Dr. Levine answers: During the course of the study, patients were seen on a monthly basis and assessed for changes they noted. Overall what appeared to occur was that a few patients had measurable improvement after 1-2 months of therapy with a minimum of 4-6 hours a day. Typically by the second to fourth month, measured improvement was in stretched length gain, curvature reduction and girth enhancement. During the fourth to sixth months, some patients noted further improvement, but about 30% had mild discomfort with use of the device, which necessitated reducing the duration of traction or using fewer spacers to reduce the force the traction. It is presumed that this discomfort was associated with what is known as “tissue fatigue” and, by reducing the duration or the intensity of the traction, that there would be less discomfort. Currently, many patients are using daily traction along with verapamil injections. It appears that the response to treatment has a similar pattern to the pilot study. The key to success with traction is clearly daily use for at least 4-6 hours.