Traction Flashcards
What are the effects of traction?
Distract joint surfaces Reduce protrusions of nuclear discal material Stretch soft tissue Relax muscle Mobilize joints Reduce pain
How much pull do you want to use with traction?
Lumbar - 50% BW or 40-60#
Cervical - 7% BW or 12#
Name some clinical indications for spinal traction.
Disc Bulge or herniation (best outcomes when used early, shouldn’t be only treatment)
Nerve root impingement
Joint hypomobility (will effect multiple joints)
Subacute joint inflammation (not treatment of choice for edema)
Paraspinal Muscle spasm
Which part of the vertebra is affected if you increase the amount of flexion?
Lower cervical
Upper lumbar
Which part of the vertebra is affected if you are in a more neutral or in extended position?
Lower lumbar
Upper cervical
How can traction help with paraspinal muscle spasms?
Static or low-load intermittent traction interrupts the pain-spasm-pain cycle and can inhibit alpha motor neuron firing
Higher load traction reduces protective paraspinal muscle spasms
What are the cervical traction clinical prediction rules?
Peripheralization with C4-C7 mobility testing \+ Shoulder Abd Test Age > 54 \+ ULTT A \+ Neck distraction test
What is the lumbar traction clinical prediction rule?
+ crossed SLR
Peripheralization with extension
What kind of population will you want to try traction with?
Age-18-60
ODI >19
Signs of nerve root compression ( + SLR < 70 degrees, and/or sensory, reflex, strength deficits)
Name the contraindictations for traction.
Where motion is contraindictated Joint Hypermobility Uncontrolled Hypertension Acute injury or inflammation Peripheralization of symptoms with traction
Name the precautions for traction.
Structural disease/conditions affecting spine
When belt pressure may be hazardous (pregnancy)
Displaced annular fragment
Medial disc protrusion
When severe pain fully resolves with traction
Claustrophobia
Inability to tolerate prone or supine positions
Disorientation
What are the precautions for cervical traction?
TMJ problems
Dentures
What are some adverse effects of traction?
If excessive can increase symptoms (rebound effect)
May experience lumbar pain or lumbar radicular discomfort after cervical traction (spinal OA)
At what degrees of flexion do you want for cervical traction?
24 - Lower cervical
15 - Higher cervical
What all do you want to document with traction?
Type of traction Area of body Patient position Type of halter Maximum force Treatment duration Response to intervention With intermittent traction (hold time, relax time, force during relax time)
