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68 Cards in this Set
- Front
- Back
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Where can mechanical traction be applied |
Cervical or lumbar spine and hip types of mechanical traction |
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Types of mechanical traction |
Electrical over the door and home traction |
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Versions of mechanical traction |
Continuous(static) or intermittent |
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Advantages of mechanical |
Force and time well controlled, graded, and replicable. Clinician does not need to be with patient throughout Electric units can be static or intermittent Some types inexpensive Some types can be used as part of home program |
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Disadvantages of mechanical |
Electric units expensive Time consuming to set up Passive patient role Belts uncomfortable Mobilizes broad regions of the spine |
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Electrical mechanical units |
Lumbar or cervical regions Force applied by electric motor Continuous or intermittent |
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Over the door cervical traction advantages and disadvantages |
A- inexpensive, easy to set up, compact D- not as precise, unable to use if they have tmj issues |
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Is over the door cervical traction only static? |
Yes |
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Donut tractioner and slide machine traction what are disadvantages and advantages |
A-offer more treatment options, more precise than over the door. D more expensive than over the door More complex take up more space |
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Example of self traction How does it work what does it work for |
Dead hangs Uses gravity and body weight Only low load possible Fixate upper body Varies positions |
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Advantages and disadvantages of dead hangs |
A-Minimal or no equipment needed, Easy for patient to control and perform, can be performed in many environments at so can be performed throughout the day D-low Max force so maybe not be affective, requires strong injury free upper extremities, canβt be used for cervical, no research to support efficacy must have adequate postural awareness and control to position the body appropriately |
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What is positional traction |
Prolonged placement of the patient in a position that places tension on only one side of the lumbar spine |
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What does positional traction do |
Gently stretches the lumbar spine by applying a prolonged low load longitudinal force to one side of the spine |
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What is positional traction most effective for? |
Unilateral symptoms |
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What are all the effects of positional traction |
Unlikely to cause distraction but it decreases muscle spasms stretched soft tissue, spinal elongation. |
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When is positional traction effective Early or late |
Early |
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What is manual traction and where can it be applied to |
With hands/ by force from the therapist Cervical lumbar spine and peripheral joints |
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For long for static manual traction and who is it indicated for
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15 seconds up to 5 minutes Patients whose symptoms are relieved my traction and aggravated by motion |
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How long for intermittent manual traction |
15-30 seconds Release for 15-30 seconds Patients symptoms are relieved by traction and motion |
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Effects of spinal traction |
Distract joint surface Reduce protrusion of nuclear disc material Stretch soft tissue Relax muscles Mobilize joints Gate pain by stimulation of mechanoreceptors |
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Separation of to articular surfaces perpendicular to the plane of articulation |
Joint distraction |
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What does joint distraction do |
Reduce compression of joint surfaces Widens intervertebral foramen Reduce pain originating from a joint injury, inflammation, or nerve root compression |
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For distraction to occur force applied has to be what |
Great enough to cause sufficient elongation of soft tissue surrounding the joint surfaces to separate |
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What percentage of the patients body weight is sufficient to increase the length of the lumbar spine |
25 |
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What percent of patients body weight is needed to distract lumbar facet apophyseal joints |
50 |
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What percentage of parents body weight for cervical |
7 or 7-10 |
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How many pounds to treat soft tissue or muscle spasms |
11-15 pounds |
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What percentage of body weight required for joint distraction treatment |
13-20 |
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What percentage of body weight required for joint distraction treatment |
13-20 |
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How many pounds for joint distraction Cervical max |
20-30 lbs |
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How many pounds to reduce disc prolapse to cause retraction of herniated disc material in lumbar How many for cervical |
60-120 15-30 |
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What is suction caused by |
Decreased intradiscal pressure pulling the displaced parts of the disk back towards the center |
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What does reduction of disc protrusion do |
Reduce the size of disc herniation Increase space between the spinal canal Widen the neural foraminifera Decrease the tension of soft tissues and nerve Modify tone of low back muscles
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Are manual and self traction sufficient enough to reduce herniated disc material |
No |
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Why does soft tissue stretching traction lengthening help |
