical KEOMT, Interventions were administered three times a week for four weeks. Pain was measured using the Visual Analog Scale (VAS), ROM was assessed for flexion and lateral flexion, and Neck Pain and Disability Index (NPDI) and Short-Form 36 Health Survey (SF-36) were used for evaluation.
Interventions
OTHERKaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT)
Kaltenborn's biomechanical approach to diagnosis and treatment emphasizes ergonomic principles and trial-based techniques. His mobilization methods, classified into Grades I-III, target pain relief (Grades I-II) and joint hypomobility (Grade III) by enhancing glide and tissue elasticity. The Kaltenborn-Evjenth Orthopedic Manual Therapy (KEOMT) further refines this approach using arthrokinematic principles to restore physiological joint motion based on the concave-convex rule.
Sponsors
Fenerbahce University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
After obtaining informed consent forms from the participants who accepted to join the study, participants were randomly assigned to two groups-Group A (cervical-only KEOMT) and Group B (combined cervical and lumbar KEOMT)-using a computer-generated randomization sequence. Block randomization was employed to ensure balanced group sizes.
Eligibility
Sex/Gender
ALL
Age
25 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed with cervical disc herniation at least 8 weeks but not more than 5 years prior. * Cervical disc herniation verified by magnetic resonance imaging (MRI) at 1 or 2 segmental levels, consistent with clinical findings. * Neck Disability Index (NDI) score greater than 5. * No use of analgesic medication other than the prescribed treatment before or during the study period.
Exclusion criteria
* History of myelopathy, whiplash-associated disorder, generalized myalgia, malignant tumor, or inflammatory disease. * Painful back problems or neurological symptoms within the past year. * Psychiatric disorders or drug abuse. * Contraindications to physical therapy or inability to return to work or perform physical therapy due to other diseases or disabilities. * Inability to communicate effectively. * Participation in any additional interventions outside the prescribed treatment during the study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visuel Analog Scale | Through study completion, an average of 1 year | Pain intensity was evaluated with a visual analog scale (VAS). A 10 cm visual scale was divided into equal segments and numbered from 0 to 10. Patients were instructed that 0 represents no pain, while 10 indicates unbearable pain. Based on this explanation, they were asked to rate their pain intensity accordingly |
| Range of motion | Through study completion, an average of 1 year | A universal goniometer was used to measure joint position and range of motion, following the guidelines of Kendall and the American Association of Orthopedic Surgeons. The assessment was conducted with the patient in a sitting position. Patients were instructed to actively perform movements of cervical flexion, extension, right and left rotation, and right and left lateral flexion, with the corresponding degrees of motion recorded. |
| Neck Pain and Disability Assessment | Through study completion, an average of 1 year | Neck pain and disability were evaluated using the Neck Pain Disability Index (NPDI), a validated tool developed by Vernon and Mior (1991). The index comprises 20 items scored on a Visual Analog Scale (VAS), assessing the impact of neck pain on daily activities, occupational performance, and emotional well-being. Scores range from 0 (no disability) to 100 (complete disability), with higher scores indicating greater functional limitations. This study employed the Turkish version of the NPDI, which has demonstrated reliability |
| Quality of life scale | Through study completion, an average of 1 year | The participants' quality of life was assessed using the Short Form 36 (SF-36), a self-reported scale developed by the Rand Corporation in 1992. The SF-36 evaluates general health status through 36 questions, divided into 8 subscales: physical function, physical role limitations, bodily pain, general health, vitality, social function, emotional well-being, and mental health. Scores on the SF-36 range from 0 to 100, with 0 representing the worst health status and 100 representing the best. The Turkish version of the scale was used in this study |
Countries
Turkey (Türkiye)
Outcome results
None listed