Mechanical Traction & Tilt Table Flashcards
Learn stuff for traction and tilt table
traction on a patient with severe disc herniation including displaced disc?
no, contraindicated
what is STENOSIS?
spinal cord compression
What is the strenght of the evidence for lumbar and cervical traction?
moderate for both;
A number of studies do argue that there is no beneficial effect
traction on a patient with OSTEOPOROSIS?
no, contraindicated
true or false: There is no evidence that exist to show that one mode of traction is more effective than the other. Unfortunately, trial and error wins here.
true
cervical traction in patients with TMJ problems?
no, contrainidicated
traction in patients with spinal cord compression (stenosis)?
no, contrainidicated
What are the potential indications for spinal traction?
- Spine degenerative joint disease (osteoarthritis)
- Radiculopathy secondary to:
- HNP
- Narrowing of inter-vertebral foramen
- Osteophyte encroachment
- Ligament encroachment
- Spondylolisthesis (anterior displacement of one vertebrae on another.
Tilt table treatment duration:
10-20 min; varies with patient’s condition and tolerance.
traction in patients when peripheralization or pain increases
no, contrainidicated
traction force may cause sudden and unexpected exacerbation of cervical or lumbar pain (Laban et al., 1992, 2005). If present, stop treatment and reassess the need for traction therapy.
Spinal traction In patients suffering from spondylolysis and spondylolisthesis?
Precaution with acute spinal conditions
traction on patients with abdominal/hiatal hernia?
no, contrainidicated
Tilt Table Procedures:
- Assess vitals (BP & HR) before & during treatment at each elevation change.
- Gradually elevate to upright position starting at baseline tolerance level then gradually increase with goal of 70-80 degrees.
- Do NOT put patient at 90° since they will feel like they are too far forward.
- Treatment duration between 10-20 min; varies with patient’s condition and tolerance.
traction on a patient with spinal disease, infection, inflammation, and tumor?
no, contraindicated.
induces further damage
What is the pt positioning for lumbar traction?
- Supine: with hips flexed at 90 degrees.
- Prone is used when lying supine or excessive flexion of lumbar-spine causes pain or further peripherilization of symptoms.
traction on a patient with rheumatoid arthritis
no, contraindicated
traction in patients with respiratory & hypertensive disorders
precation
True or false: Spinal traction decreases pain and enhances spinal mobility.
True.
Results from reduced nerve root compression, release of adhesions around the vertebral joints & decrease in muscle spasm.
What are the Proposed Physiological Effects of spinal traction?
- Spinal enlongation
- Widens inter-vertebral foramen
- Stretches ligaments, muscles, facet joints
- Decreases pain*
- Enhances Spinal mobility*
*Results from reduced nerve root compression, release of adhesions around the vertebral joints & decrease in muscle spasm.
A mechanical table that is able to provide gradual angles across the horizontal to vertical axis for the therapeutic progression of patient tolerance from supine to upright/standing.
Tilt Table
Positioning for cervical traction:
- Hooklying: neck at 0-30 degress of flexion
- Sitting, greater force is needed
- Some Research shows that neutral positioning yields greater percentages of intervertebral/ facet joint separation versus traction at 15-30 °
traction in patients with History of spine surgery
precaution
traction on patients with aortic aneurysm
no, contrainidicated
traction on a vertebral fracture?
no, contraindicated
mechanical spinal traction plays an important role by providing passive spinal elongation, the key purpose of which is to
increase intervertebral spaces.
Signs of tilt table intolerance:
- Excessive increase/decrease in BP or HR
- Changes in consciousness
- Excessive perspiration
- Facial pallor
- Edema formation in LE’s (use compressive bandaging prior to tilt table treatment)
- Decrease or loss of pedal pulses
- Complaint of nausea, numbness/tingling in LE’s
- Dizziness
Tilt Table Treatment Documentation:
- Blood pressure at rest, at each angle change, &after treatment
- Document each increase in angle of table
- Duration of each angle increase
- Any adjunct activities that patient was able to perform (ie. head control exercises, UE/LE ROM exercises etc.) during treatment session
- Patient’s response to treatment (Was patient was able to tolerate treatment without symptoms?)
Suggested progression for spinal traction
as needed pending patient response:
- Cervical: Increase force by 3-5 lbs per treatment session
- Lumbar: Can increase by 5-15 lbs each treatment session
*Do not exceed max limits
Indications for tilt table
- Orthostatic hypotension
- Neurogenic syncope
- Decreased orientation & arousal
- Spasticity
- Muscle Contractures
- Chronic critical illness
After prolonged bed rest
traction on patients with uncontrolled HTN
precaution, inverse traction only
spinal traction in patienta with Internal jugular vein thrombosis
Precaution, but should be a contrainidication
traction on patients unable to tolerate prone/supine position
precaution
Weight of hip & pelvis:
About 30% of body weight
What is spinal traction used for?
to treat cervical & low back pain disorders.
Premise: Elongates spine & increases inter-vertebral
spaces.
traction in patients with spinal instability/hypermobility?
no, contraindicated
traction on a patient with Vertebral artery & TMJ dysfunction
no, contrainidicated.
may aggravate the condition if an occipitomandibular halter is used. Use only an occipital halter.
Angle of pull with traction:
- Symmetric central traction force: force directly in line with patient’s long axis of spine
- Off axial traction force: Offsets the axis of traction pull to provide lateral flexion
Static traction Indicated for:
- Disc protrusion/ herniation.
- If symptoms are easily aggravated by motion.
- Sub-acute inflammation
what is the premise of traction?
Elongates spine & increases inter-vertebral spaces.
Force Needed for Cervical Traction Treatment:
Weight of head: 8.3% body weight
Contraindications/Precautions for tilt table:
- Acute spinal injury
- Sepsis without fluid resuscitation
- Bilateral LE fractures Unstable blood pressure
- More than one ventricular ectopic beat in every five beats
Traction Force needed for lumbar traction treatment?:
30-60% of Body Weight.
traction on Patients with dentures
precaution (use occipital halter only)
lumbar traction in pregnant women?
no, contrainidicated
duration and frequency of lumbar traction:
10-30 minutes daily or every other day pending patient’s response and therapeutic progress
traction in patients with Down syndrome?
no, contrainidicated
who promoted spinal traction?
promoted by Cyriax in 1950s
Maximun angle in the tilt table:
70-80 degress
traction on Patients with breathing problems (lumbar traction)
precation
Spine degenerative joint disease
AKA:
Osteoarthritis
