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Immediate Changes in Spinal Height and Pain After Aquatic Vertical Traction in Patients With Persistent Low Back Symptoms: A Crossover Clinical Trial


Journal: Physical Medicine and Rehabilitation 


Authors: Simmerman SM, Sizer PS, Dedrick, Apte GG, PT, ScD, Brismée JM, 2011


Authors compared 30 participants (28F, 32M) who presented with LBP and/or numbness that extended distal to the buttock in the past 24 hours, (2) pain level 7/10 on the NRS, and (3) signs of NRC, which consisted of any of the following: (i) intensification or reproduction of more distal symptoms with extension testing of the lumbar spine in a standing position, (ii) positive straight leg raise (reproduction of more peripheral symptoms), (iii) reflex changes of the Achilles or patella tendon, (iv) sensory loss in the symptomatic lower extremity, or (v) symptomatic lower extremity muscle strength deficit. They did 10 minutes (‘) of lying, 15‘ of loaded walking, 5’ sitting then either 15’ crook lying or 15’ vertical in deep end. Two days later the subject did the other intervention (land or aquatic recovery).


Results: The spinal height change was not sig diff between land and water but the reported pain was sig less post aquatic vertical traction compared to supine lying and more centralization of symptoms was reported after aquatic vertical traction (this is good!). 


Take Home Message: Unloading techniques, like immersion, can result in temporary spinal height changes, temporary clinically significant improvement of pain sensation and centralization that can translate into enhanced overall daily function. Spinal height change was the same but symptoms differed so it could be the effects of immersion, not just unloading, that alleviated the symptoms. What a great place to begin strengthening of the core muscles, which is vital for recovery!

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