Kashmala Khan, Muhammad Khan, Wardah Ejaz Qazi.
The use of Mechanical and Manual lumbar Traction in the Management of Prolapsed Inter-vertebral Disc (PIVD). A Survey of Physical Therapists in Pakistan.
Med Forum Jan ;3(2):78-82.

Objective: To evaluate the use of mechanical and manual traction in the management of lumbar spine prolapsed inter-vertebral disc and its time and cost effectiveness. Study Design: Observational / Analytical study Place and duration of study: Alain physiotherapy clinic Karachi and musculoskeletal outpatient Physiotherapy departments (public sector and non public sectors) across Karachi, Lahore, Rawalpindi and Peshawar between October 2012 and January 2013. Materials and Methods: Participants were selected from Alain physiotherapy clinic Karachi and various physiotherapy departments who offer musculoskeletal assessment and treatment services across Pakistan. Information were gathered on the use of mechanical and manual traction with their effectiveness and its cost and time effectiveness. Descriptive data analysis of information on the use of mechanical and manual traction was done with its time and cost effectiveness in clinical practice. Results: The overall response rate of 82% in which 79% use mechanical and manual lumbar traction in Patients with prolapsed inter vertebral disc and nerve root symptoms. The effectiveness of traction was reported by 98% of physical therapists. Time effectiveness was reported by 78% and overall the physical therapists reported that both mechanical and manual tractions were cost effective treatments. Conclusions: Study results show that traction continued to be used in prolapsed inter-vertebral disc of the lumbar spine. The results also clarify the clinical, time and cost effectiveness of the traction treatment.

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