Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 269-274 , February 2008

Outcomes After a Prone Lumbar Traction Protocol for Patients With Activity-Limiting Low Back Pain: A Prospective Case Series Study

Presented in part to the Combined Sections of the American Physical Therapy Association, February 26, 2005, Nashville, TN.

  • Paul F. Beattie, PhD, PT, OCS

      Affiliations

    • Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
    • Corresponding Author InformationReprint requests to Paul Beattie, PhD, PT, OCS, Program in Physical Therapy, Dept of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208
    • ,
  • Roger M. Nelson, PhD, PT

      Affiliations

    • Expert Clinical Benchmarks LLC, King of Prussia, PA
    • Department of Physical Therapy, Lebanon Valley College, Annville, PA
    • ,
  • Lori A. Michener, PhD, PT, ATC, SCS

      Affiliations

    • Department of Physical Therapy, Virginia Commonwealth University—Medical College of Virginia Campus, Richmond, VA
    • ,
  • Joseph Cammarata, DC

      Affiliations

    • Non-Surgical Solutions LLC, Narberth, PA
    • ,
  • Jonathan Donley, DPT

      Affiliations

    • Department of Internal Medicine, Richland-Palmetto Health, Columbia, SC.

References 

  1. Cyriax J. Textbook of orthopedic medicine. In: Vol 1: Diagnosis of soft tissue lesions. London: Bailliere Tindall; 1981;p. 484;493-7
  2. Li C, Bombardier C. Physical therapy management of back pain: an exploratory survey of therapist approaches. Phys Ther. 2001;81:1018–1028
  3. Harte A, Gracey J, Baxter G. Current use of lumbar traction in the management of low back pain: results of a survey of physiotherapists in the United Kingdom. Arch Phys Med Rehabil. 2005;86:1164–1169
  4. Borman P, Keskin D, Bodur H. The efficacy of lumbar traction in the management of patients with low back pain. Rheumatol Int. 2003;23:82–86
  5. van der Heijden G, Beurskens A, Koes B, Assendelft W, de Vet H, Bouter L. The efficacy of traction for back and neck pain: a systematic, blinded review of randomized clinical trial methods. Phys Ther. 1995;75:93–104
  6. Krause M, Refshauge K, Dessen M, Boland R. Lumbar spine traction: evaluation of effects and recommended application for treatment. Man Ther. 2000;5:72–81
  7. Harte A, Baxter G, Gracey J. The efficacy of traction for back pain: a systematic review of randomized controlled trials. Arch Phys Med Rehabil. 2003;84:1542–1553
  8. Beurskens A, de Vet H, Koke A, et al. Efficacy of traction for nonspecific low back pain: 12-week and 6-month results of a randomized clinical trial. Spine. 1997;22:2756–2762
  9. Maher C. Effective physical treatment for chronic low back pain. Orthop Clin North Am. 2004;35:57–64
  10. van Tulder M, Koes B, Bouter L. Conservative treatment of acute and chronic nonspecific low back pain: a systematic review of randomized controlled trials of the most common interventions. Spine. 1997;22:2128–2156
  11. Clarke J, van Tulder M, Biomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine. 2006;31:1591–1599
  12. Bigos S, Bowyer O, Braen G, et al. Acute low back pain in adults. Clinical practice guideline no. 14 Rockville: Dept of Health and Human Services; 1994;AHCPR Publication No. 95-0642
  13. Philadelphia Panel. Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for low back pain. Phys Ther. 2001;81:1641–1674
  14. VAX-D. Available at: http://www.vax-d.com. Accessed November 27, 2006.
  15. Tilaro F. An overview of vertebral axial decompression. Can J Clin Med. 1998;5:2–7
  16. Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg. 1994;13:350–353
  17. Naguszewski W, Naguszewski R, Gose E. Dermatomal somatosensory evoked potential demonstration of nerve root decompression after VAX-D therapy. Neurol Res. 2001;23:706–714
  18. Gose E, Naguszewski W, Naguszewski R. Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Neurol Res. 1998;20:186–190
  19. Sherry E, Kitchener P, Smart R. A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain. Neurol Res. 2001;7:780–784
  20. Jensen M, Karoly P, Beaver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27:117–126
  21. Price D, McGrath P, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45–56
  22. Roland M, Morris R. A study of the natural history of back pain (Part I: Development of a reliable and sensitive measure of disability in low back pain). Spine. 1983;8:141–144
  23. Lee J, Hobden E, Stiell I, Wells G. Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med. 2003;10:1128–1130
  24. Farrar J, Young J, LaMoreaux L, Werth J, Poole R. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94:149–158
  25. Ostelo R, de Vet H, Knol D, van den Brandt A. 24-item Roland-Morris Disability Questionnaire was preferred out of six functional status measures for post-lumbar disc surgery. J Clin Epidemiol. 2004;57:268–276
  26. Stratford P, Binkley J, Solomon P, Gill C, Finch E. Assessing change over time in patients with low back pain. Phys Ther. 1994;74:528–533
  27. Stratford P, Binkley J, Solomon P, Finch E, Gill C, Moreland J. Defining the minimum level of detectable change for the Roland-Morris Questionnaire. Phys Ther. 1996;76:359–365
  28. Streiner D, Geddes J. Intention-to-treat analysis in clinical trials when there are missing data. Evid Based Ment Health. 2001;4:70–71
  29. Ruiz-Canela M, Martinez-Gonzales M, de Irala-Estevez J. Intention-to-treat analysis is related to methodologic quality. BMJ. 2000;320:1007–1008
  30. Ottenbacher K, Barrett K. Measures of effect size in the reporting of rehabilitation research. Am J Phys Med Rehabil. 1989;68:52–58
  31. Deen G, Rizzo T, Fenton D. Sudden progression of lumbar disk protrusion during vertebral axial decompression traction therapy. Mayo Clin Proc. 2003;78:1554–1556
  32. Lancourt J, Kettelhut M. Predicting return to work for lower back pain patients receiving worker’s compensation. Spine. 1992;17:629–640
  33. Turner J, Deyo R, Loeser J, Von Korff M, Fordyce WE. The importance of placebo effects in pain treatment and research. JAMA. 1994;271:1609–1614
  34. Deyo R. Practice variations, treatment fads, rising disability (Do we need a new clinical research paradigm?). Spine. 1993;18:2153–2162
  35. Haldeman S. North American Spine Society: failure of the pathology model to predict back pain. Spine. 1990;15:718–724
  36. Beattie P, Meyers S, Stratford P, Millard R, Hollenberg G. Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance. Spine. 2000;25:819–828

 Supported, in part, by a grant from Independence Blue Cross.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01669-3

doi: 10.1016/j.apmr.2007.06.778

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 2 , Pages 269-274 , February 2008

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