Immediate Changes in Spinal Height and Pain After Aquatic Vertical Traction in Patients With Persistent Low Back Symptoms: A Crossover Clinical Trial

Simmerman, S. M.; Sizer, Phillip S.; Dedrick, Gregory S.; Apte, Gail; Brismée, Jean‐Michel

doi:10.1016/j.pmrj.2011.01.010

Cited by 22 publications

(20 citation statements)

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“…Kim et al found the a tilt degree of 60 resulted in improve levels of pain, spine flexibility and trunk extensors strength compared to tilt degrees of 30 or 0 (supine position) [ 13 ]. Further, Simmerman et al found that aquatic traction resulted in significant pain reduction and centralization of symptoms compared to land-based exercises in patients with chronic LBP associated with nerve root compression symptoms [ 14 ]. Finally, Diab and Moustafa found that traction in combination with stretching and infrared radiation resulted in significant improvement of pain and disability levels compared to stretching and infrared in patients with chronic LBP at 6 months [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of variability in traction interventions for patients with low back pain: a systematic review

2018

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BackgroundPrevious systematic reviews have concluded that lumbar traction is not effective for patients with low back pain (LBP), yet many clinicians continue to assert its clinical effectiveness.ObjectiveTo systematically identify randomized controlled trials (RCTs) of traction and explore the variability of traction interventions used in each RCT.MethodA literature search started in September 2016 to retrieve systematic reviews and individual RCTs of lumbar traction. The term “lumbar traction” and other key words were used in the following databases: Cochrane Registry, MEDLINE, EMBASE, and CINAHL. The retrieved systematic reviews were used to extract individual RCTs. The most current systematic review included RCTs from inception until August 2012. We performed an additional literature search to update this systematic review with newer RCTs published between September 2012 and December 2016. All of the identified RCTs were combined and summarized into a single evidence table.ResultsWe identified a total of 37 traction RCTs that varied greatly in their method of traction intervention. The RCTs included several types of traction: mechanical (57%), auto-traction (16%), manual (10.8%), gravitational (8.1%) and aquatic (5.4%). There was also great variability in the types of traction force, rhythm, session duration and treatment frequency used in the RCTs. Patient characteristics were a mixture of acute, subacute and chronic LBP; with or without sciatica.ConclusionThere is wide variability in the type of traction, traction parameters and patient characteristics found among the RCTs of lumbar traction. The variability may call into question the conclusion that lumbar traction has little no or value on clinical outcomes. Also, this variability emphasizes the need for targeted delivery methods of traction that match appropriate dosages with specific subgroups of patients with LBP.

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Section: Introductionmentioning

confidence: 99%

Assessment of variability in traction interventions for patients with low back pain: a systematic review

2018

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“…However, if we studied the overall impact of swimming, it would most probably be evident that while swimming has beneficial effects on muscles and the spine, in general, because muscles actively engaged in swimming contract, the stretching in the spine is less effective than in an inactive, relaxed position during hydrotraction suspension. Simmerman et al showed in a crossover trial with 30 participants that the aquatic vertical traction results in short-term improvements of the low back pain (Simmerman et al 2011 ).…”

Section: Discussionmentioning

confidence: 99%

“…Another study showed that land-based therapeutic exercise in chronic LBP with nerve compression symptoms are not so effective in pain reduction if the patient first receives aquatic traction therapy (Simmerman et al 2011 ) .…”

Section: Introductionmentioning

confidence: 99%

A multicentre randomized controlled follow-up study of the effects of the underwater traction therapy in chronic low back pain

Gáti¹,

Czímer²,

Cserháti

et al. 2020

Int J Biometeorol

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Low back pain (LBP) is one of the most costly diseases in the developed world. This study aimed to investigate the effects of underwater traction therapy on chronic low back pain. The primary objective was to prove that underwater traction therapy has favorable effects on LBP. Our secondary objective was to evaluate whether it also leads to improvement in the quality of life. This is a prospective, multicenter, follow-up study. A total of 176 patients with more than 3 months of low back pain enrolled from outpatient clinics were randomized into three groups: underwater weight bath traction therapy and non-steroidal anti-inflammatory drugs (NSAIDs); weight bath; and only NSAIDs. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: levels of low back pain in rest and during activity were tested using the visual analogue scale (VAS), the Oswestry Low Back Disability Questionnaire, and the EuroQol-5D-5L Questionnaire. The VAS levels improved significantly ( p < 0.05) in both underwater weight bath traction therapy groups by the end of the treatment, whereas the improvement in the third group was not statistically significant. Furthermore, the improvements measured in the groups receiving traction therapy were persistent during the follow-up period. There were no significant changes in the Oswestry Index or the EuroQol-5D-5L without VAS parameters in any of the groups. Based on our results, for patients suffering from LBP pain who underwent underwater weight bath traction therapy, there were favorable impacts on the pain levels at rest or during activity. Clinical trial registration ID: NCT03488498, April 5, 2018

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“… 35 The divergence between clinical practice and recommendations from systematic reviews may be related to the empirical evidence that supports the benefits of lumbar traction. 35 – 37 These studies indicated the potential efficacy of NSSD in patients with LBP.…”

Section: Introductionmentioning

confidence: 90%

Impact of nonsurgical spinal decompression on paraspinal muscle morphology and mechanical properties in young adults with low back pain

Lei

Leng

et al. 2020

J Int Med Res

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Objective The mechanism underlying the benefit of nonsurgical spinal decompression (NSSD) on low back pain is unclear. This study was performed to investigate the immediate impact of NSSD on the mechanical properties and morphology of the paraspinal muscles. Methods Participants with low back pain were recruited. NSSD therapy was provided on one occasion. A myotonometer was placed perpendicularly on the skin surface over the paraspinal muscle at the level of L3/L4 to measure the mechanical muscle properties. The multifidus thickness was measured using B-mode ultrasound and defined as the distance between the transverse process and subcutaneous tissue fascia. The difference between before and after NSSD was analyzed by a paired t-test. Results Thirty participants (mean age, 20.9 ± 0.8 years; 9 male, 21 female) were recruited. No significant difference was observed in the muscle mechanical properties or morphology between before and after the intervention. Conclusions NSSD intervention did not induce immediate changes in the paraspinal muscle mechanical properties or multifidus thickness in young adults with low back pain. NSSD might produce benefits by stimulating mechanical receptors rather than inducing morphological changes or mechanical property alterations of the muscle fibers. These parameters may not be suitable outcome measures for NSSD intervention.

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Immediate Changes in Spinal Height and Pain After Aquatic Vertical Traction in Patients With Persistent Low Back Symptoms: A Crossover Clinical Trial

Abstract: Although both the aquatic and land interventions produced significant increases in overall spinal height, the aquatic intervention produced greater pain relief and centralization response in subjects with low back pain and signs of nerve root compression.

Cited by 22 publications

References 50 publications

Assessment of variability in traction interventions for patients with low back pain: a systematic review

Assessment of variability in traction interventions for patients with low back pain: a systematic review

A multicentre randomized controlled follow-up study of the effects of the underwater traction therapy in chronic low back pain

Impact of nonsurgical spinal decompression on paraspinal muscle morphology and mechanical properties in young adults with low back pain

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