Sustained natural apophyseal glide versus neurodynamic mobilization in the management of chronic unilateral discogenic cervical radiculopathy

Samar Abdelrahman, S. Abdelmegeed, Wael Shendy, Hosam Salah
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Abstract

Background: Cervical radiculopathy is a pathological condition of the cervical nerve root , causing sensory and motor deficits. The greater demand for neurological physical therapy identifies the need for more evidence-based techniques. Purpose: To compare the effect of neurodynamic mobilization versus sustained natural apophyseal glides in the management of patients with chronic discogenic unilateral cervical radiculopathy. Methods: 42 patients complaining from cervical radiculopathy with age from 30 to 45years were randomly assigned to three equal groups. Group (A) received neural mobilization for median and radial nerve in addition to conventional treatment group (B) received sustained natural apophyseal glide (SNAG) in addition to the conventional treatment group (C) received a conventional physiotherapy program (Hot pack, stretching and strengthening exercises for cervical muscles) for 12 sessions during 4 weeks, 3 sessions /week. All patients were evaluated with the Visual analogue scale, Arabic version of the neck disability index and cervical range of motion device. Results: All groups had statistically significant improvements in all outcome measures post treatment. No significant differences were recorded among the three groups in the pain post treatment. Group A and B similarly improved and higher than group C in respect to neck functional performance. Group B showed significant improvement in cervical range of motion post treatment more than group A and C. Conclusion: Adding sustained natural apophyseal glide or neural mobilization to traditional physiotherapy program is beneficial in management of individuals with chronic unilateral discogenic cervical radiculopathy.
在治疗慢性单侧椎间盘源性颈椎病时,持续的自然顶叶滑动与神经动力调动疗法的比较
背景:颈椎病是颈神经根的一种病理状态,会导致感觉和运动障碍。随着神经理疗需求的增加,需要更多循证技术。目的:在治疗慢性椎间盘源性单侧颈椎根病变患者时,比较神经动力动员与持续自然顶骨滑行的效果。方法:将年龄在 30 至 45 岁之间的 42 名颈椎病患者随机分为三组。A组:在常规治疗的基础上,对正中神经和桡神经进行神经移位术治疗;B组:在常规治疗的基础上,进行持续自然椎弓根滑行术(SNAG)治疗;C组:进行常规物理治疗(热敷、颈部肌肉拉伸和强化训练),为期4周,每周3次,共12次。所有患者均接受了视觉模拟量表、阿拉伯语版颈部残疾指数和颈椎活动范围测量仪的评估。结果所有治疗组在治疗后的所有结果指标上都有明显改善。三组在治疗后疼痛方面无明显差异。在颈部功能表现方面,A 组和 B 组同样有所改善,且高于 C 组。治疗后,B 组在颈椎活动范围方面的改善明显高于 A 组和 C 组:在传统的物理治疗方案中加入持续的自然顶叶滑动或神经调动,对慢性单侧椎间盘源性颈椎病患者的治疗是有益的。
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