Proposition of patient stratification and parameter setting for mechanical traction in patients with LBP

Michał Igor Dylewski, Monika Dylewska, Alicja Kasprzak, Roman Bednorz, Jakub Maliszewski, Krzysztof Cygoń, Joanna Boczula



Mechanical traction of the lumbar spine remains a procedure very willingly used by therapists in many countries of the world, despite at least equivocal scientific evidence. One of the problems reducing its effectiveness is the problem with the selection of patients for therapy as well as selecting the therapeutic goals and treatment parameters for the patient in an individualized and, at the same time, repeatable manner. In this work, the authors presented such a model developed as part of Research and Development works carried out at the Leśny Dom Seniora in Piastów.


Low Back Pain; Mechanical traction; Lumbar Spine

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Andersson GB “Epidemiological features of chronic low-back pain” Lancet 1999; 354(9178): 581–5

Biering-Sorensen F “A prospective study of low back pain in a general population: I. Occurrence, recurrence, and etiology” Scand J Rehabil Med 1983; 15(2): 71–79

Dagenais S, Caro J, Haldeman S “A systematic review of low back pain cost of illness studies in the United States and internationally” Spine J 2008; 8(1): 8–20

Katz JN “Lumbar disc disorders and low-back pain: socioeconomic factors and consequences” J Bone Joint Surg Am 2006; 88(Suppl 2): 21–4

Hides JA, Richardson CA, Jull GA “Multifidus muscle recovery is not automatic after resolution of acute, first episodes low back pain” Spine 1996; 21:2763-9

Kiwerski J. „Rehabilitacja Medyczna” Wyd. Lekarskie PZWL, W-wa 2007

Kamper SJ et al.. „Treatment-based subgroups of low back pain: A guide to appraisal of research studies and a summary of current evidence” Best Practice & Research Clinical Rheumatology 2010; 24: 181–191

Savingy P et al. “Low back pain: early management of persistent non-specific low back pain. Full guideline” London: National Collaborating Centre for Primary Care and Royal College of General Practitioners; May 2009

Koes BW, van Tulder MW, Ostelo R, Burton AK, Waddell G “Clinical guidelines for the management of low back pain in primary care. An international comparison” Spine 2001; 26: 2504–2514

Adams M “Biomechanika bólu kręgosłupa” DB Publishing, Warszawa 2006. Wyd 2

Chou R, Qaseem A, Snow V, et al. “Diagnosis and Treatment of Low Back Pain: a joint clinical practice guideline from the american college of physicians and the American Pain Society” Ann Intern Med 2007; 147(7): 478–91

Delitto A “Research in low back pain: time to stop seeking the elusive ” Phys Ther 2005; 85(3): 202–4.

Fritz JM, Cleland JA, Childs JD “Subgrouping patient with low back pain: evolution of a classification approach to physical therapy” J Orthop Sports Phys Ther 2007; 37: 290–302)

Kent P, Keating J “Do Primary-Care Clinicians Think That Nonspecific Low Back Pain Is One Condition?” Spine 2004; 29(9): 1022–31

Kent P, Keating JL “Classification in nonspecific low back pain: what methods do primary care clinicians currently use? [Research Support, Non-U.S. Gov’t]” Spine 2005; 15;30(12):1433–40.

van Tulder MW et al. “European guidelines for the management of acute nonspecific low back pain in primary care” 2004 European Commission, Research Directorate General. COST B13 Working group []

Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M “Low back pain evidence review” Royal College of General Practitioners 1999, London

Marketos SG, Skiadas P. „Hippocrates. The father of spine surgery” Spine 1999; 24: 1381–7.

Harte AA, Baxter GD, Gracey JH “The efficacy of traction for back pain: a systematic review of randomized controlled trials” Arch Phys Med Rehabil 2003; 84(10): 1542–53

Krause M, Refshauge KM, Dessen M, Boland R “Lumbar spine traction: evaluation of effects and recommended application for treatment” Man Ther 2000; 5: 72–81.

van Tulder MW, Koes B, Malmivaara A “Outcome of non-invasive treatment modalities on back pain: an evidence-based review” Eur Spine J 2006b; 15(Suppl.): S64–81.

