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S2 PTA 103 techniques > Traction > Flashcards

Traction Flashcards

1
Q

Effects of traction

A
  1. Distracts joint surfaces
  2. Decreases disc bulges/protrusion
  3. Stretches and increases elasticity of soft tissue structures
  4. Relaxes mm
  5. Mobilizes joints
  6. Decreases pain
  7. Promotes arterial, venous, and lymphatic flow
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2
Q

Planes

A
  • traction force is applied in the frontal and Sagittarius planes
  • discs, nerve roots, and vertebrae lie in the transverse plane
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3
Q

Joint distraction

A

Separation of 2 articular surfaces perpendicular to the plane of articulation

  • stretches soft tissue structures: 25% lumbar and 7-10% (11-15lbs) cervical
  • distracts joint surfaces 50% lumbar and 13-20% (20-29lbs) cervical
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4
Q

Reduction of disc protrusions

A
  • traction is the tax of choice for small nuclear disc protrusions
  • traction suctions protruding disc fragments back towards center of disc by decreasing intradiscal pressure or stretching of the PLL
  • traction is NOT effective on large protrusions that fill the spinal canal or when disc protrusions are calcified
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5
Q

Pic

A

Pic

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6
Q

Disc bulge

A

?

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7
Q

Disc protrusion

A

?

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8
Q

Disc herniation

A

?

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9
Q

Disc rupture (annular tear)

A

?

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10
Q

Soft tissue stretching

A
  • traction increases the length of tendons, ligaments, and mm around the joints which will contribute to joint distraction, reduce disc protrusions, and decrease connective tissue contracture = increase ROM
  • increasing spinal ROM with ST stretching decreases pressure on joints, discs, and nerve roots
  • achieved with moderate force over a longer duration
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11
Q

Relaxation of paraspinal mm

A

Traction interrupts the pain-spasm cycle

  • static: reflex inhibition of mm
  • intermittent: creates an ‘oscillatory effect”
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12
Q

Joint mobilization

A
  • traction increases joint ROM and decreases joint related pain by increasing extensibility of surrounding soft tissue structures
  • indicated for multisegmental joint stiffness
  • destructing the joint takes up slack in all planes which increases ROM in all directions
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13
Q

Indications

A

Neck or back pain with or without radicals symptoms caused by

  1. Nerve root impingement
  2. Fiscal etiology
  3. Joint hypomobility (generalized)
  4. Osteophyte formation / foraminal narrowing (stenosis)
  5. Subacute joint inflammation and pain
  6. Paraspinal mm spasm and guarding
    * *if a pt has bilateral UE or LE, or global symptoms, could indicate a central cord compression and referral back to MD for surgical intervention
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14
Q

Order of nerve compression

A
  1. Sharp pain (dermatomes)
  2. N&T (dermatomes)
  3. Loss of mm strength (myotome)
  4. Loss of reflexes (myotome)
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15
Q

Nerve root impingement

A

Compression of peripheral nerve root by a disc, inflammation, joint space narrowing, bone spurring or compression at the foramen (stenosis)

S&S

  • shape shooting pain primarily on the side of nerve is impinged with or without radiation along a dermatomes
  • if prolonged onset of N&T, motor weakness, and loos of reflexes
  • aggravated with lateral or rotational motions to the involved side, but varies depending on cause
  • *presenting symptoms often indicative of cause of compression
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16
Q

Pic

A

Pic

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17
Q

Disco genie etiology and pain

A

Caused by disc bulge, protrusion, herniation, or rupture

S&S

  • pain is typically across the spine with or without radiation
  • pain is usually aggravated with flexion based activities and 1st thing upon walking
18
Q

Joint hypomobility

A

Usually associated with degenerative changes, OA, bone spurs, DDD, and/or stenosis
- indicated for multi-segmental stiffness and joint restriction

S&S

  • pain usually with extension based activities
  • stiffness 1st thing upon waking
  • symptoms are usually alleviated with activity/mvmt
19
Q

Subacute joint inflammation

A

Usually associated with rheumatic conditions or low grade chronic inflammatory conditions such as RA, OA, and residual irritation form a previous injury (chemical)

S&S

  • achy, vague diffuse type pain
  • with or without radicular symptoms
20
Q

Paraspinal mm spasm

A

Usually associated with acute trauma/injury or can be a result of repetitive micro trauma
- inflammatory component related to damage can contribute to nerve impingement

S&S
- pain typically upon movement

21
Q

Centralization phenomenon

A

Traction goal!

