title: Lumbar Traction for Managing Low Back Pain: A Survey of Physical Therapists in the United States.
abstract: METHODS
  Cross-sectional survey.
  
  
  OBJECTIVE
  To examine how many physical therapists use traction, the patients for whom traction is used, the preferred delivery modes/parameters of traction, the supplemental interventions used with traction, and whether professional characteristics influence traction usage.
  
  
  BACKGROUND
  Several systematic reviews and clinical guidelines have questioned the effectiveness of traction for managing low back pain, yet some patients may benefit from lumbar traction. While traction usage among physical therapists in other countries has been described, usage among physical therapists in the United States has not been examined.
  
  
  METHODS
  We surveyed a random sample of 4000 Orthopaedic Section members of the American Physical Therapy Association. Associations among respondents' professional characteristics and survey responses were explored with chi-square analyses (α = .05).
  
  
  RESULTS
  The response rate was 25.5% (n = 1001), and 76.6% (n = 767) of respondents reported using traction. Most (58.4%) of the respondents used traction for patients with signs of nerve root compression, though many (31.4%) did not. Common delivery modes included manual methods (68.3%) and mechanical tables (44.9%), most often supplemental to other interventions (eg, stabilization exercises, postural education). Levels of professional preparation (doctoral/masters level versus bachelors/certificate level) were associated with many variables, as was attainment of an orthopaedic specialist certification.
  
  
  CONCLUSIONS
  Most of the orthopaedic physical therapists in the United States who responded to our survey reported that they used lumbar traction, though not necessarily consistent with proposed criteria that identify patients most likely to benefit from traction. They used various traction delivery modes/parameters and used traction within comprehensive plans of care incorporating multiple interventions. Professional characteristics (education levels and clinical specialist credentialing) were associated with traction usage.
authors.affiliation: Physical Therapy Doctoral Program, Mayo School of Health Sciences, Rochester, MN.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Madson
authors.forename: John H
authors.initials: JH
authors.lastname: Hollman
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D059825:Physical Therapists / Q000592:standards; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D014143:Traction / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: cross-sectional studies; low back pain; physical therapists; physical therapy modalities; traction