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Cervical RadiculopathyNCT07366983

Effect of Cervical Traction With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

A study testing traction (30 degree) head flexion, Deep neck flexor strengthening exercise and Sub occipital Release in people with Cervical Radiculopathy and Traction, run by Cairo University at 1 site in Egypt.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study will be conducted to examine 1. The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis. 2. The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes. 3. Read more about this study

Who is it for?
Ages 30 to 45 years
What is being tested?
traction (30 degree) head flexion, Deep neck flexor strengthening exercise and Sub occipital Release
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
45 participants
Where
1 siteEgypt
Study dates
1 Feb 2026to 1 Jun 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 to 45 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • The patient's age will be ranged from 30 to 45 years old for both genders.
  • The patient's with unilateral C5-6 and C6-7 (posterior lateral disc protrusion) confirmed by T 2, axial view of magnetic resonance imaging
  • The patient's symptoms more than 3 months and positive provocative test for cervical radiculopathy (Spurling's test, shoulder abduction test, neck distraction test, and upper limb tension test 1 (Median nerve).
  • Sensory, reflex, and/ or motor changes in the upper limb

Who cannot join

  • History of surgical procedures for pathologies giving rise to neck pain or carpal tunnel syndrome
  • Clinical signs or symptoms of medical "red flags" (infection, cancer, and cardiac involvement).
  • Patients with neck pain for signs and symptoms of serious pathology, including suspected arterial insufficiency, upper cervical ligamentous insufficiency, unexplained cranial nerve dysfunction, and fracture.
  • Systemic diseases such as autoimmune and metabolic diseases.
  • History of steroid injection.
  • Complete loss of sensation along the involved nerve root.
  • bilateral radiating upper extremity
  • Diabetic polyneuropathy.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mohamed Nagy Abd ELfatah ELshafey, Assistant lecturer contact

01155273157

mnagy@horus.edu.eg

Egypt1 site
  • out-patient clinic, faculty of physical therapy, Horus university

    Damietta

    Mohamed Nagy Abd ELfatah ELshafey, Assistant lecturer, 01155273157, mnagy@horus.edu.eg

Other trials in Egypt

About this study

Official title: Effect of Cervical Traction From Different Angles With Neural Mobilization on Nerve Root Functions in Cervical Radiculopathy Patients

This study will be conducted to examine

  1. The efficacy of mechanical traction from decompression angles combined with neural mobilization on the H reflex of flexor carpi radialis.
  2. The efficacy of mechanical traction from decompression angles combined with neural mobilization on ultrasonography changes.
  3. The efficacy of mechanical traction from decompression angles with neural mobilization has a Numeric Pain Rating Scale.
  4. The efficacy of mechanical traction from decompression angles combined with neural mobilization on Neck Disability Index.
Read the detailed description

Cervical radiculopathy is a condition characterized by pain, sensory and motor impairments, and slowed reflexes caused by the compression of cervical nerve roots, often stemming from cervical disc herniation. The etiology includes mechanical compression and chemical irritation, commonly due to foraminal stenosis. Cervical radiculopathy pain is a combination of nociceptive and neuropathic components, with various conservative treatments available, including immobilization and physical therapy, although evidence for their efficacy is limited. Neural mobilization especially when combined with cervical traction, shows promise in alleviating nerve-related pain and enhancing treatment adaptability. Techniques involving specific joint movements can enhance foraminal dimensions, thereby affecting nerve tension and circulation. This study uniquely examines the effects of head positions on foraminal opening and clinical outcomes, including H reflex and ultrasonography changes.

Being tested
traction (30 degree) head flexion, Deep neck flexor strengthening exercise, Sub occipital Release, Hold/Relax Stretch, Prone Cervical Unilateral Poster anterior Mobilization
Medical subject headings
Radiculopathy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • traction (30 degree) head flexionDevice

    Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30-degree head flexion) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

  • Deep neck flexor strengthening exerciseOther

    All patients are instructed to perform a home program involving chin-in exercises from a supine position, focusing on upper cervical spine extension and flexion. Participants will move their heads backwards and then return to the starting position, ensuring slow, controlled movements while palpating their necks to relax superficial neck muscles. The exercises will be done twice a week for six weeks, with each hold lasting 10 seconds, 15-second breaks between holds, and 10-15 repetitions in total.

  • Sub occipital ReleaseOther

    In a supine position with the head on a pillow, the patient is treated by a therapist seated at the head of the table. The therapist uses both hands (digits 2 to 5) to contact the base of the occiput, gently lifting the head anteriorly while allowing the dorsum of the hands to rest on the pillow. This technique involves cranial pulling as the patient's sub occipital muscles relax, with distraction maintained for up to 5 minutes as tissue slack becomes available. Once relaxation is achieved, the therapist positions the shoulder against the patient's forehead to enhance sub occipital distraction.

  • Hold/Relax StretchOther

    The therapy procedure involves positioning the patient supine and performing specific movements to address shoulder and neck tension. The therapist supports the occiput and rib area while guiding the neck into forward bending and lateral flexion, combined with right or left rotation, depending on the sequence. The patient is instructed to perform isometric contractions by elevating the shoulder against resistance for 10 seconds, followed by relaxation, with additional stretches held for 10 seconds. This process is repeated three to four times and includes a home stretching program, holding stretches for 30 to 60 seconds two to three times daily.

