title: Efficacy of traction for nonspecific low back pain. 12-week and 6-month results of a randomized clinical trial.
abstract: METHODS
  A randomized clinical trial.
  
  
  OBJECTIVE
  To assess the efficacy of motorized continuous traction for low back pain.
  
  
  BACKGROUND
  The available studies on the efficacy of lumbar traction do not allow clear conclusions because of severe methodologic flaws. The current trial aimed to overcome these shortcomings.
  
  
  METHODS
  Patients with at least 6 weeks of nonspecific low back pain were selected. High-dose traction was compared with sham (or low-dose) traction. Sham traction was given with a specially developed brace that becomes tighter in the back during traction. This was experienced as if real traction were exerted. The patients and the outcome assessor were unaware of treatment allocation. Outcome measures were: patient's global perceived effect, severity of main complaints, functional status, pain, range of motion, work absence, and medical treatment. Results for the outcome measures at 12 weeks and 6 months after randomization are presented.
  
  
  RESULTS
  One hundred and fifty-one patients were randomly allocated to one of the two treatment methods. Intention-to-treat analysis of the 12-week and 6-month results showed no statistically significant differences between the groups on all outcome measures: all 95% confidence intervals included the value zero. The number of patients lost to follow-up study was very low. Other analyses showed the same results.
  
  
  CONCLUSIONS
  Most common flaws of earlier studies on traction therapy could be overcome. This trial did not support the claim that traction is efficacious for patients with low back pain.
authors.affiliation: Department of Epidemiology, Maastricht University, The Netherlands. ajhm.beurskens@epid.unimaas.nl
authors.forename: A J
authors.initials: AJ
authors.lastname: Beurskens
authors.forename: H C
authors.initials: HC
authors.lastname: de Vet
authors.forename: A J
authors.initials: AJ
authors.lastname: Köke
authors.forename: W
authors.initials: W
authors.lastname: Regtop
authors.forename: G J
authors.initials: GJ
authors.lastname: van der Heijden
authors.forename: E
authors.initials: E
authors.lastname: Lindeman
authors.forename: P G
authors.initials: PG
authors.lastname: Knipschild
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D014143:Traction / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome