Traction Flashcards
spinal traction
applying distraction forces to the spine to separate articular surfaces btw vertebral bodies and elongate the spine
methods of traction
manual mechanical pneumatic positional gravity assist inversion
goals for traction
decrease: joint stiffness meniscoid blocking muscle spasm disc protrusion discogenic pain joint pain nerve root impingement
indications
presently lack of agreement
- cervical or lumbar spine pain with radiculopathy
- pts who have reduction of symptoms with manual traction
contraindications
acute strains, sprains and inflammation spondylolisthesis fx increased peripheralization with traction increased nerve root symptoms joint hypermobility or instability pregnancy pt who have received surgical stabilization or decompression, spine implants or prosthetic disks
precautions
claustrophobia
hiatal hernia
impaired cognition
any disease or condition that can compromise the structure of the spine
joint distraction effects
relieves pressue on nerve root
decreases compressive forces on facets
reduction of disc protrusion does what
separation of vertebral bodies occurs at higher forces –> decreased intradiscal pressure creating suction like effect on nucleus, drawing it back centrally –> ligaments are taut
soft tissue stretching does what
surrounding spinal muscles, ligaments, tendons and discs cant be stretched
- decreases pressure on facets, nerve roots, vertebral bodies and discs without achieving joint separation
muscle relaxation with traction does what
gate control theory
variables for cervical traction
static or intermittent
angle of traction
dosage
what is the dosage of cervical traction determined by
goals and pt tolerance
the amount of weight is to start light, not exceed 30-40 lbs
treatment time for cervical traction with acute conditions and disc protrusions
5-10 mins
treatment time for cervical traction for other conditions
15-30 mins
when do you do static traction - with cervical traction
disc protrusions or when symptoms aggravate by movement
when do you do intermittent traction - with cervical traction
disc protrusion 3:1 hold/rest ratio
joint distraction/mobility 1:1 hold/rest ratio
post traction what should u look out for in general
rebound effect –> muscles spasm and lock up
relax for 5 mins after before getting up
what improves with the intervertebral foramen with cervical traction
decrease pressure within and increase in dimensions while in flexion
variables for lumbar traction
supine or prone position positioning of lower extremities static or intermittent angle of traction dosage
how much hip flexion needed to free space in the intervertebral space for L5/S1
45-60
how much hip flexion needed to free space in the intervertebral space for upper lumbar region
75-90
where do u put the thoracic harness for lumbar traction
inferior to widest lateral dimension of rib cage
two straps that will be attached to the end of table
where do u put the lower harness for lumbar traction
at or below iliac crest but superior to greater trochanter
two straps that will attach to a metal V shape rod that then attaches to unit
amount of force for acute phase for lumbar traction
less force
30-40lbs
amount of force for disc protrusion, spasm, elongation of tissue for lumbar traction
25% of body weight
amount of force for joint distraction for lumbar traction
50% body weight
treatment time for lumbar traction
ranges depending from 5-30 mins
home traction for cervical
pneumatic pump with gauge quantifying tension
adjustable head rest, similar positioning
sustained traction
home traction for lumbar
pneumatic pump, harness to stabilize
less tension produced than clinic
positioning on floor required
