Mechanical Traction Flashcards
Traction
a drawing or separating tension applied to a body segment
A separating force
Ancient treatment technique
Enough force to cause physical movement
Physical effects of traction
Spinal movement Bone Ligaments Disks Articular facets Muscles Nerves
Spinal movement
Facilitates movement
Separation 1-2mm per intervertebral space - enough to centralize the np
Transient change - coming off of traction everything can go back but feels good while traction on (disc herniation can see sustained effects though)
Effects on bone
limited effect
Facilitation of movement may reduce immobilization related to bone density loss
Effects on ligaments
Elongating force - if up to 20 minutes can see creep and elongation of ligaments
Proprioceptive effect - use gate control theory to reduce pain
Effects on disk
most widely supported
Dec central disc pressure
Encourages np to centralize
Effects on articular facet joints
Separates joint surfaces
Improves synovial fluid exchange
Proprioceptive effect
Effects on muscles
Provides muscle stretch
Relaxation effect - inhinit muscle tone and reduce mm spasm
Effects on nerves
Relieves pressure on nerve roots
Proprioceptive effect
Induction of movement - Dec inflammatory soup
Common indications for spinal traction
Nerve root impingement Disc herniation Spondylolisthesis Stenosis Joint hypomobility Subacute pain Muscle spasm or guarding
Contraindications for spinal traction
Acute inflammation Fractures Vertebral joint instability Tumors Osteoporosis Bone or joint infection Pregnancy Cardiovascular or pulmonary concerns
Traction techniques
Positional
Inversion
Manual
Mechanical
Parameters of traction
Body position Force utilized Intermittent vs Sustained Progressive vs Regressive Duration of tx Assessment of effectiveness
Parameters - Body position
Most often supine but prone is good too for example if you have patient with disc herniation you don’t want to be pulling them into flexion
Parameters - force utilized
Depends on if cervical or lumbar
50% of body weight for lumbar
Parameters - Intermittent vs sustained
on and off vs a static pull for duration of treatment
Parameters - progressive vs regressive
Slowly ramp up the pull and regressive is slowly ramp down
parameter - Duration of treatment
total of how long they will be on traction
Assessment of effectiveness
Both duringa nd after
Check on the frequently
Kill switch if needed
Positional lumbar traction
Knees to chest (inc space btw facets)
Childs pose
Traction over a therapy ball
Sidelying with rotation and towel
Manual lumbar traction
Unilateral leg pull
Segmental lumbar flexion
Assisted sidelying with rotation
Mechanical lumbar traction - patient position
Neutral spine position is ideal
Prone vs supine depending on dx
Consider patient comfort
Mechanical lumbar traction - force
65-200 pounds is therapeutic - depends on their body weight though
50% of pt bodyweight
Mechanical lumbar traction - intermittent vs sustained
Sustained preferred for herniated disc
All other indications PT may choose
Mechanical lumbar traction - progressive vs regressive
Based on patient comfort
Mechanical traction lumbar - duration
8 - 30 minutes
Typically start with 8 and then can add time and move up to 15-20 minutes
Need at least 8 minutes of sustained pull to get therapeutic effect
Herniated disc - lateral malleolus fracture - what are your parametes
Prone
50% of their body weight
Static
8 minutes
Manual cervical traction - bilateral vs. unlateral
if bilateral problem go bilateral
if unilateral go unilateral
Manual cervical traction - force
less than 20 pounds
Mechanical cervical traction - patient position
Supine with neck flexed 20-30 degrees
Force on occiput vs chin (most from occiput) because chin can cause force on TMJ
Mechanicalcervical traction - force
20-50 pounds is safe
Start with the 7-8 pounds and then can increase it from there to 20/25 pounds
Mechanical cervical traction - intermittent vs. static
Intermittent with at least 7 seconds on
Intermittent more common for cervical than static
Mechanicsl cervical traction - progressive vs regressive steps
Patient comfort
Mechanical cervical traction - duration
20-25 minutes
herniated cervical disc btw C4 and C5 - position
Supine Pull at 20-30 degree angle Start force at 20 pounds Use static for disc could start with 8-10 or 20 depending on if you did manual traction beforehand
