The efficacy of lumbar extension traction on sagittal alignment in mechanical low back pain: A randomized trial

In this study 3-point bending traction was used, each subject lied in a supine position; an anterior pull was applied by a posterior padded strap between the upper torso and lower pelvis, which placed under the patient's low back, at the level of lumbar curve. The tension in the strap was the transverse force (part 1 of 3-point bending) and was adjusted to each patient's tolerance, this strap was connected to computerized traction unit. whereas the second strap at the level of the femur heads (part 2 of 3-point bending) constrained the femurs to permit increased forward rotation of the pelvis and the third strap placed at the upper torso (part 3 of 3-point bending). The patints were having traction three times a week for ten weeks. The traction began at three minutes/session, increased one minute/session to 20minutes, at which time traction was applied for 20minutes/session. After they became familiar with the traction, patients were encouraged to use the maximum tolerable force. Stretching exercises were performed for erector spine muscles and hamstring muscle holding each movement for 30 seconds. Each exercise was repeated 3 times. The stretching program was performed 3 times a week for 10 weeks. Application of infrared radiation (wave length 800-1000nm). The patient was assumed the prone lying position where the area to be treated (the paraspinal muscles of the back) was adequately exposed, supported and relaxed. The lamp was positioned at distance ranged from (50-75cm). The radiation strikes the surface at or near right angle to achieve maximum penetration. The duration of application was fifteen minutes per session 3 times a week for 10 weeks. The Visual Analog Scale (VAS) was used to assess each patient’s pain perception. all treatments were administered simultaneously over the10 weeks.