Cervical RadiculopathyNCT07628439
Effects of Mulligan Belt Traction Versus Fisted Traction in Patients With Lower Cervical Spine Radiculopathy
A study testing muligan belt traction and Fisted traction in people with Cervical Radiculopathy, run by Riphah International University at 1 site in Pakistan.
Trial summary
Individuals with a lower cervical spine radiculopathy diagnosis will undergo screening to determine their eligibility based on inclusion and exclusion criteria. Eligible participants will be asked for their informed consent Read more about this study
- Who is it for?
- Ages 25 to 60 years
- Conditions the study is for
- Cervical Radiculopathy
- What is being tested?
- muligan belt traction and Fisted traction
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 2 Jul 2025to 4 Sep 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 25 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Both Male and Female
- Clinically or radiologically diagnosed lower cervical radiculopathy(C5-C7)
- Neck pain radiating to the arm and hand
- Positive Spurling's Test or Upper Limb Tension test
- Subacute to chronic phase (>4 weeks to 6< weeks)
- Moderate pain (VAS> 4/10)
Show all 15Show fewer
- Evident by a score on Neck Disability Index (NDI >20%)
- Able and willing to give informed consent and follow the protocol
- Cervical spine active range of motion (CSAROM) Exclusion Criteria:• Cervical Fracture
- Thoracic outlet syndrome or carpal tunnel syndrome
- History of previous cervical surgery
- Osteoporosis of cervical spine
- Sign of myelopathy
- Severe cervical disc herniation with cord compression
- Red flag signs (Rheumatoid arthritis, history of trauma, ankylosing spondylitis, prolonged steroid used and malignancy
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Mulligan Belt Traction Versus Fisted Traction on Pain, Range of Motion and Disability Level in Patients With Lower Cervical Spine Radiculopathy
Individuals with a lower cervical spine radiculopathy diagnosis will undergo screening to determine their eligibility based on inclusion and exclusion criteria. Eligible participants will be asked for their informed consent
Read the detailed description
Participants will receive a unique identifying code to maintain confidentiality and be formally enrolled in the study upon obtaining informed consent. Following that, they will have baseline evaluations for outcome factors such as neck disability index, range of motion using goniometry and pain using a numerical pain rating scale. After completing the baseline evaluation, participants will be divided into two groups: Group A will receive a Mulligan Belt Traction, while Group B will receive a Fisted Traction. Every participant will get treatment for four weeks, with three sessions per week. At the conclusion of the intervention period, a post-intervention assessment will be carried out Randomization:Random allocation of participants into the two groups, Group A and Group B, will be performed by a lottery method. The participants of Group A will be managed by Mulligan Belt Traction while in Group B, participants will receive Fisted Traction. The physiotherapists will provide both interventions during a specified time period.
- Conditions
- Cervical Radiculopathy
- Being tested
- muligan belt traction, Fisted traction
- Keywords
- cervical spine rediculopathy, muligan belt traction, fisted traction, pain and disability
- Medical subject headings
- Radiculopathy, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
muligan belt tractionOther
Patient Position:
- The Patient lies supine on the treatment table.
- Head in neutral or slightly flexed position (according to comfort and symptoms).
- Arms rest by the sides.
Therapist Position:
- Therapist stands at the head end of table, therapist places the middle finger on the concerned cervical segment.
- To maintain joint contact and control movement at the level.
Belt Placement:
- The Mulligan belt is positioned at an angle to apply gentle traction targeting the lower cervical spine (C5-C7) (16)
- Make sure there is no pressure on the throat or jaw.
Application of Traction:
- While maintaining contact at the target segment, therapist leans backward, to apply gentle sustained and controlled traction (distraction force) along the line of the cervical spine.
- This help to open up the intervertebral foramen, reduce nerve compression and restore normal joint mechanics. (17)
Duration:
- Traction is applied for 10-30 seconds per repetition, repeated 3-5 times per session base
Fisted tractionOther
Sit upright in a chair with back support.
- Keep your spine straight and head in a neutral position.
Hand Placement:
- One fist is placed at the upper chest\sternum, acting as a fulcrum.
- A towel is used between the fist and chest for comfort and positioning.(18)
- The opposite hand is placed around the back of head (occiput).
Traction Technique:
- The head is pulled forward and down, guiding cervical flexion over the fist.
- Maintain for 10-15 seconds, repeat 5-10 times, depending on comfort.
| Study group | Role | What they receive |
|---|---|---|
| conventional group | Experimental | Conventional physiotherapy which include cervical traction, hot pack and isometric strengthening exercises for lower cervical radiculopathy Receives: Other: muligan belt traction; Other: Fisted traction |
| conventional therapy | Active comparator | Conventional physiotherapy which include cervical traction, hot pack and isometric strengthening exercises for lower cervical radiculopathy Receives: Other: muligan belt traction; Other: Fisted traction |
What is being measured
The primary outcome is the main question the study is designed to answer.
