Influence of Obesity on Outcomes of Traction Therapy for Women With Chronic Low Back Pain: An Observational Study

This study aimed to determine whether obesity influences the effects of traction therapy on pain, disability, lumbar mobility, and the biomechanical and viscoelastic properties (BVPs) of tissues in the lumbar region in women with low back pain (LBP).

Women aged 34 to 50 years with chronic LBP and obesity (n = 26) or normal body weight (bw; n = 17) underwent 20 traction therapy sessions. LBP (on a visual analog scale), Oswestry Disability Index, BVPs, lumbar spine mobility, and trunk tissue fat were assessed before and then 3 days and 3 months after therapy. Two-way repeated measures ANOVAs were used.

Pain and disability were significantly decreased (P < .01) and anterior lumbar flexion was increased (P < .05) after treatment and maintained at this level for 3 months in both women with obesity and normal body mass index (BMI). However, while stiffness was only reduced in women with normal BMI after treatment (P < .05), this effect was not maintained at follow-up. The mobility in posterior and lateral flexions and rotations did not change. All BVPs correlated with trunk tissue fat content (P < .01).

The outcomes of traction therapy with continuous mode at a force of 25% to 30% of the patient's bw were not different for women with BMI ≥ 30 and <25 kg/m². Only the effect on muscle stiffness seems to be more beneficial for women without obesity. However, myotonometric results are strongly related to trunk fat content, subject to a potential measurement error in women with obesity.