Clarke JA et al. “Traction for low-back pain with or without sciatica” Cochrane Database Syst Rev 2007 ;2: CD003010

Gay RE,. Brault JS, “Evidence-informed management of chronic low back pain with traction therapy” The Spine Journal 2008; 8: 234–242

Harte AA, Gracey JH and Baxter GD “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

Li LC, Bombardier C “Physical therapy management of low back pain: an exploratory survey of therapist approaches” Phys Ther 2001; 81(4): 1018–28

Poitras S, Blais R, Swaine B et al. „Management of Work-Related Low Back Pain: A Population-based Survey of Physical Therapists” Phys Ther 2005; 85:1168-81

Webster BS, Courtney TK, Huang YH et al. “Survey of Acute Low Back Pain Management by Specialty Group and Practice Experience” J Occup Environ Med 2006; 48: 723-32

Foster NE, Thompson KA, Baxter GD, Allen JM. Management of non-specific low back pain by physiotherapists in Britain and Ireland. Spine 1999;24:1332-42

Gracey JH, McDonough SM, Baxter GD. Physiotherapy management of low back pain: a survey of current practice in Northern Ireland. Spine 2002;27:406-11

Van der Heijdan GJ, Beurskens AJ, Dirk MJ, Bouter LM, Lindeman E. Efficacy of lumbar traction: a randomised clinical trial. Physiotherapy 1995;81:29-35

Jette AM, Delitto A. Physical therapy treatment choices for musculoskeletal impairments. Phys Ther 1997;77:145-54

Fritz JM et al “Is There a Subgroup of Patients with Low Back Pain Likely to Benefit from Mechanical Traction? Results of a Randomized Clinical Trial and Subgrouping Analysis” Spine 2007; 32(26): E793-E800

Raney N et al. ‘‘Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise’’ Eur Spine J 2009; 18: 382–391

Congcong Cai, Yong Hao Pua, Kian Chong Lim “A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction” Eur Spine J 2009; 18: 554–561

Fritz J M, Thackeray A, Childs J D, Brennan G P “Randomized clinical trial of the effectiveness of mechanical traction for sub-groups of patients with low back pain: study methods and rationale” BMC Musculoskeletal Disorders 2010, 11:81

Saunders DH “Lumbar Traction” The Journal of orthopedic and sport physical therapy 1979; pp 36 – 42

Saunders DH “The Controversy over Traction for Neck and Low Back Pain” Physiotherapy; 1998, vol 84, no 6: 285-289

Saunders HD, Ryan RS “Evaluation, Treatment and Prevention of Musculoskeletal Disorders, Volume 1: The Spine” The Saunders Group, Chaska, MN 2004. 4th Edition

Kane MD, Karl RD, Swain JH “Effects of Gravity-Facilitated Traction on lntervertebral Dimensions of the Lumbar Spine” JOSPT 1985, Vol. 6, No. 5

Onel D, Tuzlaci M, Sari H, et al. “Computed Tomographic Investigation of the Effect of Traction on Lumbar Disc Herniations” Spine 1989;14: 82-90

Sari H, Akarirmak U, Karacan I et al „Computed tomographic evaluation of lumbar spinal structures during traction” Physiother Theory Pract 2005; 21: 3-11.

Mathews JA “Dynamic discography: A study of lumbar traction” Ann Phys Med 1968; IV: 275-279

Gay RE et al.. “Stress in lumbar intervertebral discs during distraction: a cadaveric study” Spine J 2008; 8: 982-90

Ferrara L, Triano JJ, Sohn MJ et al. “A biomechanical assessment of disc pressures in the lumbosacral spine in response to external unloading forces” Spine J 2005; 5: 548-53.

Ramos G, Martin W “Effects of vertebral axial decompression on intradiscal pressure” J Neurosurg 1994; 81: 350-3.

Ranu HS “Measurement of pressures in the nucleus and within the annulus of the human spinal disc: due to extreme loading” Proc Inst Mech Eng H 1990; 204: 141-6.

Gupta RC, Ramarao SV “Epidurography in the Reduction of Lumbar Disc Prolapse by Traction. Archives of Physical Medicine and Rehabilitation 1978; 59: 322-327

Ozturk B et al “Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation” Rheumatol Int 2006; 26: 622–626

Saal JA, Saal JS “Nonoperative Treatment of Herniated Lumbar Intervertebral disc with Radiculopathy. An Outcome Study” Spine 1989; 14(4): 431-437

Meszaros T, et al. “Effect of 10%, 30% and 60% Body Weight on the Straight Leg Raise Test of Symptomatic Patients with Low Back Pain” J Orthop Sports Phys Ther 2000; 30(10): 595-601

Cholewicki J et al. “Trunk muscle response to various protocols of lumbar traction” Manual Therapy 2009; 14: 562–566

Letchuman R, Deusinger RH “Comparison of sacrospinalis myoelectric activity and pain levels in patients undergoing static and intermittent lumbar traction” Spine 1993; 18(10): 1361–5

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Journal of Education, Health and Sport formerly Journal of Health Sciences

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