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Modalities > Mod. 9-11: Traction, Compression, Man. Therapy > Flashcards

Mod. 9-11: Traction, Compression, Man. Therapy Flashcards

1
Q

Traction Indications:

A

spinal disc bulge/herniation*
narrowing of IV foramen*
nerve root impingement*
joint hypomobility
mm guarding
mm spasm
osteophyte/bone spurs
spinal ligament/CT contractures
subacute/chronic pain
subacute/chronic joint inflammation

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2
Q

Traction Contraindications:

A

acute strain/sprain*
acute inflammation*
fracture or dislocation*
vertebral joint instability*
peripheralization of symptoms*
movement-exacerbating symptoms
pregnancy (lumbar)
spinal infection of bone/joint
spine malignancy/tumor
meningitis
severe HTN or cardiovasc. disease
rheumatoid arthritis
aortic aneurysm
osteoporosis
hiatal hernia
cardiopulm problems
positive Alar ligament test or vertebral artery test (cervical)

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3
Q

Traction Physio Effects:

A

decrease disc protrusion
decrease pain
increase joint mobility
increase mm relaxation
increase ST extensibility
promote arterial, venous & lymphatic flow

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4
Q

Traction effect on facet joints:

A

widens IV foramen
exchange synovial fluid
joint mobilization

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5
Q

Traction effect on muscles

A

increase spinal mm extensibility
mm relaxation

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6
Q

Traction effect on ligaments

A

viscoelasticity
low load/long duration

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7
Q

Traction effect on nervous system

A

relieves nerve pressure
facilitates blood flow

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8
Q

Traction effect on bone

A

stress can increase bone density (Wolff’s Law)

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9
Q

Traction effect on IV discs

A

decrease size of herniated disc material via pressure gradient

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10
Q

Traction effect on pain/inflammation

A

reduce pressure on inflamed joint surface
mechanical stimuli for gate control

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11
Q

Lumbar spine traction: initial/subacute phase-
force,
hold/relax,
time

A

29-44 lbs
static
5-10 min

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12
Q

Lumbar spine traction: joint distraction
force,
hold/relax,
time

A

50% of body weight (min. 50 lbs)
15 sec/15 sec
20-30 min

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13
Q

Lumbar spine traction: disc/ST stretch
force,
hold/relax,
time

A

25% body weight
60 sec/20 sec
20-30 min

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14
Q

Lumbar spine traction: mm spasm-
force,
hold/relax,
time

A

25% body weight
5 sec/5 sec
20-30 min

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15
Q

Cervical spine traction: initial/subacute phase-
force,
hold/relax,
time

A

7-9 lbs
static
5-10 min

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16
Q

Cervical spine traction: joint distraction-
force,
hold/relax,
time

A

7% body weight (< 30 lbs)
15 sec/15 sec
20-30 min

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17
Q

Cervical spine traction: disc/ST stretch-
force,
hold/relax,
time

A

11-15 lbs
60-sec/20sec
20-30 min

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18
Q

Cervical spine traction: mm spasm-
force,
hold/relax,
time

A

11-15 lbs
5 sec/5sec
20-30 min

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19
Q

use what type of exercise for posterolateral herniated discs?

A

extension-based; prone positioning

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20
Q

peripheralization vs. centralization of symptoms

A

P: when symptoms follow nerve pathway to periphery (inc. compression and worsened nerve function)
C: symptoms move back to localized origin

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21
Q

Lumbar spine traction: high angle of pull targets ___
low angle of pull targets ___

A

high: L1/L2
low: L3-L5

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22
Q

Cervical spine traction (supine):
0-5* flex targets ___
10-20* flex targets ___
25-35 * flex targets ___

A

0-5: C1/C2
10-20: C3/-C5
25-35*: C6/C7

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23
Q

Compression Indications:

A

edema
lymphedema
hypertrophic scarring
stasis ulcer
new residual limb
DVT risk (post-op)

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24
Q

Compression Contraindications

A

DVT
heart failure
infection of treated area (cellulitis)
pulmonary edema
circulatory obstruction (lymphatic or venous return)
acute/unstable fracture
malignant area
peripheral artery disease (arterial ulcer)

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25
Q

Compression physiological effects:

A

control peripheral edema (promote fluid circulation proximally)
manage scar formation (collagen balance, reshape tissue)
promote lymphatic & venous return (improve circulation & oxygenation, dec. ulcer)
shaping residual limb (dec. size & edema)
prevent DVT (improve venous flow)

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26
Q

intermittent compression: LE pressure

A

40-80 mm Hg or diastolic BP
-pick the lower

27
Q

intermittent compression: UE pressure

A

30-60 mm Hg or diastolic BP
-pick the lower

28
Q

intermittent compression parameters:
on/off time (2)
tx time
total sessions

A

3:1 or 4:1
30 min to 4 hrs
3x/wk to 4x/day

29
Q

compression garments: pressure for DVT prevention

A

16-18 mm Hg

30
Q

compression garments: pressure for scar formation

A

20-30 mm Hg

31
Q

compression garments: pressure for edema control (amb)

