Plane-Specific Recovery of Cervical Range of Motion after Traction-Augmented versus Exercise-Only Therapy: A Motion-Selective Reanalysis in Generalized Neck Pain

Abstract

Background: Mechanical cervical traction is frequently added to exercise-based physiotherapy for generalized neck pain, yet cervical range-of-motion outcomes may not respond uniformly across movement directions. Objective: To conduct an exploratory motion-plane-specific secondary analysis of pain and cervical mobility after traction-augmented conventional therapy compared with conventional therapy alone. Methods: Data from a randomized controlled trial of 22 adults with generalized neck pain were analysed. Participants received cervical traction plus conventional therapy (n=11) or conventional therapy alone (n=11) for six sessions over three weeks. Flexion, extension, bilateral lateral flexion, rotation, and Numeric Pain Rating Scale scores were assessed before and after treatment using paired- and independent-samples t-tests. Results: The traction-augmented group had higher post-intervention flexion (85.00 ± 2.41° vs 65.27 ± 2.28°), extension (64.73 ± 2.80° vs 46.55 ± 2.38°), left lateral flexion (39.09 ± 3.24° vs 25.27 ± 3.61°), and right lateral flexion (36.91 ± 5.49° vs 24.73 ± 3.10°), and lower pain scores (2.00 ± 0.89 vs 5.82 ± 0.75; all p<0.05). Rotation was higher after conventional therapy alone (82.73 ± 5.26° vs 60.18 ± 2.82°, p=0.003). Conclusion: The observed response was not uniform across cervical movement directions. The motion-specific pattern is exploratory and requires confirmation in adequately powered prospective studies using standardized outcomes and formal interaction analyses