The Effects of Manual Traction Using Belt on Lumbar Intervertebral Space of Lumbar HIVD

벨트를 이용한 도수견인이 허리뼈 척추사이원반 탈출증 환자의 허리뼈 척추사이 공간에 미치는 효과

  • Received : 2022.08.01
  • Accepted : 2022.08.27
  • Published : 2022.12.30

Abstract

Background: Manual traction with a belt is a physiotherapy treatment method that reduces disk pressure and widens the disk space. In clinical settings, it is applied to numerous patients with herniated intervertebral disk (HIVD). This study aimed to identify the effects of manual traction with a belt on the intervertebral space in patients with lumbar HIVDs. Methods: The intervention was performed on 17 patients with lumbar HIVDs who were divided into two groups: one with eight patients having HIVD at L4~L5 and another group with nine patients having HIVD at L5~S1. The participants received manual traction with a belt twice a week for 12 weeks, and radiographic imaging was used to visualize the intervertebral space and compare it before and after treatment. Results: Manual traction with a belt increased the lumbar intervertebral space at L4~L5 and L5~S1 in patients with L4~L5 HIVD. A significant difference was observed in the L4-L5 distance (p<.01); however, no significant difference was observed in the L5~S1 distance (p>.05). The intervertebral space significantly increased at both L4~L5 and L5~S1 in patients with L5~S1 HIVD (p<.05). Conclusion: Thus, manual traction with a belt increased the intervertebral space in patients with L4~L5 and L5~S1 HIVDs. These results are expected to guide studies on manual traction with belts in clinical settings in the future. Further studies using the present research as an objective study method are anticipated.

Keywords

References

  1. Adams MA, Roughley PJ. What is intervertebral disc degeneration, and what causes it?. Spine. 2006;31(18):2151-2161. http://doi.org/10.1097/01.brs.0000231761.73859.2c.
  2. Andersson GB, Schultz AB, Nachemson AL. Intervertebral disc pressures during traction. Scand J Rehabil Med Suppl. 1983;9:88-91.
  3. Bridger RS, Ossey S, Fourie G. Effect of lumbar traction on stature. spine. 1990;15(6)522-524. http://doi.org/10.1097/00007632-199006000-00017.
  4. Cox J, Hazen LJ, Mungovan M. Distraction manipulation reduction of an L5-S1 disk herniation. J Manipulative Physiol Ther. 1993;16(5):342-346.
  5. Cox JM. Low Back Pain: Mechanism, Diagnosis, and Treatment: Lippincott Williams & Wilkins. 2012.
  6. Deyo RA, Walsh NE, Martin DC, et al. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain, N Engl J Med. 1990;322(23):1627-1634. https://doi.org/10.1056 /NEJM199006073222303. https://doi.org/10.1056/NEJM199006073222303
  7. Frymoyer JW, Gordon SL. American academy of orthopaedic surgeons symposium: New perspective on low back pain. Chicago, American academy of orthopaedic surgeons, 1989:168-198.
  8. Gay RE, Bronfort G, Evans RL. Distraction manipulation of the lumbar spine: A review of the literature. J Manipulative Physiol Ther. 2005;28(4):266-273. https://doi.org/10.1016/j.jmpt. 2005.03.012.
  9. Gong WT. The effects of cervical range of motion and forward head posture on cervical manual traction in normal adults. J Kor Ortho Man Phys Ther. 2019;25(1):1-7.
  10. Greenwood DM. Improvement in chronic low back pain in an aviation crash survivor with adjacent segment disease following flexion distraction therapy: a case study. J Chiropr Med. 2012;11(4):300-305. https://doi.org/10.1016/j.jcm.2012.07.002.
  11. Gudavalli MR, Cambron JA, McGregor M, et al. A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. Eur Spine J. 2006;15(7):1070-1082. https://doi.org/10.1007/s00586-005-0021-8.
  12. Gupta RC, Ramarao SV. Epidurography in reduction of lumbar disc prolapse by traction. Arch Phys Med Rehabil. 1978;59(7):322-327.
  13. Jung MK, Kim SY. The effects of cervical traction and nerve mobilization exercise on pain, disability and muscle strength in computer workers with cervical radiculopathy. J Kor Ortho Man Phys Ther. 2014;20(2):27-34.
  14. Kim HK, Bahn HJ, Kim S, et al. Correlation analysis between radiological result and radiating pain in lumbosacral pain. J Kor Acupuncture & Moxibustion. 2009;4(1):95-102.
  15. Koes BW, Bouter LM, van der Heijden GJ. Methodological quality of randomized clinical trials on treatment efficacy in low back pain. Spine 1995;20(2):228-235. https://doi.org/10.1097/00007632-199501150-00021.
  16. Kwon WA. The Effects of Intermittent Traction and Manual Traction on Lumbar Herniated Disc. Daegu University. Doctoral Dissertation. 2008.
  17. Lee KS, Kim WW, Seong IH, et al. The relationship between width of lumbar disc space and severity of herniated intervertebral disc in patients diagnosis disc space narrowing. J Kor CHUNA Man Med for Spine & Nerves. 2013;8(2):79-86.
  18. Ma SY, Gong WT, Cho GY. The effects of motorized flexion-distraction treatment on the lumbosacral region angle in patients with chronic low back pain. J Kor Data & Infor Scien Soci. 2009;20(2):339-348.
  19. Oh HJ, Choi SJ, Lee KS, et al. The effect of flexion-distraction technique and drop technique on pain and sacral angle of patients with lumbar spine herniated intervertebral disc. J Phys Ther Sci. 2018;25(3):9-16. https://doi.org/10.26862/jkpts.2018.12.25.3.9.
  20. Paige NM, Miake-Lye IM, Booth MS, et al. Association of spinal manipulative therapy with clinical benefit and harm for acute low back pain: Systematic review and meta-analysis. JAMA. 2017;3170(14):51-1460. https://doi.org/10.1001/jama.2017.3086
  21. Park JH, Kwon HS. Unilateral traction effects for a herniated nucleus pulposus in the lumbar disk. J Kor Ortho Man Phys Ther. 1995;1(1);99-104.
  22. Park WM, Kim KS, Kim YH. Biomechanical analysis of two-step traction therapy in the lumbar spine. Man Ther. 2014;19(6):527-533. https://doi.org/10.1016/j.math.2014.05.004.
  23. Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg. 1994;81(3):350-353. https://doi.org/10.3171/jns.1994.81.3.0350.
  24. Shin WS, Jung DH, Park WH, et al. The relationship between cervical intervertebral space in X-ray and herniated disc in CT. J Kor Med Rehab. 2015;25(4):75-81. https://doi.org/10.18325/jkmr.2015.25.4.75.
  25. Spangfort EV. The lumbar disc herniation. A computer-aided analysis of 2,504 operations. Acta Orthop Scand Supple. 1972;142:1-95. https://doi.org/10.3109/ort.1972.43.suppl-142.01
  26. Tomasz Kuligowski, Agnieszka Debiec-Bak, Anna Skrzek. Effectiveness of traction in young patients representing different stages of degenerative disc disease. Ortop Traumatol Rehabil. 2019;21(3):187-195. http://doi.org/10.5604/01.3001.0013.2925.