Demonstration of central conduction time and neuroplastic changes after cervical lordosis rehabilitation in asymptomatic subjects: a randomized, placebo-controlled trial

Ibrahim M Moustafa, Aliaa A Diab, Fatma Hegazy, Deed E Harrison, Ibrahim M Moustafa, Aliaa A Diab, Fatma Hegazy, Deed E Harrison

Abstract

A randomized controlled study was conducted to evaluate the effect of rehabilitation of the cervical sagittal configuration on sensorimotor integration and central conduction time in an asymptomatic population. Eighty (32 female) participants with radiographic cervical hypolordosis and anterior head translation posture were randomly assigned to either a control or an experimental group. The experimental group received the Denneroll cervical traction while the control group received a placebo treatment. Interventions were applied 3 × per week for 10 weeks. Outcome measures included radiographic measured anterior head translation distance, cervical lordosis (posterior bodies of C2-C7), central somatosensory conduction time (latency) (N13-N20), and amplitudes of potentials for spinal N13, brainstem P14, parietal N20 and P27, and frontal N30. Outcomes were obtained at: baseline, after 10 weeks of intervention, and at 3 months follow up. After 10 weeks and 3-months, between-group analyses revealed statistically significant differences between the groups for the following measured variables: lordosis C2-C7, anterior head translation, amplitudes of spinal N13, brainstem P14, parietal N20 and P27, frontal N30 potentials (P < 0.001), and conduction time N13-N20 (P = 0.004). Significant correlation between the sagittal alignment and measured variables were found (P < 0.005). These findings indicate restoration of cervical sagittal alignment has a direct influence on the central conduction time in an asymptomatic population.

Conflict of interest statement

DEH is the CEO of a company that is licensed to sell the Denneroll orthotics to spine health care providers/physicians in the USA. DEH lectures in post graduate courses for continuing education credit for Chiropractic physicians and Physical therapists. IMM, AAD, and FH all have nothing to declare.

© 2021. The Author(s).

Figures

Figure 1
Figure 1
On the far left, the Denneroll orthotic is shown with a mid-cervical spine placement. In the middle, the placebo as a rolled cervical hydrocollator towel is shown placed in the mid-cervical spine. On the far right, a closeup of the placebo treatment is shown for the control group as a cervical hydro-collator towel. Copyright CBP Seminars, Inc. All rights reserved, reprinted with permission, and informed consent from all persons depicted was obtained.
Figure 2
Figure 2
A diagram of patients’ retention and randomization throughout the study.
Figure 3
Figure 3
A representative example of spinal, cortical and sub-cortical findings at three intervals of measurement: baseline or pre-treatment, following 10-weeks of treatment, and 3-month follow-up.
Figure 4
Figure 4
A representative example of central conduction time (N13–N20) at three intervals of measurement: baseline or pre-treatment, following 10-weeks of treatment, and 3-month follow-up. Time is shown in ms.
Figure 5
Figure 5
A statistically significant, multiple regression model to predict central conduction N13–N20 from cervical lordosis (absolute rotation angle or ARA C2–C7) and anterior head translation (AHT) was identified for the intervention group as no such relationship existed for the control/placebo group. Left: the 10-week versus pre-treatment (P < 0.001). On the right: the 3-month follow-up versus pre-treatment (P < 0.001). Note as AHT reduces towards 0 mm and lordosis ARA C2–C7 becomes more lordotic, N13–N20 becomes faster in time.

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