No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy®

Schimmel, Janneke J. P.; Kleuver, Marinus de; Horsting, Philip P.; Spruit, Maarten; Jacobs, Wilco C. H.; Limbeek, Jacques van

doi:10.1007/s00586-009-1044-3

Cited by 36 publications

(30 citation statements)

References 16 publications

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“…Nevertheless, the results of the current study seem to support the conclusions of recent reviews 17,30,31) in which no uniform evidence of the efficacy of traction therapy as a treatment for LBP was reported 23) . A limitation of our study is the lack of follow-up concerning the effects for at least after 3 months.…”

Section: Discussionsupporting

confidence: 81%

“…For example, studies that have been reported that lacked a randomized comparison group 1,18) , had a retrospective design [19][20][21][22] , had sample that were small 19,20) , studied heterogeneous patient groups 31) or had authors who were commercially related to the evaluated therapy 20,21) . Moreover, there is still controversy within this particular field because various different traction techniques and corresponding protocols exists 23) .…”

Section: Introductionmentioning

confidence: 99%

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Stretching Versus Mechanical Traction of the Spine in Treatment of Idiopathic Scoliosis

et al. 2012

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Abstract.[Purpose] Traction-based therapies are non-invasive and probably cost-effective and have received interest recently. This study was conducted to compare two training programs, traction and stretching exercises, in rehabilitation of moderate scoliotic patients.[Subjects] Forty patients who were 15 to 25 years of age and had moderate scoliosis (Cobb's angle of 20 to 40 degrees) were randomized to either a stretching exercises group (n=20) or mechanical traction group (n=20).[Methods] All the patients were informed about the testing and training procedure and were allocated randomly into two groups. Both the groups received a common physical therapy program of 3 sessions a week for 3 months. In addition, the stretching exercises group received stretching of muscles on the concave side with postural instructions for activities of daily living. The mechanical traction group received mechanical traction of the lumbar spine with postural instructions for activities of daily living. The outcome measures used were anteroposterior view of loading X-ray to detect any change in the Cobb's angle of the lower spine, tape measurement to detect forward flexion of the trunk by using fingertip-to-floor test (FFT), and the visual analogue scale (VAS) for pain measurement. [Results] There was more significant improvement of the Cobb's angle in the stretching exercises group than in the mechanical traction group. There was no significant difference in VAS and FFT values between the groups. [Conclusion] Stretching exercises led to significant improvement in the Cobb's angle and resulted in improvement of scoliotic curves in moderate scoliotic patients.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Stretching Versus Mechanical Traction of the Spine in Treatment of Idiopathic Scoliosis

et al. 2012

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“…Animal models have shown potential benefits of traction on restoring disc disruption, and such distraction and relaxation cycles are theorized to promote disc health by increasing nutrient flow into the degenerated disc. 34–37 The RCT on traction therapy by Schimmel et al 37 found no significant differences in any clinical outcomes between patients receiving traction therapy, according to the manufacturer’s protocol, and a sham group using non-therapeutic weights. 37 (Table 3)…”

Section: Resultsmentioning

confidence: 99%

“…Six clinical studies failed to detect significant differences between active and sham/placebo therapies. 37–39,45–47 Five studies (Peng et al 43 , Cao et al 40 , Pauza et al 44 , Oh et al 48 and Kapural et al 49 ) which investigated intradiscal methylene blue injection, steroid therapy, IDET, ramus communicans ablation and intradiscal biacuplasty all demonstrated significant differences in clinical outcomes favoring intervention over sham treatment.…”

Section: Discussionmentioning

confidence: 99%

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Nonoperative Management of Discogenic Back Pain

Guzman

Purmessur

et al. 2014

Spine

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Study Design Systematic review of the literature. Objective A systematic evaluation of the literature was performed to investigate current non-operative management for the treatment of discogenic low back pain. Summary of Background data Back pain is a major healthcare concern with up to 39% being discogenic in origin according to one study. Non-operative therapy is likely to be the initial treatment strategy for discogenic low back pain. Methods Pubmed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for clinical studies evaluating non-operative methods of treating discogenic back pain that were published between 2000–2012. Only prospective randomized controlled studies that compared a non-surgical intervention with sham or placebo therapy were included. After removal of duplicate citations, a total of 226 articles were initially identified from the search terms. From these, we identified 11 randomized controlled trials (RCTs) from which data analysis was performed. Results The 11 RCTs investigated traction therapy, injections and ablative techniques. Results from five RCTs investigating methylene blue injection, steroid injection, ramus communicans ablation, intradiscal electrothermal therapy (IDET) and biacuplasty favored intervention over sham therapy. However, results from the study on methylene blue injections have not been replicated in other RCTs. Evaluation of the selection criteria utilized in the studies on ramus communicans ablation and intradiscal biacuplasty and a stratified analysis of results from the RCTs on IDET casts doubt on whether the conclusions from these RCTs can be applied to the general discogenic pain patient population. Conclusion There are few high quality studies evaluating non-operative treatments for reducing discogenic low back pain. Although conclusions from several studies favor intervention over sham, it is unclear whether these interventions confer stable long-term benefit. There is some promise in newer modalities such as biacuplasty; however, more inclusive studies need to be performed.

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