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Lian Yun-Perng, Physiotherapist

CPR on Mechanical Traction and Exercise for Neck Pain


Purpose:

To predict neck pain patients that are likely to improve with cervical traction and exercise.

Rule:

  1. Age > 55

  2. Positive shoulder abduction test

  3. Positive upper limb tension test A

  4. Symptom peripheralisation with central posterior–anterior motion testing at lower cervical (C4–7) spine

  5. Positive neck distraction test

Interpretation:

CPR on Mechanical Traction and Exercise for Neck Pain

Treatment given: 2-3 times a week for 3 weeks

Traction

  • Angle of pull: 24 degrees if patient had full Cx flexion; otherwise it was set at 15 degrees

  • The on/off cycle was set to 60 secs of pull force and 20 secs of relaxation force. Traction force during the off time was set to 50% of pull force.

  • Initial pull force was set at 10–12 pounds then incrementally adjusted to ‘‘moderately strong to strong’’ feel without increasing symptoms.

  • Maximum pull force for the studay was 40lbs and average pull force was 23.2 lbs±5.6 lbs (range 12–38 lbs).

  • Each session lasted approximately 15 min.

Exercises

Chin Tuck Exercise with Scapula Setting

  • Position: Sitting with natural lumbar lordosis.

  • Action: Retract and adduct scapulas and gently elongate Cx spine to achieve natural upright position

  • Repetitions: Hold minimum 10 secs and perform 2x per hour

Chin Tuck Exercise in Supine

  • Position: Supine

  • Action: Slow controlled cranio-cervical flexion with minimal effort and without contracting large superficial neck muscles

  • Repetitions: Hold for minimum 10 secs and perform 10x twice daily

Reference:

Raney NH, et al. Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. Eur Spine J. 2009; 18(3): 382-91.

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Editor
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Lian Yun-Perng  

UK Qualified Physiotherapist
Bachelor of Physiotherapy

Keele University, United Kingdom
Diploma in Physiotherapy

AIMST University, Malaysia

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