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CP2 > Spinal Traction (wk 4) > Flashcards

Spinal Traction (wk 4) Flashcards

1
Q

What are the goals for spinal traction? (7)

A

To decrease:

  1. Joint stiffness (hypomobility)
  2. Meniscoid blocking
  3. Muscle spasm
  4. Disc protrusion
  5. Discogenic pain
  6. Joint pain
  7. Nerve root impingement
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2
Q

What are the general indications for spinal traction? (2)

A
  1. Cervical or lumbar spine pain with radiculopathy

2. Patients who have reduction of symptoms with manual traction

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3
Q

Contraindication or precaution of spinal traction:

Claustrophobia

A

precaution

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4
Q

Contraindication or precaution of spinal traction:

acute strains, sprains, and inflammation

A

Contraindication

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5
Q

Contraindication or precaution of spinal traction:

Hiatal hernia

A

precaution

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6
Q

Contraindication or precaution of spinal traction:

spondylolisthesis

A

Contraindication

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7
Q

Contraindication or precaution of spinal traction:

fractures

A

Contraindication

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8
Q

Contraindication or precaution of spinal traction:

increase peripheralization with traction

A

Contraindication

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9
Q

Contraindication or precaution of spinal traction:

increase nerve root symptoms with traction

A

Contraindication

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10
Q

Contraindication or precaution of spinal traction:

Impaired cognition

A

precaution

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11
Q

Contraindication or precaution of spinal traction:

joint hypermobility or instability

A

Contraindication

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12
Q

Contraindication or precaution of spinal traction:
Any disease or condition that can compromise the structure of the spine (RA, prolonged steroid use, tumor, osteoporosis, etc.)

A

precaution

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13
Q

Contraindication or precaution of spinal traction:

pregnancy (lumbar traction)

A

Contraindication

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14
Q

Contraindication or precaution of spinal traction:

patients who have received surgical stabilization or decompression, spine implants, or prosthetic disks

A

Contraindication

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15
Q

Joint distraction, the separation of the facet joints occurs with sufficient force, does what two things to the intervertebral foramen?

A
  1. Relieves pressure on nerve root

2. Decreases compressive forces on facets

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16
Q

What type of joint distraction traction forces recommended for initial treatment?

A

Lower traction forces

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17
Q

Describe the use of traction to reduce disc protrusion:

A
  1. Separate vert bodies at higher force -> decrease intradiscal pressure creating suction like effect on nucleus potentially drawing it back in centrally
  2. Surrounding ligamentous structures taut which also helps push disc in centrally
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18
Q

What % of body weight or lbs results in cervical region joint distraction?

A

7% of body weight or about 20-30lbs results in separation

19
Q

Minimum of what % of body weight results in lumbar region joint distraction?

A

min of 50% of patient’s body weight

20
Q

Reduction of disc protrusion with traction of the lumbar region requires what % of patients body weigh

A

up to 50%

21
Q

Reduction of disc protrusion, soft tissue stretching, and muscle relaxation of the cervical region requires how many lbs?

A

12-15 lbs

22
Q

soft-tissue stretching and muscle relaxation by traction of the lumbar region requires what % of body weight?

A

25%

23
Q

Soft-tissue stretching of the surrounding spinal muscles, ligaments, tendons, and discs can be stretched with the goal of what?

A

Decreasing pressure on facets, nerve roots, vertebral bodies and discs without achieving joint separation

24
Q

Describe effect of intermittent traction and static traction on muscle relaxation:

A

intermittent traction - interrupt the pain-muscle spasm cycle by stimulating mechanoreceptors
static traction - inhibiting neuron firing

25
Q

targeting what region with greater the cervical flexion

A

lower cervical area

26
Q

T/F Cervical traction generally recommended not to exceed 30-40 lbs and to start light

A

True

27
Q

In the acute phase of cervical traction, how much weight applied for these goals:

  1. Disc protrusion, elongation of soft tissue, muscle spasm -
  2. Joint distraction -
A
  1. Disc protrusion, elongation of soft tissue, muscle spasm - 10-15 lbs
  2. Joint distraction - 20-30 lbs
28
Q

5-10 minutes of cervical traction for what 2 conditions?

A
  1. acute

2. disc protrusions

29
Q

If your there is disc protrusions or symptoms aggravated with motion in cervical region, what type of traction do you use? (duty cycle)

A

Static

30
Q

What is the expert opinion about hold/rest ratio of intermittent traction for cervical region:
disc protrusion -
joint distraction/mobility -

A

disc protrusion - 3:1 hold/rest

joint distraction/mobility - 1:1 hold/rest

31
Q

Post traction you must watch for what?

A

rebound effect - have patient relax for 5 minutes after treatment (can spasm if not)

32
Q

What are positive outcomes you record post traction?

A
  1. ↓ symptoms
  2. Centralization of symptoms
  3. ↑ ROM/strength
  4. Improved ability to perform ADLs
  5. Improved reflexes/sensation
33
Q

T/F Research shows that after traction mean area of disc herniation was reduced & disc space increased.

A

true

34
Q

T/F over-the-door traction showed equal improvements to scores on neck disability, neck pain intensity, and arm pain intensity as mechanical traction

A

False, patients who underwent mechanical traction reported lower scores on neck disability, neck pain intensity, and arm pain intensity

35
Q

For lumbar spine traction, what vert are you focusing on when hip flexion:
45-60 hip flexion =
75-90 hip flexion =

A

Closer to L1
45-60 hip flexion = L5/S1
75-90 hip flexion = upper lumbar region

36
Q

How to apply thoracic harness for mechanical traction? Lower harness?

A
  1. Placed inferior to the widest lateral dimension of the rib cage (Two straps that will be attached to the end of the table)
  2. At or just below the iliac crests but superior to the greater trochanters (Two straps that will attach to a metal V shapes rod that then attaches to the mechanical unit)
37
Q

Lumbar traction force for:
acute phase = lbs
disc protrusion, spasm, elongation of soft tissue = %
joint distraction = %

A

acute phase = 30-40 lbs (less force)
disc protrusion, spasm, elongation of soft tissue = 25% of body weight
joint distraction = 50% of body wieght

38
Q

Treatment time for lumbar traction force for:
Herniated disc =
Other conditions =

A

Herniated disc = 5-10 min

Other conditions = 10-30 min

39
Q

T/F Substantially greater reduction of the total area of herniated disc material with lumbar traction vs. use of “other modalities”.

A

True

40
Q

How can you improve lumbar traction when used with 30 & 60% of body weight?

A

Straight leg raise

41
Q

T/F Traction can be used alone for the best possible outcomes.

A

False, traction should be combined with other interventions

42
Q

Describe the home traction unit for cervical region:

A
  1. Pneumatic pump with gauge quantifying tension
  2. Adjustable headrest, similar positioning
  3. Sustained traction
43
Q

Describe the home traction unit for lumbar region:

A
  1. Pneumatic pump, harness to stabilize
  2. Less tension produced than clinical unit
  3. Positioning on floor required

CP2 (20 decks)

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