CBP Research & Instructor
Private Practice New Market, Ontario, Canada
ABSTRACT
Objective: To investigate the effects of lumbar extension traction in patients with unilateral lumbosacral radiculopathy due to L5–S1 disc herniation.
Design: A randomized controlled study with six-month follow-up.
Setting: University research laboratory.
Subjects: Sixty-four patients with confirmed unilateral lumbosacral radiculopathy due to L5–S1 disc herniation and a lumbar lordotic angle less than 39°, randomly assigned to traction or control group.
Interventions: The control group (n = 32) received hot packs and interferential therapy, whereas the traction group (n = 32) received lumbar extension traction in addition to hot packs and interferential therapy.
Main outcome measures: Absolute rotatory angle, back and leg pain rating scale, Oswestry Disability Index, Modified Schober test, H-reflex (latency and amplitude) and intervertebral movements were measured for all patients three times (before treatment, after 10 weeks of treatment and at six-month follow-up).
Results: There was a significant difference between the traction group and the control group adjusted to baseline values at 10 weeks post treatment with respect to: absolute rotatory angle (P < 0.001), Oswestry Disability Index (P = 0.002), back and leg pain (P = 0.009, P = 0.005), Modified Schober test (P = 0.002), latency and amplitude of H-reflex (P = 0.01, P < 0.001), intervertebral movements (P < 0.05). At six-month follow-up there were statistically significant differences between the study and control groups for all the previous variables (P < 0.05).
Conclusion: The traction group receiving lumbar extension traction in addition to hot packs and interferential therapy had better effects than the control group with regard to pain, disability, H-reflex parameters and segmental intervertebral movements.
ABSTRACT
Objective: The purpose of this study was to investigate the effects of lumbar extension traction with stretching and infrared radiation compared with stretching and infrared radiation alone on the lumbar curve, pain, and intervertebral movements of patients with chronic mechanical low back pain (CMLBP).
Methods: This randomized clinical study with 3-month follow-up was completed at the Cairo University research laboratory. Eighty patients (age ranged from 40 to 50 years) with CMLBP and a hypolordotic lumbar spine were randomly assigned to traction or a comparison group. The comparison group (n = 40) received stretching exercises and infrared radiation, whereas the traction group (n = 40) received lumbar extension traction in addition to stretching exercises and infrared radiation. The absolute rotatory angle, intervertebral movements, and visual analog scale were measured for all patients at 3 intervals.
Results: The results revealed a statistically significant difference between the groups at 2 follow-up time points compared with the baseline values for the translational and sagittal rotational movements of L3-L4, L4-L5, L5-S1, and L2-L3(post treatment) and absolute rotatory angle (P < .01). There were no statistically significant changes in pain (P = .1 and .3) and L1-L2 (P = .072 and .076) or L2-L3 (at follow-up; P = .3), and there was no significant difference between all the previous variables adjusted to the groups' baseline outcome interaction (P > .01).
Conclusion: Lumbar extension traction with stretching exercises and infrared radiation was superior to stretching exercises and infrared radiation alone for improving the sagittal lumbar curve, pain, and intervertebral movement in CMLBP.