Clinical response and autonomic modulation as seen in heart rate variability in mechanical intermittent cervical traction: A pilot study

Objective: To determine the influence of mechanical intermittent cervical traction on the autonomic system. Design: Prospective, cases series study. Subjects: Sixteen healthy volunteers without contraindications for cervical traction. Methods: Subjects received mechanical intermittent cervical traction in a sitting position under two traction forces (10% and 20% of total body weight). Electrocardiographic and neck surface electromyographic signals were recorded and analysed from 3 5-min periods (before, during and after traction). Subjective symptoms, heart rate and heart rate variability parameters, including standard deviation of all normal-to-normal beat intervals, very low-frequency power, low-frequency power, high-frequency power, multiscale entropy, slope of multiscale entropy, and root mean square value of electromyography amplitude were statistically compared. Results: This pilot study showed that using 10% body weight traction force was more comfortable than using 20% body weight. Only subtle perturbation was noted in the autonomic system when using 20% body weight traction force. Conclusion: The response pattern of heart rate variability analysis in this pilot study provides some early information about individual discomfort in cervical traction. The autonomic modulation and the safety of cervical traction with other modality settings or in patients with neck pain require further study.