Denneroll extension traction

Participants in the intervention group received the Denneroll cervical orthotic (Denneroll Industries, Sydney, Australia; http://www.denneroll.com). In the current study, Denneroll cervical traction was used to restore the normal cervical alignment. This intervention was utilized because 3-ponit bending traction procedures have been found to improve cervical sagittal alignment in several previous studies^20,35–37. We followed previously published protocols and procedures for application of this orthotic^35–37. The Denneroll orthotic was performed in the physiotherapy clinic setting. The participants were instructed to lie supine on the floor, in a straightened position, with their arms gently folded across their stomach. The Denneroll was placed on the ground and the examiner positioned the apex of the Denneroll in one of two regions: the mid cervical spine (C4–C5) or the lower cervical spine (C6–T1) depending on the location of the apex or most kyphotic/straightened region of each participant’s cervical curvature deformity. Placement of the Denneroll at the apex of the cervical curve abnormality achieves maximum extension bending in that region. Note, both radiographic measurement and visualization of the cervical curvature abnormality on each participant’s spine radiograph was used to determine Denneroll placement^35–37.