To Pass Traction

Question 1

cervical spine initial treatment:

pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 1

pt position: neutral position
traction force: 7 - 10 lbs
static or intermittent?: static
on/off time: N/A
tx time: 5 - 10 minutes

Question 2

cervical disc problem: bulge, protrusion, herniation

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 2

SandS: pain with flexion activities and have pain in morning
pt position: cervical neutral
traction force: 11-15 lbs or 7% - 10% of body weight
static or intermittent?: intermittent (static decrease 50% weight)
on/off time: 3:1 ratio 60 secs on, 20 secs off
tx time: 5 - 15 minsutes, can be up to 30 minutes

Question 3

cervical muscle spasms:

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 3

SandS: pain with movement. may have palpable mm guarding or spasm
pt position: cervical neutral
traction force: 11 - 15 lbs or 7% - 10% body weight
static or intermittent?: intermittent (static decrease 50% weight)
on/off time: 1:1 ratio, 5 secs on, 5 secs off
tx time: 20 - 30 minutes

Question 4

cervical subacute joint inflammation: whiplash injury, strain, or sprain

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 4

SandS: c/o vague, achy, diffuse pain. Not always position dependant. Can be aggravated
pt position: cervical neutral
traction force: 11 - 15 lbs or 7% - 10% of bodyweight
static or intermittent?: intermittent
on/off time: 3:1 ratio, 60 secs on, 20 secs off
tx time: 20 - 30 minutes

Question 5

cervical spine degeneration: DDD, stenosis, bone spur, hypomobility

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 5

SandS: increased pain with extension. More comfortable in flexed position. increased pain with cervical joint loading (associated with bad posture)
pt position: cervical neutral
traction force: 20 - 29 lbs or 13% - 20% bodyweight (jt. distraction)
static or intermittent?: intermittent
on/off time: 1:1 ratio, 15 secs on, 15 secs off
tx time: 20 - 30 minutes

Question 6

cervical spine tx progression:

traction force:
static or intermittent?:
on/off time:
tx time:

Answer 6

traction force: increase 1 - 2 lbs each tx
static or intermittent?: depends
on/off time: off weight will be 50% of on weight always

Question 7

lumber spine initial treatment:

traction force:
static or intermittent?:
on/off time:
tx time:

Answer 7

traction force: 29 - 44 lbs or 25% of bodyweight (whichever is less)
static or intermittent?: static
on/off time: N/A
tx time: 5 - 10 minutes

Question 8

lumbar disc problem: bulge, protrusion, herniation

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 8

SandS: pain with flexion based activities
pt position: bolster, neutral spine or slight extension. same cases prone
traction force: 25% of bodyweight
static or intermittent?: intermittent
on/off time: 3:1 ratio, 60 on, 20 off
tx time: 5 - 10 minutes for disc herniation. 20 - 30 minutes otherwise

Question 9

lumbar muscle spasms:

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 9

SandS: pain with motion, palpable guarding or spasms
pt position: neutral spine or pos of comfort
traction force: 25% body weight
static or intermittent?: static
on/off time: N/A
tx time: 20 - 30 minutes

Question 10

lumbar subacute joint inflammation: MVA, strain, or sprain

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 10

SandS: vague, achy, diffuse pain across whole LB. Not position dependent and can be specific
pt position: neutral spine
traction force: 25% of body weight
static or intermittent?: intermittent
on/off time: 3:1 ratio, 60 secs on, 20 secs off
tx time: 20 - 30 minutes

Question 11

lumbar spine degeneration: DDD, stenosis, bone spur, hypomobility

SandS:
pt position:
traction force:
static or intermittent?:
on/off time:
tx time:

Answer 11

SandS: pain with extension or jt loading abilities. standing, walking, flexion biased pts
pt position: supine and neutral, or supine with flexion (big bolster)
traction force: 50% body weight
static or intermittent?: intermittent
on/off time: 3:1 ratio, 60 on, 20 off
tx time: 20 - 30 minutes

Question 12

lumbar spine tx progression:

Answer 12

traction force: 5 - 15 lbs each tx

Question 13

order of nerve compression:

Answer 13

sharp pain (dermatome) –> NandT (dermatome_ –> loss of mm strength (myotome) –> loss of reflexes (myotome)

Question 14

CONTRAS (5):

Answer 14

• where motion is contraindicated (unstable or acute fx or immediately following
• acute injury or inflammation (within first 72 hrs or in presence of cardinal signs of inflammation)
• hyper mobile or unstable joint (can be found with pregnancy or breastfeeding, RA, Down’s, or spondylothesis)
• peripheralization of symptoms (characterized by increased pain or radicular symptoms and indicates worsening of condition. Goal is to centralize symptoms)
• uncontrolled hypertension

Question 15

Precautions (9):

Answer 15

• diseases/conditions affecting bones- CA, RA, osteoporosis, prolonged steroid use (associated with asthma or chronic inflammatory conditions), infection –> weaken bones and soft tissue support structures
• pressure of belts may be hazardous: pregnancy, hiatal hernia, femoral or vertebral artery insufficiency, cardiac or pulmonary history
• displaced anular fragment: traction is ineffective once annulus is no longer attached to the disc
• medial disc protrusion: can increase symptoms and increase nerve impingement
• severe pain full resolves with traction
• claustrophobia
• inability to tolerate prone/supine
• disorientation
• TMJ/dentures

Question 16

Questions to ask (10):

Answer 16

• have you been instructed not to move your neck or back? If so, by whom?
• have you been instructed not to remove your brace at any time?
• how recent was your injury? When did pain start?
• Are you pregnant? Breastfeeding?
• do you have RA?
• do you have Osteoporosis?
• are you claustrophobic?
• do you have high BP? Is it controlled?
• do you have hiatal hernia? (lumbar only)
• do you have pain in your calves with walking short distances?