Effect of cervical traction on balance parameters in patients with cervical radiculopathy: a randomized controlled trial

Cervical Radiculopathy (CR) is a neurologic condition characterized by a dysfunction of a cervical spinal nerve, the roots of the nerve, or both. In CR, one of the most unpleasant symptoms after radicular pain is cervicogenic dizziness, which is characterized by postural balance disorders. Despite its effectiveness on pain and function, cervical traction has not been used to treat postural balance disorders in CR patients. Thus, the objective of this study was to evaluate the effect of mechanical intermittent cervical traction (MICT) on clinical and posturographic balance parameters in patients with CR. Patients with cervical radiculopathy (CR), were randomized into three active intervention groups receiving different traction loads: 2 kg (group A), 8 kg (group B), and 12 kg (group C), allowing for a dose–response comparison within a randomized controlled framework. The 2 kg traction group served as a control condition. Each group underwent 12 sessions of MICT (three sessions per week), combined with a standard rehabilitation program. Assessments were conducted at baseline, at the end of treatment, and at 3 and 6 months post-treatment. Outcome measures included posturographic parameters, clinical balance (Brief BESTest), CR pain, cervical active range of motion, proprioception, muscle strength, handgrip strength, neck-related disability (Neck Disability Index), psychological status (Hospital Anxiety and Depression Scale), and quality of life (WHOQOL-Bref). The results showed that the surface of postural sway in the eyes-closed condition improved more significantly in group C than in groups A and B at the end of treatment (p = 0.04) and at 6-month (p = 0.014) follow-up. Radicular pain showed greater improvement in group C compared to groups A and B at the end of treatment (p = 0.029). Depression scores improved significantly in group C compared to group A at 3 months (p = 0.038). The physical domain of the WHOQOL-Bref improved more significantly in group C than in groups A and B at 3 months (p = 0.04) and 6 months (p = 0.001). Additionally, the psychological domain of the WHOQOL-Bref improved more significantly in group C than in groups A and B at 6 months (p = 0.017). MICT demonstrates a beneficial medium-term effects on posturographic parameters, pain, and depression in patients with CR, particularly when using a 12 kg load. The study protocol was retrospectively registered at the ClinicalTrials.gov Registry (NCT06727747). Date of registration is 2024-10-14.