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DPT 690 - PT Interventions II > Spinal Traction > Flashcards

Spinal Traction Flashcards

1
Q

What is spinal traction?

A

A mechanical force applied to the body that separates the joint surfaces and elongates surrounding soft tissues.

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2
Q

Different Types of Spinal Traction = ?

A

Different Types of Spinal Traction - Lumbar Traction:

1) Mechanical

  • Static
  • Intermittent

2) Inversion

3) Self-Traction/Positional

4) Manual

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3
Q

Mechanical Traction

Advantages & Disadvantages = ?

A

Mechanical Traction:

- Advantages:

  • Force & time well controlled
  • Readily graded
  • Replicable
  • Does not require constant clinician attention
  • Static or intermittent traction

- Disadvantages:

  • Expensive
  • Time-consuming to set up
  • Lack of patient control or participation
  • Restriction by belts poorly tolerated by some patients
  • Mobilizes broad region rather than specific spinal segments
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4
Q

Manual Traction

Advantages & Disadvantages = ?

A

Manual Traction:

- Advantages:

  • Minimal equipment required
  • Short set-up time
  • Force can be finely graded
  • The clinician is present throughout the treatment
  • Trial: Can be applied briefly, before mechanical traction, to determine if mechanical traction will be tolerated
  • It can be used with patients who do not tolerate tight belts

- Disadvantages:

  • Limited maximum traction force
  • Amount of traction force cannot be easily replicated or specifically recorded
  • Cannot be applied for a prolonged period of time
  • Required a skilled clinician to apply
  • Can be labor intensive for PT
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5
Q

Traction - Precations = ?

A

Traction - Precations:

i) Structural diseases affecting the spine

  • Tumor, Infection, Osteoporosis,
  • Prolonged systemic steroid use

ii) When pressure from belts may be hazardous

  • Pregnancy, Hiatal hernia, Vascular compromise, Osteoporosis

iii) Displacement of annular fragment

  • Traction will not change the position of the fragment

iv) Medial disc protrusion (see next slide for details)

v) When severe pain fully resolves with traction

  • Increased compression on nerve root can cause complete nerve block

vi) Claustrophobia or psychological aversion

vii) Inability to tolerate prone or supine positions

viii) Disorientation

ix) TMJ problems or dentures (for cervical traction)

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6
Q

What are the physiological effects of spinal traction?

A
  • Distracts joint surfaces
  • Stretches soft tissues,
  • Reduces disc protrusions,
  • Relaxes muscles.
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7
Q

What are the clinical indications for using spinal traction?

A

Back or neck pain with or without radicular symptoms, caused by disc bulge or herniation, and nerve root impingement.

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8
Q

What are the contraindications for spinal traction?

A
  • Unstable fractures
  • Cord compression
  • Fused vertebrae
  • Acute injury or inflammation
  • Joint hypermobility or instability
  • Uncontrolled hypertension
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9
Q

How does mechanical traction differ from manual traction?

A

Mechanical traction allows for controlled force and timing, whereas manual traction requires a skilled clinician and cannot be easily replicated or prolonged.

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10
Q

What are the benefits of inversion traction?

A

Minimal equipment needed, easy for the patient to perform, and can be done in various environments.

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11
Q

Types of Cervical Traction = ?

A
  • Mechanical
  • Manual
  • Wall mounted or “over the door” traction units
  • Other home units (Saunders)
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12
Q

What is the primary mechanism proposed for traction reducing herniated nucleus pulposus (HNP)?

A

Reduction of disc protrusion, thus relieving compression on spinal nerves.

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13
Q

What specific settings are recommended for lumbar spine traction to address disc problems?

A
  • 25% of body weight
  • 60 seconds hold / 20 seconds relax
  • 20-30 minutes
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14
Q

What parameters are advised for cervical spine traction during the acute phase?

A
  • 7-9 lbs force
  • Static
  • 5-10 minutes
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15
Q

What should be assessed before applying spinal traction?

A
  • Type of traction
  • Patient position
  • Traction force
  • Duration and frequency of treatment
  • Patient’s response.
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16
Q

Prone mechanical traction signs of nerve root compression = ?

A

(1) Peripheralization with repeated lumbar extension

(2) Positive crossed SLR

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17
Q

What are the adverse effects of spinal traction?

A

Increased symptoms with high-force treatments, rebound pain increases, and potential lumbar radiculopathy from cervical traction.

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18
Q

How should traction force be adjusted for initial treatments?

A

Start with low force and monitor the patient’s response.

19
Q

What are some examples of when traction might be contraindicated due to joint-related issues?

