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Moustafa, I. M., and A. A. Diab, "Extension traction treatment for patients with discogenic lumbosacral radiculopathy: a randomized controlled trial", Clinical Rehabilitation, vol. 27, issue 1, pp. 51-62, 2013. Abstract

Objective: To investigate the effects of lumbar extension traction in patients with unilateral lumbosacral radiculopathy due to L5–S1 disc herniation.

Design: A randomized controlled study with six-month follow-up.

Setting: University research laboratory.

Subjects: Sixty-four patients with confirmed unilateral lumbosacral radiculopathy due to L5–S1 disc herniation and a lumbar lordotic angle less than 39°, randomly assigned to traction or control group.

Interventions: The control group (n = 32) received hot packs and interferential therapy, whereas the traction group (n = 32) received lumbar extension traction in addition to hot packs and interferential therapy.

Main outcome measures: Absolute rotatory angle, back and leg pain rating scale, Oswestry Disability Index, Modified Schober test, H-reflex (latency and amplitude) and intervertebral movements were measured for all patients three times (before treatment, after 10 weeks of treatment and at six-month follow-up).

Results: There was a significant difference between the traction group and the control group adjusted to baseline values at 10 weeks post treatment with respect to: absolute rotatory angle (P < 0.001), Oswestry Disability Index (P = 0.002), back and leg pain (P = 0.009, P = 0.005), Modified Schober test (P = 0.002), latency and amplitude of H-reflex (P = 0.01, P < 0.001), intervertebral movements (P < 0.05). At six-month follow-up there were statistically significant differences between the study and control groups for all the previous variables (P < 0.05).

Conclusion: The traction group receiving lumbar extension traction in addition to hot packs and interferential therapy had better effects than the control group with regard to pain, disability, H-reflex parameters and segmental intervertebral movements.

Moustafa, I. M., and A. A. Diab, "The effect of adding forward head posture corrective exercises in the management of lumbosacral radiculopathy: a randomized controlled study", J Manipulative Physiol Ther, vol. 38, issue 3, pp. 167-78, 2015.
Moustafa, I. M., and A. A. Diab, "The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial", Rheumatol Int., vol. 35, issue 7, pp. 1163-74, 2015.
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