Traction

Question 1

Traction classification criteria:

Answer 1

1. Signs/Symptoms of Nerve Root Compression
2. Pain/paresthesiae below knee - myotome/reflex changes
3. Not responsive to specific exercise or active movement – no centralization

Question 2

Theoretical effects of spinal traction:

Answer 2

Joint distraction
Soft tissue stretch
Muscle relaxation
Joint mobilization
Reduce HNP/disc bulges-protrusions

Question 3

What are some indications for traction?

Answer 3

radiculopathy from HNP, disc. bulge
IVF narrowing
oseophyte encroachment
spondylolisthesis
DJD

Question 4

What is spondylolisthesis?

Answer 4

anterior displacement of one vertebra on another (grades I-IV)

Question 5

What are the contraindications to traction?

Answer 5

Systemic disease affecting spine integrity (i.e.: RA)
Fx, subluxation, dislocation (trauma)
Hypermobility or instability
Hiatal or abdominal hernia
SC compression
Pregnancy (lumbar traction)
Vertebral artery occlusion (cervical)
Aortic aneurysm
TMJ/TMD (cervical)
Uncontrolled HTN (inversion)

Question 6

What are the precautions to traction?

Answer 6

Acute cervical/lumbar pain
Claustrophobia
Mental disorientation/confusion
Children, frail, elderly
Hx of surgery to spine
Hyperactivity or restlessness
Obesity
Respiratory challenges
CV problems
Hx of domestic violence (cervical)

Question 7

Sustained traction is applied to l-spine for ____ min up to ___% BW.

Answer 7

10-45 min

50% BW

Question 8

Sustained traction is used in order to:

Answer 8

Reduce of disc herniation .
lengthen soft tissue
Muscle relaxation
Pain reduction

Question 9

Intermittent traction is applied to l-spine with alternate periods of hold/relax as follows:

Answer 9

5-60 sec
1:1 or 1:@ hold/relax
10-30 min treatment

Question 10

Intermittent traction is used in order to:

Answer 10

Reduction of disc herniation/bulging
Soft tissue lengthening
Muscle relaxation
Pain reduction
Joint mobilization
Patients who cannot tolerate static traction

Question 11

What are 4 types of traction?

Answer 11

mechanical
manual
positional
inversion

Question 12

Describe positional traction:

Answer 12

alter body position by utilizing pillows, bolsters to open the IVF to reduce nerve root irritability

adv: can use as HEP

Question 13

What is the benefit of mechanical tx?

Answer 13

table adjustable
forces replicable
can apply intermittent or static

Question 14

Describe inversion traction methods?

Answer 14

l-spine emphasis; inverted hang position at home 5-15 min

uses gravity to distract IV segments

Question 15

What is an advantage for manual traction?

Answer 15

PT can sense pt. response

Question 16

Describe the angle of pull of force for flexion:

Answer 16

want involved segment in neutral to target/bias:
L5-S1 45 -60 degrees
L4-L5 60 -75 degrees
L3-L4 75 -90 degrees

Question 17

Describe specific l-spine positional tx techniques:

Answer 17

unilaterally: Lateral flex away, may rotate toward involved side
bilaterally: flex segments in supine over pillows, bolster, chair

Question 18

When might inversion traction be contra-indicated?

Answer 18

contra-indicated with cardiovascular disease, or any condition in which a head down position is not tolerated

Question 19

How much force applied with traction?

Answer 19

Use as much force as needed without increasing symptoms.

Question 20

How soon should you expect a (+) response to traction treatments?

Answer 20

should decrease symptoms throughout duration

2-3 treatments for (+) response