  • Prone Cervical Unilateral Poster anterior MobilizationOther

    The patient is positioned prone with a pillow under their chest, and their head and neck are in a neutral position, while the therapist stands at the head. The therapist places both thumbs on the spinous process of the targeted vertebra and applies a gentle posterior to anterior force to assess pain, mobility, and end feel, gradually increasing the force for four to five repetitions.

  • traction (foramen opening)Device

    Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (flexion, lateral bending and rotation according to pain) and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

  • traction (30 degree) side bending)Device

    Triton decompression system is designed to apply traction to the cervical vertebrae in patients grouped as A, B, and C. The system includes a Triton decompression traction unit and a QuikWrapTM belting system, with traction starting from specified angles (30 degree) side bending and an initial force of 10% of the patient's body weight, increasing by 1-2 kg as needed. Each session consists of 20 minutes of intermittent traction, allowing stress management through a bursar switch. Concurrently, neural mobilization involves shoulder depression and arm abduction, leading into either sliding or gliding of the median nerve, performed over specific sets and repetitions with designated rest periods.

Study groups in NCT07366983
Study groupRoleWhat they receive
multimodal physical therapy program and traction with neural mobilization (30 degree) head flexionExperimentalPatients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical from 30-degree head flexion combined with neural mobilization, 3 sessions per week for 6 weeks
Receives: Device: traction (30 degree) head flexion; Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization
multimodal physical therapy program and traction with neural mobilization (30 degree) side bendingActive comparatorPatients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while head will in 30° lateral bending to the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
Receives: Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization; Device: traction (30 degree) side bending)
multimodal physical therapy program and traction with neural mobilization (foramen opening position)Active comparatorPatients will receive multimodal physical therapy program, and 20 min mechanical traction of cervical while the head will be in 30° flexion, 15° rotation toward the painful side, and 30° lateral bending toward the pain-free side combined with neural mobilization, 3 sessions per week for 6 weeks.
Receives: Other: Deep neck flexor strengthening exercise; Other: Sub occipital Release; Other: Hold/Relax Stretch; Other: Prone Cervical Unilateral Poster anterior Mobilization; Device: traction (foramen opening)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. assessment of pain intensity

    Pain intensity was evaluated using the Numeric Pain Rating Scale (NPRS), a validated self-reported measure. Participants rated their pain on an 11-point scale from 0 (no pain) to 10 (worst pain imaginable), after receiving an explanation of the scale. NPRS scores were documented at baseline and scheduled follow-ups to track pain intensity changes during the intervention, with higher scores reflecting greater pain severity.

    Measured: at baseline and after 6 weeks

Secondary outcomes (3)
  1. Assessment of neck functional activities

    The Neck Disability Index is a widely recognized tool for assessing the impact of neck pain on functional activities and measuring outcomes in clinical settings. It includes 10 questions addressing pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, and recreation. The Arabic version of the Neck Disability Index is a valid instrument for evaluating disabilities in neck pain patients, demonstrating high reliability with an interclass correlation of 0.96.

    Measured: at baseline and after 6 weeks

  2. assessment of H reflex for the median nerve

    Flexor carpi radialis H-reflex is measured using an electromyogram in a semi-supine position with a supinated forearm. Hair may be removed from the anterior forearm to reduce signal resistance. The motor point of the Flexor carpi radialis is identified by applying low-threshold stimuli, aiming for the maximum response at the lowest threshold. A recording electrode is positioned at this motor point, with a reference electrode on the lateral forearm and a ground electrode proximally. To elicit the H-reflex, a surface-stimulating electrode is applied along the median nerve in the antecubital fossa.

    Measured: at baseline and after 6 weeks

  3. assessment of nerve root function

    High-resolution ultrasonography will utilize a 12- to 18-MHz linear probe to assess cervical nerve roots (NR) in seated patients with lateral neck flexion. Contralateral unaffected nerve root will serve as controls. To minimize anisotropy, the transducer will be positioned at right angles and rotated to identify the minimal cross-sectional area. C7 vertebra identification will precede imaging of the anterior and posterior tubercles of C6. The transducer will be moved to capture axial views of C5, C6, and C7 nerve roots, maintaining proximity to the transverse processes at the nerve root exit points.

    Measured: at baseline and after 6 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jan 2026
  2. Study start1 Feb 2026 (estimated)
  3. Primary completion1 May 2026 (estimated)
  4. Study completion1 Jun 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
45 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07366983
Sponsor's protocol ID
Nagy-Phd
Status last verified
Jan 2026
First submitted
17 Jan 2026
Last updated
26 Jan 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing traction (30 degree) head flexion, Deep neck flexor strengthening exercise and Sub occipital Release in people with Cervical Radiculopathy and Traction, run by Cairo University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 26 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mohamed Nagy Abd ELfatah ELshafey, Assistant lecturer (01155273157, mnagy@horus.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

assessment of pain intensity (time frame: at baseline and after 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jan 2026.

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