No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy
- PMID: 19484433
- PMCID: PMC2899427
- DOI: 10.1007/s00586-009-1044-3
No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy
Abstract
Low back pain (LBP) poses a significant problem to society. Although initial conservative therapy may be beneficial, persisting chronic LBP still frequently leads to expensive invasive intervention. A novel non-invasive therapy that focuses on discogenic LBP is Intervertebral Differential Dynamics Therapy (IDD Therapy, North American Medical Corp. Reg U.S.). IDD Therapy consists of intermittent traction sessions in the Accu-SPINA device (Steadfast Corporation Ltd, Essex, UK), an FDA approved, class II medical device. The intervertebral disc and facet joints are unloaded through axial distraction, positioning and relaxation cycles. The purpose of this study is to investigate the effect of IDD Therapy when added to a standard graded activity program for chronic LBP patients. In a single blind, single centre, randomized controlled trial; 60 consecutive patients were assigned to either the SHAM or the IDD Therapy. All subjects received the standard conservative therapeutic care (graded activity) and 20 sessions in the Accu-SPINA device. The traction weight in the IDD Therapy was systematically increased until 50% of a person's body weight plus 4.45 kg (10 lb) was reached. The SHAM group received a non-therapeutic traction weight of 4.45 kg in all sessions. The main outcome was assessed using a 100-mm visual analogue scale (VAS) for LBP. Secondary outcomes were VAS scores for leg pain, Oswestry Disability Index (ODI), Short-Form 36 (SF-36). All parameters were measured before and 2, 6 and 14 weeks after start of the treatment. Fear of (re)injury due to movement or activities (Tampa Scale for Kinesiophobia), coping strategies (Utrecht Coping List) and use of pain medication were recorded before and at 14 weeks. A repeated measures analysis was performed. The two groups were comparable at baseline in terms of demographic, clinical and psychological characteristics, indicating that the random allocation had succeeded. VAS low back pain improved significantly from 61 (+/-25) to 32 (+/-27) with the IDD protocol and 53 (+/-26) to 36 (+/-27) in the SHAM protocol. Moreover, leg pain, ODI and SF-36 scores improved significantly but in both groups. The use of pain medication decreased significantly, whereas scores for kinesiophobia and coping remained at the same non-pathological level. None of the parameters showed a difference between both protocols. Both treatment regimes had a significant beneficial effect on LBP, leg pain, functional status and quality of life after 14 weeks. The added axial, intermittent, mechanical traction of IDD Therapy to a standard graded activity program has been shown not to be effective.
Figures
![Fig. 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2899427/bin/586_2009_1044_Fig1_HTML.gif)
![Fig. 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2899427/bin/586_2009_1044_Fig2_HTML.gif)
![Fig. 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2899427/bin/586_2009_1044_Fig3_HTML.gif)
![Fig. 4](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/2899427/bin/586_2009_1044_Fig4_HTML.gif)
Similar articles
-
Effects of segmental traction therapy on lumbar disc herniation in patients with acute low back pain measured by magnetic resonance imaging: A single arm clinical trial.J Back Musculoskelet Rehabil. 2017;30(2):247-253. doi: 10.3233/BMR-160741. J Back Musculoskelet Rehabil. 2017. PMID: 27636836
-
Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.Spine (Phila Pa 1976). 2013 Apr 1;38(7):E409-22. doi: 10.1097/BRS.0b013e3182877f11. Spine (Phila Pa 1976). 2013. PMID: 23334400 Review.
-
Inversion therapy in patients with pure single level lumbar discogenic disease: a pilot randomized trial.Disabil Rehabil. 2012;34(17):1473-80. doi: 10.3109/09638288.2011.647231. Epub 2012 Jan 23. Disabil Rehabil. 2012. PMID: 22263648 Clinical Trial.
-
A randomized clinical trial of the effectiveness of mechanical traction for sub-groups of patients with low back pain: study methods and rationale.BMC Musculoskelet Disord. 2010 Apr 30;11:81. doi: 10.1186/1471-2474-11-81. BMC Musculoskelet Disord. 2010. PMID: 20433733 Free PMC article. Clinical Trial.
-
Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.Pain Pract. 2006 Sep;6(3):171-8. doi: 10.1111/j.1533-2500.2006.00082.x. Pain Pract. 2006. PMID: 17147594 Review.
Cited by
-
The effects of the addition of mechanical traction to physical therapy on low back pain? A systematic review with meta-analysis.Acta Orthop Traumatol Turc. 2023 Jan;57(1):3-16. doi: 10.5152/j.aott.2023.21323. Acta Orthop Traumatol Turc. 2023. PMID: 36939359 Free PMC article.
-
The Real Time Geometric Effect of a Lordotic Curve-Controlled Spinal Traction Device: A Randomized Cross Over Study.Healthcare (Basel). 2021 Jan 27;9(2):125. doi: 10.3390/healthcare9020125. Healthcare (Basel). 2021. PMID: 33514047 Free PMC article.
-
Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized-controlled trial.Turk J Phys Med Rehabil. 2017 Feb 16;64(1):17-27. doi: 10.5606/tftrd.2017.154. eCollection 2018 Mar. Turk J Phys Med Rehabil. 2017. PMID: 31453485 Free PMC article.
-
Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment.JBMR Plus. 2019 Mar 4;3(5):e10180. doi: 10.1002/jbm4.10180. eCollection 2019 May. JBMR Plus. 2019. PMID: 31131347 Free PMC article.
-
Lumbar mechanical traction: a biomechanical assessment of change at the lumbar spine.BMC Musculoskelet Disord. 2019 Apr 9;20(1):155. doi: 10.1186/s12891-019-2545-9. BMC Musculoskelet Disord. 2019. PMID: 30961554 Free PMC article. Clinical Trial.
References
-
- Anema JR, Steenstra IA, Bongers PM, et al. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine. 2007;32:291–298. doi: 10.1097/01.brs.0000253604.90039.ad. - DOI - PubMed
-
- 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. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous