Distraction Manipulation of the Lumbar Spine: A Review of the Literature
Received 5 November 2003
Abstract
Objective
The purpose of this study is to review the literature concerning distraction manipulation of the lumbar spine, particularly regarding physiological effects, clinical efficacy, and safety.
Data Sources
A search of the English language literature was conducted using the MEDLINE, Embase, CINAHL, Chiropractic Research Archives Collection, and Manual, Alternative, and Natural Therapies Information System databases. A secondary hand search of bibliographies was completed to identify older or nonindexed literature.
Data Selection and Extraction
Articles were identified, which described the characteristics of distraction manipulation beyond a simple description or the results of treatment with distraction manipulation. Data were extracted on the basis of relevance to the stated objective.
Data Synthesis and Results
Thirty articles were identified. Three were uncontrolled or pilot studies, 3 were basic science studies, and 6 were case series. Most were case reports. Lumbar distraction manipulation is a nonthrust mechanically assisted manual medicine technique with characteristics of manipulation, mobilization, and traction. It is used for a variety of lumbar conditions and chronic pelvic pain. The primary rationale for its use is on the basis of the biomechanical effects of axial spinal distraction. Little data are available describing the in vivo effect of distraction when used in combination with flexion or other motions.
Conclusions
Despite widespread use, the efficacy of distraction manipulation is not well established. Further research is needed to establish the efficacy and safety of distraction manipulation and to explore biomechanical, neurological, and biochemical events that may be altered by this treatment.
Sources of support: Supported in part by the National Institutes of Health/National Center of Complementary and Alternative Medicine grant K07 AT00972.
aAssistant Professor of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, Minn
bProfessor and Director of Neck and Back Research Program, Northwestern Health Sciences University, Bloomington, Minn
cAssociate Professor and Director of Operations, Wolfe-Harris Center for Clinical Studies Northwestern Health Sciences University, Bloomington, Minn
Submit requests for reprints to: Ralph E. Gay, DC, MD, Eisenberg 2D, 200 First St SW, Rochester, MN 55905
Sources of support: Supported in part by National Institutes of Health/National Center of Complementary and Alternative Medicine grant K07 AT00972.
ABSTRACT