Traction & Tilt Table Flashcards
- tensional mechanical force applied to the body in a way that separates the joint surfaces and elongates surrounding soft tissues
- gained popularity in the 1950s and 1960s by james cyriax
traction
effects of traction
- joint distraction
- reduction of spinal disc protrusion
- soft tissue stretching
- muscle relaxation
- joint mobilization
indications of traction
- spinal disc bulge or herniation
- spinal nerve root impingement
- joint hypomobility
- subacute joint inflammation
- muscle spasm
contradications of traction
- where motion is contraindicated (fracture)
- acute injury or inflammation
- joint hypermobility
- peripheralization of symptoms with traction
- incontrolled hypertension
precautions of traction
- structural disease or condition affecting the tissue area
- when pressure of the belts may be hazardous
- displaced annular fragment
- medial disc protusion
- when severe pain fully resolves with traction
- claustrophobia/disorientation
- inability to tolerate prone or supine position
- tmj problems & dentures
- it can be applied with ___ and ___, ___, ___, ___, and ___
- electrical and weighted mechanical devices
- self traction
- positional traction
- inversion traction
- manual traction
clinician should first determine whether presenting symptoms and problems are likely to respond to treatment with traction
application
documentation of traction
- type of traction
- area of the body where traction is applied
- patient position
- type of halter if one is used
- maximum force
- total treatmemt time (intermittent traction, hold & relax type)
- response to treatment
- supine or sitting position
- neck should be flexed approximately 20-30 degrees
- traction force should start at 8-10 lbs (3-4kg) and may increase gradually as needed up to approximately 7% of the patients body weight
cervical traction
- decrease compression: 20-30 lbs (9-13kg)
- decrease muscle spasm, stretch soft tissue or exert a centripetal force on the disc by spinal elongation without joint surface separation 12-15 lbs (5-7kg)
cervical traction
Hold/relax times (duty cycle)
- 1:1
- 3:1 for disc problems or strech of soft tissue
total traction time (duration)
- initial/acute phase - 5-10 mins
- other conditions - 20-30 mins
- prone or supine position, comfortable position allows muscle relaxation while maximizing the separation between involved structures
- secure appropriate belts or halter to prevent slipping when traction force is applied (thoracic and pelvic belt)
lumbar traction
- traction force should start at 30-25 lbs (13-20kg) and may increase gradually as needed up to approximately 60% of the patients body weight
lumbar traction
initial/acute phase of lumbar traction
29-44 lbs (13-20 kgs)
decrease muscle spasm, stretch soft tissue or disc problem of lumbar traction
25% of body weight
joint distraction of lumbar traction
50% of body weight
decrease compression on a spinal nerve root or facet joint of lumbar traction
50 lbs (22.5 kg) and approximately 60% of body weight
should be decreased during treatment if any peripheralization of signs or symptoms occur or if complete relief of severe pain is attained
force
maximum traction force
hold
lower traction force
relax
when intermittent traction is used, the relaxed force should be ___ of the maximum force or less
50%
recommended ration and duration of hold and relax times depend on the patient’s ___ and ___
condition and tolerance
total traction time (duration) lumbar traction
- disc protrusion: 8-10 mins
- other conditions: 20 - 40 mins
- device that may benefit persons who need to physiologically acclimate to an upright position as a result of a varierty of conditions
tilt table
- designed to detect postural hypotension, a condition that results from changing body position from e prone, supine or sitting position to a more vertical position
tilt table
- useful because it can be elevated gradually and maintained at any position between horizontal and completely vertical
tilt table
- allows the patient to adpat or adjust to any given elevation providing a safe method for the body to accomplish physiological accomodation for upright activities
gradual elevation
- involves placing the patient on a table with a foot support
tilt table
postural hypotension
orthostatic hypotension
equipment of tilt table
- padded board
- foot rest
- straps
- protactor
- crank
physiologic effects of tilt table
- increased circulation in upright position
- improved bowel and bladder function
- increased bone density
- musculoskeletal muscle tone increases in antigravity muscles
neurologic effects of tilt table
- sensory receptors of the soles of the feet, joint proprioceptors, mucles spindles, SCC canals
respiratory effects of tilt table
- increased ventilation, gravity drains bronchioles
patient Vital Signs should be measured before treatment to establish baseline values every after
5-10 minutes
excessive increases or decreses in BP and PR
stop tilt table and stay infront of patient and check consciousness
check patients for tilt table
- consciousness
- excessive perspiration
- formation of edema in lower legs
- decrease in or loss of pedal pulses
- reports of nausea or numbness
- change in facial or limb color
- tingling in the LE and vertigo
___ to the lower ex may be used in tilt table
elastic bandages or hose
indications of tilt table
- any situation where you need to slowly elevate the individual partially or fully
- orthostatic hypotension/postural hypotension
- patient requiring postural drainage
- post fracture, CVA, MS, para or quad, amputee, bronchitis
- circulatory conditions
contraindications of tilt table
- acute spinal or pelvic fractures, acute lumoscaral spain, acute cardiac infarctions
- any patient can stand on their own
- claustrophobic
procedure of tilt table
- introduction
- explain to the patient the procedure, purpose, and what he may experience (dizziness, nausea, lightheadedness)
- asses the pt baseline vital sign
- asses the pt vs at every elevation change
before loading the patient to the tilt table
- check the table is locked and flat
- transfer and position pt properly observing proper body mechanics, positioning and draping
when patient is on the tilt table
- secure strap: pelvic area, above knees, and below breast
- slowly elevate to 20 degrees (10 for initial treatmment)
- elevate on 10 degrees increments
- check the patient every 5 minutes until resting vitals are achieved
elevation of ___ - ___ is sufficient, elevating the table to 90 degrees usually will not be necessary
70-80 degrees
each person must be considered ___, depending on his/her condition, tolerance, etc.
individually
used for elevation beyond 70 degrees
chest straps
frequency and duration, vary depending on person’s:
- condition/diagnosis
- response to treatment
- ability or capacity to adapt to, accommodate or tolerate an upright position
a session may be as brief as ___ - ___ minutes or as long as ___ hour. it may occur once or twice per day or on alternate days
5-10; 1
