RESEARCH REPORT POSTER DISPLAY

EFFECT OF CERVICAL TRACTION ON CARDIOVASCULAR AND SELECTED ECG VARIABLES OF CERVICAL SPONDYLOSIS PATIENTS USING VARIOUS WEIGHTS. Akinbo S¹, Criety N¹, David O¹, Abayomi O², Mustapha D³; ¹Dept. of PT. College of Med. Univ of Lagos, Nigeria. ²Dept. of Anatomy College of Med. Univ of Lagos, Nigeria. ³Dept. of Medicine College of Med. Univ of Lagos, Nigeria

PURPOSE: There is currently no consensus among the clinicians regarding standardized cervical traction (CT) weight to be employed during CT therapy that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. The purpose of this study is to investigate the cardiovascular (CV) responses and side-effects associated with different CT weights in patients with cervical spondylosis (CS). RELEVANCE: The efficacy of CT in the management of neck pain has been established, so also are side effects associated with its application. Anecdotal reports indicate that patients following CT may experience vertigo, nausea, mild headache, and vertebral artery damage inducing stroke leading to the possibility of a perturbation of the patient’s cardiovascular system (CVS). It is therefore important to further investigate the CV responses in order to establish a safe and efficacious policy in CT therapy. PARTICIPANTS: Sixty out of 78 patients with radiological and clinical features of CS participated in this study. METHODS: Subjects were randomly assigned into three experimental groups; A, B and C with 20 subjects in each group. Their SBP, DBP and HR were measured. Rate pressure product (RPP) was calculated using standard equation and ECG also recorded. The outcome measures were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects’ 7.5% kg total body weight (TBW) (group A), 10% kg TBW (group B) and 15% TBW (group C) at different time intervals/phases (end of 5, 10 and 15 minutes respectively). ANALYSIS: Obtained data was analyzed using the SPSS -PC, Version 7. A one-way ANOVA was employed to determine if there was a significant difference in the CV and ECG variables between the baseline position and the different experimental phases within the same group for all the three experimental groups. For all statistical tests, the level of significance was set at 0.05 alpha level. RESULTS: Compared with the baseline values, there was a drop in SBP, DBP and RPP for all subjects. The drop/alteration were not significant for the 7.5% TBW, but significant (p < 0.05) for the 10% and 15% TBW tractions. The HR and ECG variables revealed no significant difference in all the groups, these results signified that the cardiac muscles were not adversely affected by any of the traction weights during application. Twenty subjects had side-effects including 5 subjects that terminated the treatment due to pain during the CT application. CONCLUSIONS: Cardiovascular alterations do occur during the CT resulting in untoward patient’s reactions. Clinicians should carry out cardiovascular assessment of patients before, and immediately after CT therapy especially in “high risk” patients, that is, the elderly and patients with unstable cardiovascular systems to avoid complications associated cervical manipulation. IMPLICATIONS: Findings from this study revealed that the higher the CT weights used the more the side/adverse effects. Therefore to determine the suitability of patients for CT, we urge physiotherapists to question patients regarding any unusual sensitivity they may have with respect to clothing around their neck, history of fainting, and precipitating causes. KEYWORDS: Cervical traction, Cardiovascular Variables, Cervical spondylosis,Traction side-effects. FUNDING ACKNOWLEDGEMENTS: Self sponsored. CONTACT: sonnyakinbo@yahoo.com

ETHICS COMMITTEE: Research and Ethical Committee of Lagos University Teaching Hospital, Lagos Nigeria.