A

In cases of Down’s syndrome and rheumatoid arthritis due to joint instability.

20
Q

Why must traction parameters be carefully selected?

A

Incorrect parameters can aggravate symptoms, lead to discomfort, or fail to provide therapeutic benefits.

21
Q

What is the significance of the study on traction for low-back pain with or without sciatica?

A

It showed that traction may have little or no impact on pain intensity, functional status, or global improvement.

22
Q

What are some practical recommendations for patients undergoing traction?

A

Avoid heavy meals before treatment, empty bladder, and ensure correct positioning.

23
Q

What should be documented after a traction session?

A
  • Type of traction
  • Area treated
  • Patient position
  • Type of halter or belt used
  • Maximum force applied
  • Total treatment time
  • Patient’s response
24
Q

What is the contraindication of spinal traction in cases of structural diseases affecting the spine?

A

Structural diseases like tumor, infection, osteoporosis, and prolonged systemic steroid use are contraindications.

25
Q

What parameters are recommended for lumbar traction to decrease muscle spasm?

A
  • 5 sec. hold / 5 sec. relax
  • typically lasting 20-30 minutes
26
Q

For which conditions is spinal traction contraindicated due to potential for increased symptoms?

A

Unstable fracture, cord compression, recent spinal surgery, or fused vertebrae.

27
Q

What precautions should be taken when applying spinal traction in patients with vascular compromise?

A

Ensure that pressure from belts is not hazardous, especially in conditions like pregnancy or hiatal hernia.

28
Q

What is a key precaution when using cervical traction to avoid increasing pain?

A

Avoid using high-force traction as it may cause rebound increase in pain and other complications.

29
Q

What are the recommended settings for intermittent lumbar traction to treat disc problems?

A
  • 25% of BW
  • 60 sec. hold / 20 sec. relax
  • 20-30 min.
30
Q

Why is it crucial to monitor a patient’s response to traction therapy?

A

To adjust traction settings based on individual tolerance and prevent adverse effects like increased pain or discomfort.

31
Q

What specific traction setting is recommended for soft tissue stretching in the cervical region?

A
  • 11-15 lbs force
  • 60 sec. hold / 20 sec. relax
  • 20-30 min.
32
Q

When is traction considered contraindicated due to peripheral symptoms?

A

When traction causes peripheralization of symptoms, indicating potential worsening or improper force application.

33
Q

What is a precaution for traction usage in patients with joint hypermobility or instability?

A

Traction is contraindicated in conditions like Down’s syndrome and rheumatoid arthritis due to joint instability.

34
Q

What clinical signs suggest traction should be reconsidered for a patient?

A

If symptoms are aggravated by joint loading or relieved by distraction, careful evaluation and adjustment of traction are necessary.

35
Q

What precaution should be taken for patients with disc protrusion during traction?

A

Traction should not be applied if there is a displacement of an annular fragment as it will not alter the fragment’s position.

36
Q

What are the implications of using traction in patients with spondylolisthesis?

A

Traction is contraindicated as it may worsen the condition by further displacing the vertebrae.

37
Q

What is Spondylolisthesis = ?

A

Spondylolisthesis:

  • Slippage of one vertebrae on another due to fracture of pars interarticularis
  • There is a grade 5 = complete dislocation of the spine
  • Surgery for spinal fusion is indicated for grades 3, 4 and 5
38
Q

How does traction impact patients with acute injury or inflammation?

A

Traction is contraindicated in acute conditions as it may exacerbate pain and inflammation.

39
Q

What are the guidelines for traction force during the treatment of joint hypomobility?

A

For patients with segmental hypomobility, manual techniques are preferred over mechanical traction.

40
Q

What is the best practice for applying traction to patients with cervical issues?

A
  • Increased flexion focuses forces on the lower cervical area
  • Neutral / Extension focuses on the upper cervical area
41
Q

What guidelines should be followed for patients undergoing traction to minimize risk?

A

Patients should be instructed to empty the bladder and avoid heavy meals prior to traction to ensure comfort and safety.

42
Q

How should traction be adjusted for patients who experience severe pain resolution during the session?

A

If severe pain resolves completely with traction, it may indicate an increased compression on nerve roots, requiring adjustment of force.

43
Q

What are the contraindications for traction based on specific spinal conditions?

A

Conditions such as medial disc protrusion, where traction may increase nerve root impingement.

44
Q

What factors should be documented after applying spinal traction?

A
  • Type of traction
  • Patient position
  • Traction force
  • Duration
  • Patient’s response

DPT 690 - PT Interventions II (13 decks)

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