Who will be a good responder for cervical traction?
Wednesday, March 23, 2011 at 11:54PMCervical traction is a great tool for managing neck pain in certain individuals. The trick as a physician is to figure out which patients will benefit most from this form of intervention.
A recent study published in the European Spine Journal provides some interesting answers on the use of a clinical prediction rule to determine who is likely to respond to home-based mechanical cervical traction.[i]
The study was a prospective cohort study, which included patients with neck pain referred to a clinic for physical therapy. A home-based mechanical cervical traction program was given to participants for 2 weeks. The patient's demographic data, Numerical Pain Scale (NPS) score, Neck Disability Index (NDI), and Fear-Avoidance Beliefs Questionnaire score were collected, and standard physical examination of the cervical spine was conducted before intervention. The NPS score, NDI, and a global rating of perceived improvement were collected after the intervention was completed.
A total of 103 patients participated in the study; 47 had a positive response to HMCT. A clinical prediction rule with the following four 4 variables was identified:
- (Fear-Avoidance Beliefs Work Subscale score < 13
- Pre-intervention pain intensity ≥ 7/10
- Positive cervical distraction test
- Pain below shoulder
If a person met at least 3 out of 4 variables (positive likelihood ratio = 4.77), the intervention's success rate increased from 45.6% to more than 80%.[ii]
[i] Eur Spine J. 2011 Jan 15.
[ii] Eur Spine J. 2011 Jan 15.
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