Hanlon BJ, Fitzgerald PI, Farabaugh ML, Flaherty KM, Moxey SG, Stemple KN; Saint Francis University, Loretto, PA, USA. bhanlon@francis.edu.

PURPOSE: The purpose of this case study was to determine if an alternate method of lumbar traction could be used to produce distraction of lumbar intervertebral joint spaces. SUBJECTS: The subject of this case study was a healthy 22 year old college female. Results of an examination of the subject indicated no lumbar spine or sacroiliac joint pathology. METHODS AND MATERIALS: Radiographs were taken before and during the two traction techniques. Lumbar traction was applied using a pelvic harness (PH), with the subject in the 90/90 position, or with a padded ankle cuff (AC), with the subject in the supine position. Manual traction forces were measured using a calibrated strain gauge. PH traction was applied using 60% and 80% of the subject’s body weight (BW), using a centralized pulling force. AC traction was applied at the left ankle using 60% of the subject’s BW. Higher percentages of BW were not used with AC due to subject discomfort. The subject was familiarized with both traction techniques prior to data collection. Interpedicular distances (ID) were determined at each vertebral level as well as the change in total lumbar spine length (TLSL) for both traction methods. Intervertebral separation was determined by measuring the radiographic images of the interpedicular spaces from T12 to the sacral base. TLSL was determined from the pedicle of T12 to the sacral base. One investigator blinded with regard to intervention made all measurements. ANALYSES: Descriptive analyses were tabulated with pre-post traction radiographic data on the following parameters for each of the interventions: ID at each lumbar spinal level, left and right sides of each vertebra, and TLSL. RESULTS: TLSL was increased by both methods of traction. However, AC traction produced the greatest amount of distraction on the ipsilateral side, 14mm, which was 7mm greater than the distraction produced by PH traction. Increasing PH traction force to 80% BW produced a 6mm increase in TLSL. The greatest ID increases were produced with AC traction on the ipsilateral side at L4-L5. AC traction produced 7mm separation at L4-L5 and 5mm distraction at L5-S1 on the ipsilateral side. CONCLUSIONS: In this subject, the AC traction technique was more effective in increasing TLSL and ID than PH traction. Also noteworthy is that AC traction is more comfortable than PH traction and may be useful for patients who are uncomfortable in a pelvic harness. Further study of AC traction is recommended. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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