Neck Disability Index
The NDI contains 10 items - 7 relating to activities of daily living, 2 relating to pain and 1 relating to concentration items is scored from 0-5, and the total score is expressed as a percentage (total possible score, 100%), with higher scores corresponding to greater disability. Scoring the NDI: 0 - 4 = No disability 5 - 14 = Mild disability 15 - 24 = Moderate disability 25 - 34 = Severe disability 35 or over = Complete disability
Measured: baseline to 4 week
Numeric pain rating scale
The NPRS is a reliable and effective tool for measuring pain. A straight line is drawn on the evaluation sheet, labeled from '0' to '10', where '0' represents no pain and '10' indicates the worst possible pain. Patients are asked to mark a point on the line that reflects the intensity of pain they are experiencing at the time of assessment
Measured: baseline to 4 week
Cervical Range of Motion
Cervical Flexion (Looking Down) Position: The patient sits upright. Goniometer Axis: Placed at the external auditory meatus (ear). Stationary Arm: Kept perpendicular to the floor. Moving Arm: Aligned with the base of the nose. Normal Range: 0 to 45 degrees 2 Cervical Extension (Looking Up) Position: Patient remains seated upright. Goniometer Axis: Centered at the external auditory meatus. Stationary Arm: Vertical, perpendicular to the floor. Moving Arm: Follows the line of the nose. Normal Range: 0 to 45 degrees
- Cervical Lateral Flexion (Side Bending) Position: Patient sits straight. Goniometer Axis: Over the C7 spinous process. Stationary Arm: Aligned vertically along the spine. Moving Arm: Follows the midline of the head toward the occipital bone. Normal Range: 0 to 45 degrees 4.Cervical Rotation (Turning Head Side to Side) Position: Patient remains upright. Goniometer Axis: Placed at the top center of the head. Stationary Arm: Imaginary line between both shoulder tips.
Measured: baseline to 4 week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Jun 2026
- Study start2 Jul 2025
- Primary completion6 Aug 2026 (estimated)
- Study completion4 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Cervical RadiculopathyStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 44 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07628439
- Sponsor's protocol ID
- REC/RCR&AHS/25/0210
- Status last verified
- Jun 2026
- First submitted
- 1 Jun 2026
- Last updated
- 5 Jun 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: nill
Publications
Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. HSS J. 2011 Oct;7(3):265-72. doi: 10.1007/s11420-011-9218-z. Epub 2011 Sep 9.
PubMed 23024624Kim HJ, Nemani VM, Piyaskulkaew C, Vargas SR, Riew KD. Cervical Radiculopathy: Incidence and Treatment of 1,420 Consecutive Cases. Asian Spine J. 2016 Apr;10(2):231-7. doi: 10.4184/asj.2016.10.2.231. Epub 2016 Apr 15.
PubMed 27114762Peene L, Cohen SP, Brouwer B, James R, Wolff A, Van Boxem K, Van Zundert J. 2. Cervical radicular pain. Pain Pract. 2023 Sep;23(7):800-817. doi: 10.1111/papr.13252. Epub 2023 Jun 4.
PubMed 37272250
Study at a glance
From the registry record, last updated by the sponsor on 5 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Mulligan Belt Traction Versus Fisted Traction on Pain, Range of Motion and Disability Level in Patients With Lower Cervical Spine Radiculopathy
- ClinicalTrials.gov ID
- NCT07628439
- Acronym / sponsor ID
- REC/RCR&AHS/25/0210
- Conditions
- Cervical Radiculopathy
- Keywords
- cervical spine rediculopathy, muligan belt traction, fisted traction, pain and disability
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 44 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 2 Jul 2025 (actual)
- Primary completion
- 6 Aug 2026 (estimated)
- Study completion
- 4 Sep 2026 (estimated)
- First posted
- 5 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Individuals with a lower cervical spine radiculopathy diagnosis will undergo screening to determine their eligibility based on inclusion and exclusion criteria. Eligible participants will be asked for their informed consent
Detailed description
Participants will receive a unique identifying code to maintain confidentiality and be formally enrolled in the study upon obtaining informed consent. Following that, they will have baseline evaluations for outcome factors such as neck disability index, range of motion using goniometry and pain using a numerical pain rating scale. After completing the baseline evaluation, participants will be divided into two groups: Group A will receive a Mulligan Belt Traction, while Group B will receive a Fisted Traction. Every participant will get treatment for four weeks, with three sessions per week. At the conclusion of the intervention period, a post-intervention assessment will be carried out Randomization:Random allocation of participants into the two groups, Group A and Group B, will be performed by a lottery method. The participants of Group A will be managed by Mulligan Belt Traction while in Group B, participants will receive Fisted Traction. The physiotherapists will provide both interventions during a specified time period.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| conventional group | Experimental | Other: muligan belt traction, Other: Fisted tractionConventional physiotherapy which include cervical traction, hot pack and isometric strengthening exercises for lower cervical radiculopathy |
| conventional therapy | Active comparator | Other: muligan belt traction, Other: Fisted tractionConventional physiotherapy which include cervical traction, hot pack and isometric strengthening exercises for lower cervical radiculopathy |
