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NCT Number: NCT07628439

Effects of Mulligan Belt Traction Versus Fisted Traction 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

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This study is active but is not currently recruiting participants.

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Key information

Conditions

Cervical Radiculopathy Nervous System Diseases Neurologic Manifestations Neuromuscular Diseases Pain Pathological Conditions, Signs and Symptoms Peripheral Nervous System Diseases Radiculopathy Signs and Symptoms

Age range

25 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Lahore, Punjab Province, 54000, Pakistan

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

• Age 25-60 years

  • 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)
  • 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

Treatment and study plan

muligan belt traction

Other

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 traction

Other

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.

Primary outcomes

  1. 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

  2. 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

  3. 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

    • 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.

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Official study title

Effects of Mulligan Belt Traction Versus Fisted Traction on Pain, Range of Motion and Disability Level in Patients With Lower Cervical Spine Radiculopathy

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jun 5, 2026
Registry last updated
Jun 5, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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