Weightbath hydrotraction treatment: application, biomechanics, and clinical effects

Biomechanical analysis of two-step traction therapy in the lumbar spine

Traction therapy is one of the most common conservative treatments for low back pain. However, the effects of traction therapy on lumbar spine biomechanics are not well known. We investigated biomechanical effects of two-step traction therapy, which consists of global axial traction and local decompression, on the lumbar spine using a validated three-dimensional finite element model of the lumbar spine. One-third of body weight was applied on the center of the L1 vertebra toward the superior direction for the first axial traction. Anterior translation of the L4 vertebra was considered as the second local decompression. The lordosis angle between the superior planes of the L1 vertebra and sacrum was 44.6° at baseline, 35.2° with global axial traction, and 46.4° with local decompression. The fibers of annulus fibrosus in the posterior region, and intertransverse and posterior longitudinal ligaments experienced stress primarily during global axial traction, these stresses decreased during local decompression. A combination of global axial traction and local decompression would be helpful for reducing tensile stress on the fibers of the annulus fibrosus and ligaments, and intradiscal pressure in traction therapy. This study could be used to develop a safer and more effective type of traction therapy.

Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis

Balneotherapy is appreciated as a traditional treatment modality in medicine. Hungary is rich in thermal mineral waters. Balneotherapy has been in extensive use for centuries and its effects have been studied in detail. Here, we present a systematic review and meta-analysis of clinical trials conducted with Hungarian thermal mineral waters, the findings of which have been published by Hungarian authors in English. The 122 studies identified in different databases include 18 clinical trials. Five of these evaluated the effect of hydro- and balneotherapy on chronic low back pain, four on osteoarthritis of the knee, and two on osteoarthritis of the hand. One of the remaining seven trials evaluated balneotherapy in chronic inflammatory pelvic diseases, while six studies explored its effect on various laboratory parameters. Out of the 18 studies, 9 met the predefined criteria for meta-analysis. The results confirmed the beneficial effect of balneotherapy on pain with weight bearing and at rest in patients with degenerative joint and spinal diseases. A similar effect has been found in chronic pelvic inflammatory disease. The review also revealed that balneotherapy has some beneficial effects on antioxidant status, and on metabolic and inflammatory parameters. Based on the results, we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for lower back pain, as well as for knee and hand osteoarthritis.

Immediate changes in spinal height and pain after aquatic vertical traction in patients with persistent low back symptoms: a crossover clinical trial

OBJECTIVE

To investigate the effect of aquatic vertical traction on spinal height, pain intensity, and centralization response compared with a land-based supine flexion position for patients with low back pain and signs of nerve root compression.

DESIGN

Single-blind, repeated-measures crossover design.

SETTING

Outpatient physical therapy clinic.

SUBJECTS

Ninety-eight subjects were recruited using consecutive sampling, with 28 men and 32 women of a mean ± standard deviation (SD) age of 59.6 ± 11.6 years completing testing.

INTERVENTION

Each subject participated in 2 sessions that consisted of loaded walking for 15 minutes, followed by either 15 minutes of land-based supine position or 15 minutes of aquatic vertical traction.

MEASUREMENTS

Spinal height change, measured using a commercial stadiometer, was determined after completing loaded walking and after each intervention.

RESULTS

The mean ± SD height change of 4.99 ± 2.88 mm after aquatic vertical traction was similar to that of 4.21 ± 2.53 mm after the land-based supine flexion (P = .0969). Paired t-test indicated that both interventions resulted in significant increased height (P < .0001). Decreases in pain after aquatic intervention (2.7 ± 2.1 cm) were significantly greater than decreases after land intervention (1.7 ± 1.7 cm; P = .0034), and centralization of symptoms was more pronounced after aquatic vertical suspension compared with the supine land-based flexion condition (P < .0001). A significant correlation between height change and both pain reduction (r = 0.39; P = .001) and centralization (r = 0.29; P = .013) was observed for the aquatic intervention only.

CONCLUSION

Although both the aquatic and land interventions produced significant increases in overall spinal height, the aquatic intervention produced greater pain relief and centralization response in subjects with low back pain and signs of nerve root compression.