Week 10 Traction Flashcards

1
Q

Spinal Traction definition

A

A force applied to the body in a way that separates or attempts to separate, joint surfaces and elongates soft tissues surrounding a joint

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2
Q

Theory of Traction is

A
  • Increase space between the vertebrae
  • Intervertebral separation may help normalize the spinal discs position and morphology
  • Increase the dimension of the intervertebral foramen containing the spinal nerve root
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3
Q

Evidence for traction remains….

A

limited/lacking evidence

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4
Q

3 types of traction

A

Mechanical
Manual
Positional

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5
Q

Mechanical Traction

A
  • Application of static or intermittent force by an electrical motor through belts or a halter in the direction of distracting the joint of the spine
  • Static= continuous low load force
  • Intermittent= alternate cycles where traction is applied at a higher force for a period of time followed by a period at a lower dose
  • typical ration 3:1
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6
Q

Manual Traction

A
  • Application of force by the therapist in the direction of distracting the joints
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7
Q

Positional Traction

A

Prolonged specific positioning to place tension or open the intravertebral space on one side of the lumbar spine

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8
Q

Effects of traction on the cervical spine:

A
  • Increased blood flow, fluid exchange and nutrient transport within the disc
  • Increased intervertebral foramina space
  • Disc herniations may be reduced
  • Decrease in pain with some spine conditions
  • Conflicting evidence of effect on cervical spine musculature
  • Duration of any biomechanical or physiological effect is unknown
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9
Q

Effects of traction on the lumbar spine

A
  • Fluid exchange and nutrient transport within the disc enhanced
  • trunk muscle activity may initially increase then return to prior levels : increased blood flow to muscles with decrease in pain
  • During passive traction, intradiscal pressure can be reduced or become negative. traction occurring while the patient is actively contracting the abdominal muscle results in increased intradiscal pressure
  • Opening the intravertebral foramina may decrease nerve root compression in some radicular disorders
  • Expanse of herniated disc material is suggested to reduce in some subjects during traction. Effect seems to be temporary but repeated traction may result in a positive cumulative effect
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10
Q

Contraindications for Spinal Traction

A
  • Acute sprain/trauma
  • Connective tissue disorders or rheumatological disorders resulting in tissue laxity or joint hypermobility/ instability
  • Rheumatoid arthritis
  • Ankylosing spondylitis
  • osteoporosis and osteopenia
  • History of steroid use or medications that weaken or demineralize bone
  • Hypermobility/instability
  • Patients post surgical stabilization or decompression of the spine, spine implants or prosthetic discs
  • pregnancy
  • Peripheralization of symptoms
  • Non-mechanical pain
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11
Q

Precautions of spinal traction

A
  • COPD
  • Claustrophobia
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12
Q

Clinical Prediction Rule for Deciding to use Cervical traction

A
  • Clinical prediction rule is for identifying patients most like to respond favorably to cervical traction
  • Peripheralization of pain with lower cervical mobility testing
  • Positive shoulder abduction test
  • Age 55 years or older
  • Reduction of symptoms with manual distraction
  • positive upper limb tension test
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13
Q

Clinical Prediction rule for at home traction : cervical conditions

A
  • pain 7/10
  • Score on the fear avoidance belief questionnaire work subscale of <13
  • Relief with manually applied traction
  • Pain perceived distal to the shoulder
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14
Q

Cervical Spine Traction Application

A

Total time 10 -20 minutes
- Cycle time= static/intermittent 3:1 or 6:2
- Force max 10-25Ib (max is 30 Ib) Minimal range is 50% max force
- Start low force for 10 minutes and then go up

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15
Q

Lumbar Spine Traction Application

A
  • 10-20 minutes
  • Cycle time 3:1 or 6:2 intermittent/static
    -force up to 50% of the patients body weight
  • lower tension off cycle is 50% or less of max force
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16
Q

Post traction Effects

A
  • watch for rebound effect
  • Have patient relax for 5 minutes after
  • Positive out comes=
    Decreased symptoms
    Centralization of symptoms
    Increase in Rom
    Improved ability to perform ALDs
    Improved reflexes/sensation
    Lumbar traction-increased in symptoms free SLR
17
Q

T/F strong evidence is lacking for traction

A

True

18
Q

T/F evidence supports exercise and manual therapy as a first line treatments for cervical and lumbar spine syndromes

A

True