traction

Question 1

physiologic effects

Answer 1

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

Question 2

indications

Answer 2

musculoskeletal signs

musculoskeletal symptoms

discogenic pain

nerve root impingement

subacute joint pain

DJD/OA

compression fracture

joint hypomobility

Question 3

musculoskeletal signs

Answer 3

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

Question 4

musculoskeletal symptoms

Answer 4

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

Question 5

discogenic pain

Answer 5

decreased discal pressure and protrusion

Question 6

nerve root impingement

Answer 6

enlarges IVF

can free adherent nerve roots

Question 7

subacute joint pain

Answer 7

stretch capsule/ligaments

relax muscle spasm

Question 8

compression fracture

Answer 8

chronic state

already healed

Question 9

joint hypomobility

Answer 9

improve facet mobility

Question 10

contraidications

Answer 10

absolute

relative

Question 11

absolute contraindications

Answer 11

spinal infections

spinal cancer

spinal cord pressure

RA

osteoporosis

Question 12

relative contraindications

Answer 12

ligamentous strains

hypermobility

traction anxiety

cardiac insufficiency

respiratory insufficiency

respiratory insufficiency

pregnancy

acute strains/sprains

Question 13

types of traction

Answer 13

manual

positional

continuous

motorized (mechanical)

Question 14

manual tractions

Answer 14

PT provides force to desired segment

Question 15

positional tractions

Answer 15

sustains force through positioning

ex: side lying over cylindrical pillow

Question 16

continuous traction

Answer 16

low load applied over a long period of time

Question 17

motorized/mechanical

Answer 17

sustained

intermittent

Question 18

sustained

Answer 18

static

greater load applied over a shorter period of time

Question 19

intermittent

Answer 19

force applied and released rhythmically

Question 20

pt positioning for lumbar

Answer 20

supine or prone

Question 21

supine positioning lumbar

Answer 21

hook lying-flexion of the lumbar spine

the more flexion, the higher up the spine

Question 22

prone positioning lumbar

Answer 22

may be more appropriate for discal conditions

flexed spine increases anterior loading and posterior bulging

neutral or extended position –> anterior movement of discal materal

Question 23

cervical positioning

Answer 23

supine or sitting

flexion of cervical spine

10# to hold weight of a 25# head for vertebral seperation

Question 24

lumbar traction

Answer 24

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

Question 25

force for lumbar friction

Answer 25

spit table needs less force initially

30-50% of BW to have vertebral seperation

Question 26

harness for lumbar traction

Answer 26

traction applied via pelvic harness

thoracic harness provides stability

worn against the skin

harnesses should overlap 3”

Question 27

pelvic harness

Answer 27

superior margin lies just above iliac crests

straps to traction rope

Question 28

thoracic harness

Answer 28

sung around inferior rim of ribs 9-10 and below xiphoid process

straps to top of table

Question 29

bilateral lumbar traction

Answer 29

discal problems

Question 30

unilateral lumbar traction

Answer 30

joint hypomobility or muscle guarding

Question 31

cervical traction position

Answer 31

sitting or supine

for mm relaxation, vertebral separation and counteraction

different positions for different vertebrae

Question 32

C1-C2

Answer 32

treat in 0-5 degrees of flexion

Question 33

C2-C5

Answer 33

10-20 degrees of flexion

Question 34

C5-C7

Answer 34

25-35 degrees of flexion

Question 35

force for cervical traction

Answer 35

10-15# first treatment

20-30# to overcome soft tissue and produce elongation

Question 36

treatment time

Answer 36

static –> 3-30 min

intermittent –> 20-30 min

Question 37

treatment for discogenic pain

Answer 37

sustained –> 10 min

intermittent –> 60/20 sec on/off for 10-15 min

can adjust times based on pt response

Question 38

frequency of treatment

Answer 38

daily

twice daily

2-3x/wk

Question 39

what happens if traction is used too long

Answer 39

does more bad than good

imbibition of fluid –> increase intradiscal pressure

Question 40

when to use static traction

Answer 40

when symptoms are highly irritable

used less frequently

treatment time typically 8-25 min

Question 41

when to use intermittent traction

Answer 41

increased force usually

more comfortable

one off times usually vary b/w 1:1 to 3:1

chronic hypomobility

Question 42

more considerations

Answer 42

be sure to allow pt to rest following treatment

asses for dizziness, headache and any abnormal symptoms

Question 43

documentation

Answer 43

BE SPECIFIC OF ABSOLTELY EVERY DETAIL