- bringing nerve symptoms closer to the spine, with eventual resolution

22
Q

Guidelines for applying traction

A
  • before traction in applied, PT should have evaluated ROM, joint mobility, strength, sensation, nerve tension, ligamentos integrety, vascular integrity, applicable special tests and reflexes
  • determine if static or intermittent traction in appropriate
  • thing about positioning (alleviate pain)
23
Q

Pt position chart

A

Pic

24
Q

Static

A

Force stays the same throughout the duration of treatment; typically less force used

  • (post) acute conditions after 72 hours
  • if symptoms are aggravated by motion
  • disc protrusions
  • when separation at the jt surface is indicated
25
Q

Intermittent

A

Force alternated between 2 set weights for a set amount of time. Max (based on tx goal) and min (set to 50% of max)

  • disc pathology
  • mm spasms
  • joint distraction
  • soft tissue stretch
  • subacute joint inflammation
26
Q

LT: initial acute phase or 1st application of traction

A

29-44lbs - static - 5-10 min

27
Q

LT: joint distraction

A

50%BW - 60:20 - 20-30 min

28
Q

LT: mm spasms

A

25%BW - static - 20-30 min (5-10 hernation)

29
Q

LT: disc protrusions and stretching soft tissue

A

25%BW - 60:20 - 20-30 min

30
Q

CT: initial acute phase or 1st application of traction

A

7-10lbs - static - 5-10 min

31
Q

CT: joint distraction

A

20-29lbs (13-20%BW) - 15:15 - 20-30 min

32
Q

CT: mm spasms

A

11-15 lbs (7-10%BW) - 5:5 - 20-30 min

33
Q

CT: disc protrusions and stretching soft tissue

A

11-15lbs (7-10%BW) - 60:20 - 20-30 min

34
Q

CT: subacute jt inflammation

A

11-15lbs (7-10%BW) - 60:20 - 20-30 min

35
Q

CT: tx progression

A

1-2 lbs / tx

36
Q

LT: subacute joint inflammation

A

25% BW - 60:20 - 20-30 min

37
Q

LT: tx progression

A

5-10lbs /tx

38
Q

Contras ***(ensure correct)

A
  1. Motion: unstable or acute fx or immedialty following spinal surgery
  2. Acute injury or inflammation (sprains/strains)
  3. Hypermodible or unstable vertebral joints: preganancy, breastfeeding, RA, OA, AA, down’s, spondylolisthesis
  4. Periperalization of symptoms: characterized by increased pain or radicular symptoms
  5. HTN (BP > 140/90
  6. Aortic aneurysms
  7. Bone disease (osteoporosis, brittle)
  8. Cardiac, vascular, or pulmonary probs
  9. Vertebral subluxations, dislocations
  10. Infections / meningitis
  11. Cancer
  12. Trauma w/out diagnostic imaging
39
Q

Precautions

A
  1. Displaced anular fragment
  2. Medial disc protrusion
  3. Severe pain fully resolves with traction
  4. Claustrophobia
  5. Inability to tolerate prone/supine
  6. Disorientation
  7. Hiatal hernia
  8. Infection
  9. TMJ
40
Q

Guidelines

A
  • always start low and monitor
  • check pt after 5 min
  • D/C if pt’s symptoms worsen or peripheralize
  • improvement in 2-3 tx
  • pt should feel a moderate change in symptoms during tx, steady progress over time
  • no moving (coughing, sneezing)
  • pee before you ski

S2 PTA 103 techniques (10 decks)

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