OBJECTIVE: To determine outcomes after administration of a prone lumbar traction protocol. DESIGN: Prospective, longitudinal, case series. SETTING: Suburban, chiropractic practice. PARTICIPANTS: A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or more levels of the lumbar spine. We excluded patients involved in litigation and those receiving workers' compensation. INTERVENTION: An 8-week course of prone lumbar traction, using the vertebral axial decompression (VAX-D) system, consisting of five 30-minute sessions a week for 4 weeks, followed by one 30-minute session a week for 4 additional weeks. MAIN OUTCOME MEASURES: The numeric pain rating scale and the Roland-Morris Disability Questionnaire (RMDQ) were completed at preintervention, discharge (within 2 weeks of the last visit), and at 30 days and 180 days after discharge. Intention-to-treat strategies were used to account for those subjects lost to follow-up. RESULTS:A total of 250 (84.4%) subjects completed the treatment protocol. On the 30-day follow-up, 247 (83.4%) subjects were available; on the 180-day follow-up, data were available for 241 (81.4%) subjects. We noted significant improvements for all postintervention outcome scores when compared with preintervention scores (P<.01). CONCLUSIONS: Traction applied in the prone position using the VAX-D for 8 weeks was associated with improvements in pain intensity and RMDQ scores at discharge, and at 30 and 180 days after discharge in a sample of patients with activity-limiting LBP. Causal relationships between these outcomes and the intervention should not be made until further study is performed using randomized comparison groups.
RCT Entities:
OBJECTIVE: To determine outcomes after administration of a prone lumbar traction protocol. DESIGN: Prospective, longitudinal, case series. SETTING: Suburban, chiropractic practice. PARTICIPANTS: A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or more levels of the lumbar spine. We excluded patients involved in litigation and those receiving workers' compensation. INTERVENTION: An 8-week course of prone lumbar traction, using the vertebral axial decompression (VAX-D) system, consisting of five 30-minute sessions a week for 4 weeks, followed by one 30-minute session a week for 4 additional weeks. MAIN OUTCOME MEASURES: The numeric pain rating scale and the Roland-Morris Disability Questionnaire (RMDQ) were completed at preintervention, discharge (within 2 weeks of the last visit), and at 30 days and 180 days after discharge. Intention-to-treat strategies were used to account for those subjects lost to follow-up. RESULTS: A total of 250 (84.4%) subjects completed the treatment protocol. On the 30-day follow-up, 247 (83.4%) subjects were available; on the 180-day follow-up, data were available for 241 (81.4%) subjects. We noted significant improvements for all postintervention outcome scores when compared with preintervention scores (P<.01). CONCLUSIONS: Traction applied in the prone position using the VAX-D for 8 weeks was associated with improvements in pain intensity and RMDQ scores at discharge, and at 30 and 180 days after discharge in a sample of patients with activity-limiting LBP. Causal relationships between these outcomes and the intervention should not be made until further study is performed using randomized comparison groups.
Authors: Anthony Delitto; Steven Z George; Linda Van Dillen; Julie M Whitman; Gwendolyn Sowa; Paul Shekelle; Thomas R Denninger; Joseph J Godges Journal: J Orthop Sports Phys Ther Date: 2012-03-30 Impact factor: 4.751
Authors: Janneke J P Schimmel; M de Kleuver; P P Horsting; M Spruit; W C H Jacobs; J van Limbeek Journal: Eur Spine J Date: 2009-05-31 Impact factor: 3.134