A

30-40 mm Hg

32
Q

compression garments: pressure for edema control (non-amb)

A

60-70 mm Hg

33
Q

pressure exerted by a fluid, which is determined by BP & gravity

A

hydrostatic pressure

34
Q

pressure determined by concentration of plasma proteins inside & outside the vessel

A

osmotic pressure

35
Q

3 causes of edema

A

venous /lymphatic obstruction or insufficiency
increased capillary permeability
increased plasma volume (Na & water retention)

36
Q

qualities of hypertrophic scar

A

not pliable, rigid, raised appearance, excess/abnormal collagen, defined shape, hyperproliferation

37
Q

pressure exerted with activity or rest when elastic compression bandage is put on stretch

A

resting pressure

38
Q

pressure exerted only with activity of muscle contracting against inelastic compression bandage

A

working pressure

39
Q

type of bandage with great resting pressure and little working pressure
max 60-70 mm Hg

A

long-stretch bandage

40
Q

type of bandage with low resting pressure and high working pressure
requires ambulating muscles

A

short stretch bandage

41
Q

what are antiembolism stockings or TED hose used for?
(thrombo-embolic deterrent hose)

A

prevention of DVT formation

42
Q

Goals of therapeutic massage (2)

A

increase blood flow
promote tissue relaxation

43
Q

Goal of manual therapy: ____
by ____ (2)

A

restore normal, pain-free movement
by breaking up adhesions
addressing musculoskeletal pain

44
Q

Manual Therapy Contraindications

A

malignancy
infection (cellulitis, osteomyelitis)
acute circulatory conditions
rheumatoid arthritis
open wounds/suture sites
acute musculoskeletal trauma (hematoma, sprain, strain)

45
Q

6 general Physiological effects of Manual Therapy

A

reflexive (ANS)
analgesic (pain relief- gate control)
circulatory (blood &lymph)
skin (inc. temp & blood flow)
traumatic hyperemia (circulation helps remove by-products & congestion)

46
Q

what is fascia composed of?

A

collagen for strength
elastin for elasticity
gelatinous substance

47
Q

Goal of myofascial release

A

release fascial adhesions & restrictions

48
Q

MFR stroke: apply counter pressure w/ heel of hand; stroke at adhesion w/ 2-3 fingers; use torque to break up fascial restriction

A

J stroke

49
Q

MFR stroke: apply pressure w/ anchor hand & counter pressure in opposite direction; parallel w/ mm fibers

A

Vertical Stroke

50
Q

MFR stroke: apply downward force into mm w/ fingertips; strumming motion perpendicular to mm fibers

A

Transverse Stroke

51
Q

MFR stroke: place hands on opposite side of restriction & move them opposite to stretch fascia to point of limitation

A

Deep Release/
Cross Hand Technique

52
Q

hyper irritable area of tight mm fibers that form after injuries, overuse or adaptive shortening (knots)

A

trigger points

53
Q

Physio Effect of Trigger point release

A

ischemic compression restricts blood flow w/ sustained direct pressure
release of pressure restores blood flow to area

54
Q

goals of Transverse Friction Massage

A

increase mobility/extensibility of tissues
prevent/treat inflammatory scar tissue

55
Q

Transverse Friction Massage Indications

A

tendinopathy
chronic-inflamed bursae
tissue adhesions
healed scar tissue

56
Q

Physio effects of Transverse Friction Massage (2)

A

restarts inflammatory process of healing
helps realign collagen

57
Q

Joint Mob Indications

A

limited passive ROM
limited accessory joint motion
abnormal end feels
pain
when symptoms aggravated by activity are relieved by rest/comfortable positions

58
Q

Joint Mob Contraindications

A

joint hypermobility
potential necrosis of ligaments or joint capsule
joint swelling/effusion from trauma or disease

59
Q

Joint Mob Physio Effects

A

hydrodynamic (joint lubrication & synovial fluid)
analgesic (pain relief- gate control)
mechanical (stretch restricted tissue)
neural (inc. proprioception, relax tissues)

60
Q

Maitland Mobilizations: small amplitude oscillations at beginning of range for pain relief

A

Grade 1

61
Q

Maitland Mobilizations: large amplitude oscillations at mid-range for pain relief

A

Grade 2

62
Q

Maitland Mobilizations: large amplitude oscillations up to end range for mobility

A

Grade 3

63
Q

Maitland Mobilizations: small amplitude oscillations up to end range for mobility

A

Grade 4

64
Q

Maitland Mobilizations: small amplitude, high velocity thrust manipulations beyond point of limitation for mobility (PT Only)

A

Grade 5

Modalities (4 decks)

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