Effects of Mulligan Belt Traction Versus Fisted Traction in Patients With Lower Cervical Spine Radiculopathy

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

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.

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

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.

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

3. 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.