Authors: Timothy J. Madson, PT, MS
Study Design
Cross sectional survey.
Objectives
To examine how many physical therapists (PTs) use traction, patients for whom traction is used, preferred delivery modes/parameters, supplemental interventions, and whether professional characteristics influence traction usage.
Background
Several systematic reviews and clinical guidelines question traction’s effectiveness for managing low back pain (LBP), yet some patients may benefit from lumbar traction. While traction usage among PTs in other countries has been described, usage among PTs in the United States has not been examined.
Methods
We surveyed a random sample of 4000 orthopaedic section members of the American Physical Therapy Association. Associations among respondents’ professional characteristics and survey responses were explored with chi-square analyses (α = .05).
Results
The response rate was 25.5% (n = 1001); 76.6% (n = 767) use traction. Most (58.4%) use traction for patients with signs of nerve root compression, though many (31.4%) do not. Common delivery modes include manual methods (68.3%) and mechanical tables (44.9%), most often supplemental to other interventions (e.g., stabilization exercises, postural education). Levels of professional preparation (doctoral/masters-level versus bachelors/certificate-level) are associated with many variables, as is attainment of an orthopaedic specialist certification.
Conclusion
Most orthopaedic PTs in the United States use lumbar traction, though not necessarily consistently with proposed criteria that identify patients most likely to benefit from traction. They use various traction delivery modes/parameters and use traction within comprehensive plans of care incorporating multiple interventions. Professional characteristics (education levels and clinical specialist credentialing) are associated with traction usage. J Orthop Sports Phys Ther, Epub 25 Jun 2015. doi:10.2519/jospt.2015.6036