THE RELATIONSHIP BETWEEN STRUCTURAL AND CLINICAL CHANGES IN SEATED COMBINED EXTENSION-COMPRESSION AND TRANSVERSE LOAD (ECTL) TRACTION IN INCREASING CERVICAL LORDOSIS: A RANDOMISED CONTROLLED TRIAL

Purpose: The aim was to assess for any relationships in changes between improved cervical lordosis and clinical outcomes of neck pain and disability. Methods: Single center, randomized controlled trial in Malaysia, to compare seated combined extension-compression and transverse load (ECTL) traction combined with exercises, to the same exercises. Participants with a reduced lordosis of less than [Formula: see text] were randomly assigned into groups, and underwent 40 treatments over 14 weeks. Pre and post lateral radiographs were reviewed by a blinded musculoskeletal radiologist for changes in cervical lordosis. VAS and Neck Disability Index (NDI) scores were used to assess clinical outcomes. Correlations between changes in curve and changes in pain and disability were assessed. Non-parametric analyses were performed on all who completed ([Formula: see text]). Results: No significant correlations between changes in lordosis and pain and disability were seen, with rho less than 0.33 and 0.24, respectively. Pain scores improved significantly in both treatment and control groups ([Formula: see text]). Disability scores also showed significant decrease in both treatment ([Formula: see text]) and control ([Formula: see text]) groups, despite a non-significant reduction in lordosis. Conclusions: Improvement in neck pain and disability did not require an improvement in lordosis. Abnormal sagittal cervical alignment therefore, is perhaps not the sole underlying cause for clinical outcomes, and a number of other psychosocial factors when considering management options.