Outcomes After a Prone Lumbar Traction Protocol for Patients With Activity-Limiting Low Back Pain: A Prospective Case Series Study

Paul F. Beattie, PhD, PT, OCS, Roger M. Nelson, PhD, PT, Lori A. Michener, PhD, PT, ATC, SCS, Joseph Cammarata, DC, Jonathan Donley, DPT

Archives of Physical Medicine And Rehabilitation, Volume 89, February 2008 © 2008 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

ABSTRACT. Beattie PF, Nelson RM, Michener LA, Cammarata J, Donley J. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective, case series study. Arch Phys Med Rehabil 2008; 89:269-74.

Objective: To determine outcomes after administration of a prone lumbar traction protocol. Design: Prospective, longitudinal, case series.

Setting: Suburban, chiropractic practice.

Participants: A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or more levels of the lumbar spine. We excluded patients involved in litigation and those receiving workers’ compensation.

Intervention: An 8-week course of prone lumbar traction, using the vertebral axial decompression (VAX-D) system, consisting of five 30-minute sessions a week for 4 weeks, followed by one 30-minute session a week for 4 additional weeks.

Main Outcome Measures: The numeric pain rating scale and the Roland-Morris Disability Questionnaire (RMDQ) were completed at preintervention, discharge (within 2 weeks of the last visit), and at 30 days and 180 days after discharge. Intention-to-treat strategies were used to account for those subjects lost to follow-up.

Results: A total of 250 (84.4%) subjects completed the treatment protocol. On the 30-day follow-up, 247 (83.4%) subjects were available; on the 180-day follow-up, data were available for 241 (81.4%) subjects. We noted significant improvements for all postintervention outcome scores when compared with pre-intervention scores (P< .01).

Conclusions: Traction applied in the prone position using the VAX-D for 8 weeks was associated with improvements in pain intensity and RMDQ scores at discharge, and at 30 and 180 days after discharge in a sample of patients with activity limiting LBP. Causal relationships between these outcomes and the intervention should not be made until further study is performed using randomized comparison groups.

Key Words: Back pain; Decompression; Intervertebral disk; Lumbar region; Rehabilitation; Traction; Treatment outcomes.