TY - JOUR
T1 - Clinical examination procedures to determine the effect of axial decompression on low back pain symptoms in people with chronic low back pain
AU - Holtzman, Gregory
AU - Harris-Hayes, Marcie
AU - Hoffman, Shannon L.
AU - Zou, Dequan
AU - Edgeworth, Rebecca A.
AU - Van Dillen, Linda R.
PY - 2012/2
Y1 - 2012/2
N2 - STUDY DESIGN: Observational. OBJECTIVE: To assess the effects of spinal decompression procedures performed during a clinical exam on low back pain (LBP) symptoms. BACKGROUND: Not all patients report an immediate or complete improvement in symptoms when the direction of lumbar motion or alignment is corrected according to principles of the movement system impairment (MSI) model. Axial compression of the spine may be responsible for the remaining symptoms. METHODS: Seventy subjects (mean ± SD age, 41.9 ± 11.5 years; 38 females, 32 males) with chronic LBP were evaluated using a standardized MSI exam. Seven tests assessing the effects of spinal decompression on LBP were added to the exam if the subjects' symptoms were not alleviated with typical standardized corrections of movement and alignment. For each test of decompression, subjects reported their symptoms compared to a reference movement or position. RESULTS: When decompression was performed during lateral bending to the right and left, 21 of 21 (100%) and 16 of 20 (80%) subjects, respectively, reported an improvement. When traction was applied to subjects in right and left sidelying, 6 of 11 (55%) and 7 of 9 (78%), respectively, reported an improvement. When patients performed a push-up in sitting, 36 of 51 (71%) reported an improvement. In subjects who had symptoms in unsupported sitting, 41 of 57 (72%) reported an improvement in supported sitting. In subjects who reported symptoms in standing, 33 of 47 (70%) reported an improvement in hook-lying. CONCLUSION: Patients with chronic LBP consistently reported an improvement in symptoms with tests proposed to decrease the axial load on the spine. These tests are a quick and effective way to assess the contribution of axial decompression to LBP symptoms and potentially could be used as part of the plan of care. J Orthop Sports Phys Ther 2012;42(2):105-113, Epub 25 October 2011. doi:10.2519/jospt.2012.3724.
AB - STUDY DESIGN: Observational. OBJECTIVE: To assess the effects of spinal decompression procedures performed during a clinical exam on low back pain (LBP) symptoms. BACKGROUND: Not all patients report an immediate or complete improvement in symptoms when the direction of lumbar motion or alignment is corrected according to principles of the movement system impairment (MSI) model. Axial compression of the spine may be responsible for the remaining symptoms. METHODS: Seventy subjects (mean ± SD age, 41.9 ± 11.5 years; 38 females, 32 males) with chronic LBP were evaluated using a standardized MSI exam. Seven tests assessing the effects of spinal decompression on LBP were added to the exam if the subjects' symptoms were not alleviated with typical standardized corrections of movement and alignment. For each test of decompression, subjects reported their symptoms compared to a reference movement or position. RESULTS: When decompression was performed during lateral bending to the right and left, 21 of 21 (100%) and 16 of 20 (80%) subjects, respectively, reported an improvement. When traction was applied to subjects in right and left sidelying, 6 of 11 (55%) and 7 of 9 (78%), respectively, reported an improvement. When patients performed a push-up in sitting, 36 of 51 (71%) reported an improvement. In subjects who had symptoms in unsupported sitting, 41 of 57 (72%) reported an improvement in supported sitting. In subjects who reported symptoms in standing, 33 of 47 (70%) reported an improvement in hook-lying. CONCLUSION: Patients with chronic LBP consistently reported an improvement in symptoms with tests proposed to decrease the axial load on the spine. These tests are a quick and effective way to assess the contribution of axial decompression to LBP symptoms and potentially could be used as part of the plan of care. J Orthop Sports Phys Ther 2012;42(2):105-113, Epub 25 October 2011. doi:10.2519/jospt.2012.3724.
KW - Axial loading
KW - Distraction
KW - Lumbar spine
KW - Traction
UR - http://www.scopus.com/inward/record.url?scp=84856663435&partnerID=8YFLogxK
U2 - 10.2519/jospt.2012.3724
DO - 10.2519/jospt.2012.3724
M3 - Article
C2 - 22027267
AN - SCOPUS:84856663435
SN - 0190-6011
VL - 42
SP - 105
EP - 113
JO - Journal of Orthopaedic and Sports Physical Therapy
JF - Journal of Orthopaedic and Sports Physical Therapy
IS - 2
ER -