Increase the length of tendons Improve joint mobility Spinal joint distraction Reduction in disc protrusion Increasing spinal rom Depressing pressure on the facet joints nerve roots and discs even when joint surfaces separation is not achieved |
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How can traction relax muscles Specifically neuro wise for intermittent and static how |
Breaks up pain spasm pain cycle Depression monosynaptic response through static traction Stimulates gto to inhibit alpha motor neuron firing (intermittent traction) |
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How does traction increase joint mobility |
Stretching soft tissue structures surrounding the joint |
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How does intermittent traction mobilize joint |
Moving joints to stimulate mechanoreceptors thus decreasing joint related pain by gating the afferent transmission of pain stimuli |
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Clinical indications for traction |
Disc bulge or herniation Nerve root impingement Joint hypomobility Subacute joint inflammation Paraspinal muscle spasms |
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Clinical indications for traction |
Disc bulge or herniation Nerve root impingement Joint hypomobility Subacute joint inflammation Paraspinal muscle spasms |
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When is traction less likely to be effective |
When a large disc herniation protrudes into the spinal canal Or protruding discal material becomes calcified from chronic inflammation More effective for small and soft disc herniation |
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What does traction do for a herniated disc bulge |
Reduce it and the pressure on the nerve roots |
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What phase should you use traction for disc bulge or herniation? |
Soon but not acute |
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What causes nerve root impingement |
Bulging or herniated disc Ligament encroachment Spinal nerve root swelling Spondylolithesis |
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How does joint hypomobility get affected by traction |
Global improvement in joint mobility Can have detrimental affect on hypomobility segments |
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How does positioning assist in directing forces with hypomobility |
Lumbar flexion localizes the force to the upper lumbar and lower thoracic spine In neural or extension: localize the force to the lower lumbar spine Cervical: flexed position focused the force to lower c spine 25 degrees of flexion, mid spine 10-20 degrees upper cervical 5-10 degrees Neutral or slightly extended focuses the force to the upper c spine |
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When should intermittent traction be avoided |
After an injury Acute when repetitive motion can worsen an injury or increase inflammation Use static at this time |
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When is acute inflammation an absolute contraindication |
Intermittent traction is one for an acute injury or acute inflammatory response Both static and intermittent are contraindicated: immediately within 72 hours of an injury or of acute inflammation is present Static is okay when: after the first 72 hours and inflammation is decreasing |
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How does traction help para spinal muscle spasm |
Reduce pain helping the pain spasm pain cycle, inhibition of alpha motor neurons from stimulation of gtos , or funding the root cause |
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Contraindications |
Where motion is contraindicated( unstable fracture cord compression, immediately after spinal surgery. Acute injury inflammation: check for signs(ra oa start with static) Joint hyper mobility Peripheralization of symptoms with traction Uncontrolled hypertension |
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Contraindications |
Where motion is contraindicated( unstable fracture cord compression, immediately after spinal surgery. Acute injury inflammation: check for signs(ra oa start with static) Joint hyper mobility Peripheralization of symptoms with traction Uncontrolled hypertension |
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Examples of jointhyper mobility |
Pregnant Recent fracture dislocation poor pressure congenital ligament laxity Downβs syndrome marfans syndrome |
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Traction precautions Spine |
Structural diseases or conditions affecting spine Conditions where belts are hazardous Displaced annular ligament fragment Medial disc protrusion When severe pain resolved fully (nerve block) Claustrophobia Inability to tolerate supine or prone Disorientation |
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Precautions for cervical traction |
Tmj dentures |
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Patient has aggravated forward bending and sitting and has been diagnosed with a herniated lumbar disc Parameters??? |
Intermittent Hold 60 relax 20 5-10 (20-30) mins based on symptoms or pain scale Neutral position not flexed in prone |
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Static or intermittent for acute or chronic inflammation |
Static |
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If protrusion Static or intermittent |
Intermittent |
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Hold relax times for disc protrusion |
60/20 |
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Spasm hold and relax |
5/5 |
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Spasm hold and relax |
5/5 |
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Joint dysfunction hold release times |
15/15 |
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To target lower spine with traction is the angle bigger or more straight |
Straight |
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To target lower spine with traction is the angle bigger or more straight |
Straight |
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If youβre trying to get the higher lumbar what angle? Flexed or straight |
Flexed |
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To target lower spine with traction is the angle bigger or more straight |
Straight |
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If youβre trying to get the higher lumbar what angle? Flexed or straight |
Flexed |
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If youβre trying to get upper cervical what angle straight or flexed |
Straight |
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If youβre trying to get lower neck what angle |
More flexed |
