Traction, Intermittent Compression Pump, CPM

Question 1

Traction contraindications (10)

Answer 1

Systemic disease affecting spine integrity (CA, RA, OP, infection)
S/p trauma if fx, subluxation, or dislocation not ruled out
Spine hypermobility or instability
Hiatal or abdominal hernia
Spinal cord compression
Pregnancy (L/s traction only)
Vertebral a. Occlusion (C/s traction only)
Aortic aneurysm
TMJ (C/s traction halter)
Non-MSK causes of neck or back pain

Question 2

Traction precautions (10)

Answer 2

Acute pain
Claustrophobia 
Mental disorientation
Children or frail geriatric Pt.'s
Pt.'s who may be exaggerating sx (litigation)
PMH of spine surgery
Hyperactivity or restlessness
Obesity
Respiratory problems
Cardiovascular problems

Question 3

Intermittent pneumatic compression (IPC) indications (7)

Answer 3

Control or minimize edema that is not acute
Improve venous circulation (prevent DVT)
Healing stasis ulcers
Decreasing orthostatic HTN
Wound healing (promotes small vessel circulation)
Prevention of thrombophlebitis (contra-I if DVT)
Stump reduction in amputated limbs

Question 4

IPC contraindications (5)

Answer 4

Acute pulmonary edema or CHF
DVT
Acute fx (can delay healing)
Acute local dermatological infections
Lymphedema

Question 5

IPC possible complications (4)

Answer 5

Swelling in other areas
Joint stiffness
SOB
Numbness or tingling (nerve irritation or damage; possible DVT)

Question 6

CPM indications (5)

Answer 6

Joint surgery
Joint arthroplasty
Post manipulations 
Post tendon lacerations 
Surgical intra- or extraarticular joint fx

Benefits of early mob
Maintains articular cartilage nutrition
Decreases effects of disuse
Slows or prevents capsular contractures and joint stiffness
Decreases pain (sensory input of moving joint –> analgesia)
Muscle relaxation

Question 7

CPM contraindications (2)

Answer 7

Pt. is resistive

Active bleeding

Question 8

APTA Choosing Wisely

Answer 8

DO NOT USE CPM FOR POSTOP MANAGEMENT OF PT.’S AFTER UNCOMPLICATED TKR

Question 9

Traction indications (12)

Answer 9

Nerve root impingement
Disk herniation 
Spondylolisthesis
Narrowing intervertebral foramen
Osteophyte formation
DJD
Subacute pain
Joint hypomobility 
Muscle spasm or guarding
Muscle strain
Spinal ligament or connective tissue contractures
Improvement in arterial, venous, an lymphatic flow