traction Flashcards
physiologic effects
gentle stretch to joint capsule
increase inferior/superior dimensions of intervertebral foramina
elongate muscular tissue
increase blood flow to soft tissue and IV discs
decrease disc pressure/protrusion
distraction of vertebral bodies
straightening spinal curves
tensing of ligs and joint capsule
indications
musculoskeletal signs
musculoskeletal symptoms
discogenic pain
nerve root impingement
subacute joint pain
DJD/OA
compression fracture
joint hypomobility
musculoskeletal signs
decreased sensation, motor function or reflexes that often get reduced w/ manual traction
general hypomobility of spine
local spine hypomobility
increased mm tone that reduces w/ manual traction
musculoskeletal symptoms
numbness, pain, tingling of extremity that is temporarily relieved by manual or positional traction
unilateral, bilateral or central spine pain reduced by positional or manual traction
discogenic pain
decreased discal pressure and protrusion
nerve root impingement
enlarges IVF
can free adherent nerve roots
subacute joint pain
stretch capsule/ligaments
relax muscle spasm
compression fracture
chronic state
already healed
joint hypomobility
improve facet mobility
contraidications
absolute
relative
absolute contraindications
spinal infections
spinal cancer
spinal cord pressure
RA
osteoporosis
relative contraindications
ligamentous strains
hypermobility
traction anxiety
cardiac insufficiency
respiratory insufficiency
respiratory insufficiency
pregnancy
acute strains/sprains
types of traction
manual
positional
continuous
motorized (mechanical)
manual tractions
PT provides force to desired segment
positional tractions
sustains force through positioning
ex: side lying over cylindrical pillow
continuous traction
low load applied over a long period of time
motorized/mechanical
sustained
intermittent
sustained
static
greater load applied over a shorter period of time
intermittent
force applied and released rhythmically
pt positioning for lumbar
supine or prone
supine positioning lumbar
hook lying-flexion of the lumbar spine
the more flexion, the higher up the spine
prone positioning lumbar
may be more appropriate for discal conditions
flexed spine increases anterior loading and posterior bulging
neutral or extended position –> anterior movement of discal materal
cervical positioning
supine or sitting
flexion of cervical spine
10# to hold weight of a 25# head for vertebral seperation
lumbar traction
force 25-50% of BW needed to overcome force of frication
pelvic and thoracic harness are used
tighten both harnesses
can be bilateral or unilateral
force for lumbar friction
spit table needs less force initially
30-50% of BW to have vertebral seperation
harness for lumbar traction
traction applied via pelvic harness
thoracic harness provides stability
worn against the skin
harnesses should overlap 3”
pelvic harness
superior margin lies just above iliac crests
straps to traction rope
thoracic harness
sung around inferior rim of ribs 9-10 and below xiphoid process
straps to top of table
bilateral lumbar traction
discal problems
unilateral lumbar traction
joint hypomobility or muscle guarding
cervical traction position
sitting or supine
for mm relaxation, vertebral separation and counteraction
different positions for different vertebrae
C1-C2
treat in 0-5 degrees of flexion
C2-C5
10-20 degrees of flexion
C5-C7
25-35 degrees of flexion
force for cervical traction
10-15# first treatment
20-30# to overcome soft tissue and produce elongation
treatment time
static –> 3-30 min
intermittent –> 20-30 min
treatment for discogenic pain
sustained –> 10 min
intermittent –> 60/20 sec on/off for 10-15 min
can adjust times based on pt response
frequency of treatment
daily
twice daily
2-3x/wk
what happens if traction is used too long
does more bad than good
imbibition of fluid –> increase intradiscal pressure
when to use static traction
when symptoms are highly irritable
used less frequently
treatment time typically 8-25 min
when to use intermittent traction
increased force usually
more comfortable
one off times usually vary b/w 1:1 to 3:1
chronic hypomobility
more considerations
be sure to allow pt to rest following treatment
asses for dizziness, headache and any abnormal symptoms
documentation
BE SPECIFIC OF ABSOLTELY EVERY DETAIL
