The efficacy of traction for back pain: A systematic review of randomised controlled trials

Annette Harte, David Baxter, Jackie Gracey

Research output: Contribution to journalArticle

Abstract

Objective: To assess the efficacy of traction for patients with low back pain (LBP) with or without radiating pain, taking into account the clinical technique or parameters used.Data Sources: A computer-aided search of MEDLINE, CI- NAHL, AMED, and the Cochrane Collaboration was con- ducted for randomized controlled trials (RCTs) in the English language, from 1966 to December 2001.Study Selection: RCTs were included if: participants were over the age of 18 years, with LBP with or without radiating pain; the intervention group received traction as the main or sole treatment; the comparison group received sham traction or another conservative treatment; and the study used 1 of 4 primary outcome measures.Data Extraction: The study was conducted in 2 strands. Strand 1 assessed methodologic quality using a specific criteria list recommended by the Cochrane Back Review Group. The strength of the evidence was then rated using the Agency for Health Care Policy and Research system. Strand 2 applied further inclusion criteria based on recommended clinical pa- rameters. One reviewer conducted the selection and data ex- traction.Data Synthesis: Strand 1: 1 study scored 9 points (maxi- mum score, 10 points); the other 12 scored between 0 and 3 points, indicating that most were of poor quality. Nine studies reported negative findings, but only 1 study was of a high quality. Three studies reported positive findings and 1 study was inconclusive. Strand 2: only 4 trials having low method- ologic quality were included, 2 of which reported negative findings, and 2 positive findings.Conclusion: The evidence for the use of traction in LBP remains inconclusive because of the continued lack of meth- odologic rigor and the limited application of clinical parame- ters as used in clinical practice. Further trials, which give attention to these areas, are needed before any firm conclusions and recommendations may be made.
LanguageEnglish
Pages1542-1553
JournalArchives of Physical Medicine and Rehabilitation
Volume84
Publication statusPublished - Oct 2003

Fingerprint

Traction
Back Pain
Randomized Controlled Trials
Low Back Pain
United States Agency for Healthcare Research and Quality
Pain
Information Storage and Retrieval
MEDLINE
Language
Outcome Assessment (Health Care)

Keywords

  • Low back pain
  • Physical therapy techniques
  • Randomized controlled trials
  • Rehabilitation
  • Traction.

Cite this

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title = "The efficacy of traction for back pain: A systematic review of randomised controlled trials",
abstract = "Objective: To assess the efficacy of traction for patients with low back pain (LBP) with or without radiating pain, taking into account the clinical technique or parameters used.Data Sources: A computer-aided search of MEDLINE, CI- NAHL, AMED, and the Cochrane Collaboration was con- ducted for randomized controlled trials (RCTs) in the English language, from 1966 to December 2001.Study Selection: RCTs were included if: participants were over the age of 18 years, with LBP with or without radiating pain; the intervention group received traction as the main or sole treatment; the comparison group received sham traction or another conservative treatment; and the study used 1 of 4 primary outcome measures.Data Extraction: The study was conducted in 2 strands. Strand 1 assessed methodologic quality using a specific criteria list recommended by the Cochrane Back Review Group. The strength of the evidence was then rated using the Agency for Health Care Policy and Research system. Strand 2 applied further inclusion criteria based on recommended clinical pa- rameters. One reviewer conducted the selection and data ex- traction.Data Synthesis: Strand 1: 1 study scored 9 points (maxi- mum score, 10 points); the other 12 scored between 0 and 3 points, indicating that most were of poor quality. Nine studies reported negative findings, but only 1 study was of a high quality. Three studies reported positive findings and 1 study was inconclusive. Strand 2: only 4 trials having low method- ologic quality were included, 2 of which reported negative findings, and 2 positive findings.Conclusion: The evidence for the use of traction in LBP remains inconclusive because of the continued lack of meth- odologic rigor and the limited application of clinical parame- ters as used in clinical practice. Further trials, which give attention to these areas, are needed before any firm conclusions and recommendations may be made.",
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The efficacy of traction for back pain: A systematic review of randomised controlled trials. / Harte, Annette; Baxter, David; Gracey, Jackie.