Who may qualify
- Ages
- 25 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (15 listed)
- Both Male and Female
- Clinically or radiologically diagnosed lower cervical radiculopathy(C5-C7)
- Neck pain radiating to the arm and hand
- Positive Spurling's Test or Upper Limb Tension test
- Subacute to chronic phase (>4 weeks to 6< weeks)
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| muligan belt tractionPatient Position: * The Patient lies supine on the treatment table. * Head in neutral or slightly flexed position (according to comfort and symptoms). * Arms rest by the sides. Therapist Position: * Therapist stands at the head end of table, therapist places the middle finger on the concerned cervical segment. * To maintain joint contact and control movement at the level. Belt Placement: * The Mulligan belt is positioned at an angle to apply gentle traction targeting the lower cervical spine (C5-C7) (16) * Make sure there is no pressure on the throat or jaw. Application of Traction: * While maintaining contact at the target segment, therapist leans backward, to apply gentle sustained and controlled traction (distraction force) along the line of the cervical spine. * This help to open up the intervertebral foramen, reduce nerve compression and restore normal joint mechanics. (17) Duration: • Traction is applied for 10-30 seconds per repetition, repeated 3-5 times per session base | Other | conventional group, conventional therapy |
| Fisted tractionSit upright in a chair with back support. • Keep your spine straight and head in a neutral position. Hand Placement: * One fist is placed at the upper chest\sternum, acting as a fulcrum. * A towel is used between the fist and chest for comfort and positioning.(18) * The opposite hand is placed around the back of head (occiput). Traction Technique: * The head is pulled forward and down, guiding cervical flexion over the fist. * Maintain for 10-15 seconds, repeat 5-10 times, depending on comfort. | Other | conventional group, conventional therapy |
Primary outcome
Neck Disability Index
Time frame: baseline to 4 week
The NDI contains 10 items - 7 relating to activities of daily living, 2 relating to pain and 1 relating to concentration items is scored from 0-5, and the total score is expressed as a percentage (total possible score, 100%), with higher scores corresponding to greater disability. Scoring the NDI: 0 - 4 = No disability 5 - 14 = Mild disability 15 - 24 = Moderate disability 25 - 34 = Severe disability 35 or over = Complete disability
Numeric pain rating scale
Time frame: baseline to 4 week
The NPRS is a reliable and effective tool for measuring pain. A straight line is drawn on the evaluation sheet, labeled from '0' to '10', where '0' represents no pain and '10' indicates the worst possible pain. Patients are asked to mark a point on the line that reflects the intensity of pain they are experiencing at the time of assessment
Cervical Range of Motion
Time frame: baseline to 4 week
Cervical Flexion (Looking Down) Position: The patient sits upright. Goniometer Axis: Placed at the external auditory meatus (ear). Stationary Arm: Kept perpendicular to the floor. Moving Arm: Aligned with the base of the nose. Normal Range: 0 to 45 degrees 2 Cervical Extension (Looking Up) Position: Patient remains seated upright. Goniometer Axis: Centered at the external auditory meatus. Stationary Arm: Vertical, perpendicular to the floor. Moving Arm: Follows the line of the nose. Normal Range: 0 to 45 degrees 3. Cervical Lateral Flexion (Side Bending) Position: Patient sits straight. Goniometer Axis: Over the C7 spinous process. Stationary Arm: Aligned vertically along the spine. Moving Arm: Follows the midline of the head toward the occipital bone. Normal Range: 0 to 45 degrees 4.Cervical Rotation (Turning Head Side to Side) Position: Patient remains upright. Goniometer Axis: Placed at the top center of the head. Stationary Arm: Imaginary line between both shoulder tips.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jun 2026.
- Results publication: PubMed 23024624Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. HSS J. 2011 Oct;7(3):265-72. doi: 10.1007/s11420-011-9218-z. Epub 2011 Sep 9.
- Results publication: PubMed 27114762Kim HJ, Nemani VM, Piyaskulkaew C, Vargas SR, Riew KD. Cervical Radiculopathy: Incidence and Treatment of 1,420 Consecutive Cases. Asian Spine J. 2016 Apr;10(2):231-7. doi: 10.4184/asj.2016.10.2.231. Epub 2016 Apr 15.
- Results publication: PubMed 37272250Peene L, Cohen SP, Brouwer B, James R, Wolff A, Van Boxem K, Van Zundert J. 2. Cervical radicular pain. Pain Pract. 2023 Sep;23(7):800-817. doi: 10.1111/papr.13252. Epub 2023 Jun 4.
- Individual participant dataSharing planned: No. nill
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing muligan belt traction and Fisted traction in people with Cervical Radiculopathy, run by Riphah International University at 1 site in Pakistan.
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 15 inclusion and 0 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: under way, not looking for participants, as of the sponsor's last update on 5 Jun 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 Pakistan. 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?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Neck Disability Index (time frame: baseline to 4 week). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07628439, which also lists 3 linked publications.
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 5 Jun 2026.