The effect of sensorimotor retraining intervention in the management of persistent pain due to cervical radiculopathy

Abstract

Background. Recent evidence suggests that Sensorimotor Retraining (SMR) offers positive outcomes for patients suffering with Nonspecific Low Back Pain (Wand 2010). The objective behind this study is to evaluate the effects of SMR in patients with persistent  Cervical Radiculopathy (PCR).

Design. Multiple baseline single –subject A1-B-A2 research design

Method. A case series of five subjects complaining of unilateral PCR participated in graded SMR program and were evaluated using validated outcome measures, weekly during an eight week period of this study.

Results. The DrG goniometer app (ROM) and the tuning fork showed high Intraclass correlation coefficients (ICC’s) for flexion (0.800), abduction (0.714) and timed vibration test (TVT) (0.891). Patients reported significant short-term reductions in pain intensity and disability. Wilcoxon rank test’s post-intervention score was statistically significant. For the S-LANNS z=-2.060, p=0.039, NPRS: Z=-2.041, p=0.041, with median pain score rating dropped from 6.00 to 3.00.  T-test results for PSFS showed: t (4) = -5.138, p<0.007, while the NDI t-test was: t (4) =4.550, p<0.010.  However, there was a limited mean average improvement of 7⁰ to 9⁰ in flexion and abduction ROM’s, in spite of statistical significance. Post-hoc power analysis yielded statistically significant values (PSFS-0.96, NPRS-0.99, NDI-0.91, and S-LANSS-0.99)

Conclusion. SMR retraining offers short-term pain reduction and improvement in the disability of patients suffering from PCR pathology. However these preliminary results should be weighed with caution as it was carried out in a private practice setting and the longer term effects still need to be evaluated in a more-robust research design study.