In: Archives of Physical Medicine and Rehabilitation, Vol. 84, 10.2003, p. 1542-1553.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The efficacy of traction for back pain: A systematic review of randomised controlled trials

AU - Harte, Annette

AU - Baxter, David

AU - Gracey, Jackie

PY - 2003/10

Y1 - 2003/10

N2 - Objective: To assess the efficacy of traction for patients with low back pain (LBP) with or without radiating pain, taking into account the clinical technique or parameters used.Data Sources: A computer-aided search of MEDLINE, CI- NAHL, AMED, and the Cochrane Collaboration was con- ducted for randomized controlled trials (RCTs) in the English language, from 1966 to December 2001.Study Selection: RCTs were included if: participants were over the age of 18 years, with LBP with or without radiating pain; the intervention group received traction as the main or sole treatment; the comparison group received sham traction or another conservative treatment; and the study used 1 of 4 primary outcome measures.Data Extraction: The study was conducted in 2 strands. Strand 1 assessed methodologic quality using a specific criteria list recommended by the Cochrane Back Review Group. The strength of the evidence was then rated using the Agency for Health Care Policy and Research system. Strand 2 applied further inclusion criteria based on recommended clinical pa- rameters. One reviewer conducted the selection and data ex- traction.Data Synthesis: Strand 1: 1 study scored 9 points (maxi- mum score, 10 points); the other 12 scored between 0 and 3 points, indicating that most were of poor quality. Nine studies reported negative findings, but only 1 study was of a high quality. Three studies reported positive findings and 1 study was inconclusive. Strand 2: only 4 trials having low method- ologic quality were included, 2 of which reported negative findings, and 2 positive findings.Conclusion: The evidence for the use of traction in LBP remains inconclusive because of the continued lack of meth- odologic rigor and the limited application of clinical parame- ters as used in clinical practice. Further trials, which give attention to these areas, are needed before any firm conclusions and recommendations may be made.

AB - Objective: To assess the efficacy of traction for patients with low back pain (LBP) with or without radiating pain, taking into account the clinical technique or parameters used.Data Sources: A computer-aided search of MEDLINE, CI- NAHL, AMED, and the Cochrane Collaboration was con- ducted for randomized controlled trials (RCTs) in the English language, from 1966 to December 2001.Study Selection: RCTs were included if: participants were over the age of 18 years, with LBP with or without radiating pain; the intervention group received traction as the main or sole treatment; the comparison group received sham traction or another conservative treatment; and the study used 1 of 4 primary outcome measures.Data Extraction: The study was conducted in 2 strands. Strand 1 assessed methodologic quality using a specific criteria list recommended by the Cochrane Back Review Group. The strength of the evidence was then rated using the Agency for Health Care Policy and Research system. Strand 2 applied further inclusion criteria based on recommended clinical pa- rameters. One reviewer conducted the selection and data ex- traction.Data Synthesis: Strand 1: 1 study scored 9 points (maxi- mum score, 10 points); the other 12 scored between 0 and 3 points, indicating that most were of poor quality. Nine studies reported negative findings, but only 1 study was of a high quality. Three studies reported positive findings and 1 study was inconclusive. Strand 2: only 4 trials having low method- ologic quality were included, 2 of which reported negative findings, and 2 positive findings.Conclusion: The evidence for the use of traction in LBP remains inconclusive because of the continued lack of meth- odologic rigor and the limited application of clinical parame- ters as used in clinical practice. Further trials, which give attention to these areas, are needed before any firm conclusions and recommendations may be made.

KW - Low back pain

KW - Physical therapy techniques

KW - Randomized controlled trials

KW - Rehabilitation

KW - Traction.

M3 - Article

VL - 84

SP - 1542

EP - 1553

JO - Archives of Physical Medicine and Rehabilitation

T2 - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

ER -