The application of a pre-positioned upper cervical traction mobilization to patients with painful active cervical rotation impairment: A case series.

Background: Cervical mobilization and manipulation have been shown to improve cervical range of motion and pain. Cervical rotatory thrust manipulation has been associated with adverse patient reaction and damage to the V3 segment of the vertebral artery (VA).

Objective: To document and describe the effects of an upper cervical (UC) traction based mobilization on participants with restricted and painful cervical rotation and to document if the mobilization changed blood flow velocity through the vertebral artery.

Methods: This case series examined the effects of a traction based spinal mobilization on two different groups of participants. Group I included 93 participants with restricted bilateral cervical rotation that was also painful at end range. Group II included 30 different participants whose VA blood flow velocity was examined during the same mobilization. Pre- and post-mobilization active cervical rotation, pain intensity levels, and VA blood flow velocity during mobilization was documented.

Results: Paired T-tests were used to determine statistical significance for changes in cervical rotation, and VA blood flow velocity during mobilization. Ninety-three participants in group I demonstrated an average increase of 16 degrees of cervical rotation. No participant demonstrated an increase in pain, and no participant in group II (N= 30) demonstrated a change in VA blood flow velocity.

Conclusions: The application this UC traction based mobilization improved active cervical rotation, end range rotation pain response, did not cause pain during its application and did not alter blood flow through the VA during application.