Multimodal Intervention of High-Intensity Laser with Neurodynamic Mobilization in Cervical Radiculopathy
Nawal Abd El-Raouf Abu Shady1, Hazem Mohammed Negm2, Zizy Mostafa Youssef Zitoun3*, Nadia Mohamed Abdelhakiem
Background: Cervical radiculopathy(CR) patients demonstrate sensori motor problems radiating along the distribution of a nerve root in the upper limb, multimodal therapeutic program had significant improvement in CR.
Aim: To investigate the effect of multimodal intervention including new combined effect of high-intensity laser (HILT) and neurodynamic mobilization on pain, cervical range of motion (CROM), hand grip strength, and neck disability index (NDI)in CR patients.
Methods: sixty patients with CR were randomly divided into three equal groups; group A: received median nerve neurodynamic mobilization, group B: received HILT and group C: received the multimodal intervention of median nerve neurodynamic mobilization and HILT, all the groups received also conventional treatment, for 3 sessions/week for four weeks. The Patients were assessed by CROM device, Hand grip dynamometer, Pain Visual Analogue Scale (VAS), and NDI.
Results: Showed a significant decrease in VAS and NDI, and a significant increase in hand grip strength and CROM in group B and group C more than group A, whilegroup C showed the most significant improvement (p < 0.0001). There was a negative significant correlation between (NDI and hand grip),(VAS and CROM) and (VAS and hand grip), and a strong positive significant correlation between (VAS and NDI).
Conclusion: The multimodal intervention program hadmore effects in decreasing pain, neck disability, increasing hand grip strength, and CROM. Therefore this multimodal program considered a potential rehabilitation for CR.
Keywords: high-intensity laser therapy , neurodynamic mobilization, median nerve, hand grip, cervical radiculopathy.