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46 Cards in this Set
- Front
- Back
Description of Spinal Traction
definition |
Application of a mechanical force to the body in a way that separates, or attempts to separate the joint surfaces and elongate surrounding tissues. (Cameron, 2003)
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Description of Spinal Traction
what might it involve? |
May involve the use of electronic traction units that exert a pulling force through a rope and various halters and straps. (Hayes-2000)
Or be applied manually by the clinician |
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Joint Distraction
definition |
Defined as the separation of two articular surfaces perpendicular to the plane of the articulation. What joint surfaces are effected by this joint distraction?
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does joint distraction increase or decrease the load on a joint?
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Joint distraction decreases the load on the joint.
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with joint distraction, what happens to the size of the foramen in regards to nerve root compression?
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Through joint distraction, the size of the foramen is increased which decreases nerve root compression.
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2.Reduction of Disc Protrusion
who was the "father of traction" and what is the it best suited for? |
According to James Cyriax, traction is the treatment of choice for small nuclear protrusions
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2.Reduction of Disc Protrusion
how is suction associated with intradiscal pressure? |
May be caused by suction due to decrease intradiscal pressure or tensing the posterior longitudinal ligament. See Figure 10-2
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Soft Tissue and Muscle
what happens to tendon length with traction?: |
Tendons may increase in length and there may be increased joint mobility with moderate-load, prolonged force traction.
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Soft Tissue and Muscle
what is the effect of increasing the length of soft tissue? |
Increasing the length of the soft tissues may contribute to spinal joint distraction, increasing spinal ROM and decreasing pressure on the facet joints, the disc and even the nerve root.
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4.Muscle Relaxation
how is pressure associated with muscle relaxation? |
Through reduction of pressure on pain sensitive structures.
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4.Muscle Relaxation
how is traction associated with the gate effect? |
Through stimulation of mechanoreceptors causing a gate effect
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4.Muscle Relaxation
how are the GTOs associated with muscle relaxation? |
Through stimulation of GTO’s to inhibit ms guarding
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Joint Mobilization:
what is the result of high force traction on the surrounding soft tissue? |
High-force traction may stretch surrounding soft tissues
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Joint Mobilization:
what is the result of repetitive low level forces on mechanoreceptors? |
Repetitive low-level forces gain stimulation of mechanoreceptors similar to manual jt. mob
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Patient Immobilization
what kind of traction might be used with immobilized patients? |
Low-load, prolonged static traction can be used to immobilize patients. (10 to 20 lbs)
Fallen out of common use because most pts. don’t benefit from prolonged inactivity |
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Physiological Indications
5 main indications |
-Disc bulge or herniation HNP
-Nerve root impingement- disc or osteophyte, nerve swelling, spondylolisthesis -Joint hypomobility- level specificity through amount of flexion -Subacute joint inflammation – -Through reducing pressure on inflamed joint surface. Paraspinal muscle spasm |
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Spinal Cord Pressure
if bilateral neurologic signs, is traction indicated? |
Bilateral neurologic signs
dont use traction! |
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Spinal Cord Pressure
what kind of prolapse is not indicated with traction? |
Large disc prolapse,
dont use traction! |
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Spinal Cord Pressure
what is the likely result of using traction with severe osteophytes? |
TRACTION MAY AGGRAVATE!
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Spinal Cord Pressure
is traction indicated with a tumor? |
no, traction may aggravate!
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Clinical Indications
what kind of muslce spasms? |
Muscle spasm noted to palpation
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Clinical Indications
what kind of neurologic sign? |
+ Neurologic signs of altered sensation, strength, or reflexes
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Clinical Indications
what kind of feeling in an extremity? |
Signs of numbness, pain , or tingling in an extremity
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Clinical Indications
what kind of mobility? |
Spinal hypomobility, lack of spinal ROM
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Contraindications
where is motion contraindicated? |
Fracture
Post surgical |
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Contraindications
which phase of injury? |
Fracture
Post surgical |
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Contraindications
what kind of joint mobility and what kinds of syndromes? |
Post surgical Joint hypermobility/instability
Marfan’s or Down’s Syndromes |
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Contraindications
vascular issues? |
Uncontrolled hypertension
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Contraindications
would centralization or peripheralization of symptoms be a contraindication? |
Peripheralization of symptoms
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Precautions
lots of them... 13 total |
Tumor
Infection Rheumatoid arthritis Osteoporosis Pregnancy Prolonged steroid use Displacement of annular fragment Medial disc protrusion Severe pain fully relieved by traction Claustrophobia Unable to tolerate prone or supine TMJ/dentures Disorientation |
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Static vs. Intermittent Traction
what does static traction avoid? |
Static traction avoids the activation of the stretch reflex and is indicated during the acute phase when the area is easily aggravated by motion.
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Static vs. Intermittent Traction
what is reported to be the best type of traction with disc protrusions? |
Intermittent traction with a long hold time is reported to be most effective with disc protrusions
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Static vs. Intermittent Traction
what is the most effective type with joint dysfunctions? |
Intermittent traction with shorter hold and relax times are most effective with joint dysfunctions.
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Lumbar Traction Parameters
in the acute phase, what kind of load and for how long? |
Acute Phase – supine, low load 29-44 lbs. Static, 5-10 minutes
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Lumbar Traction Parameters
for joint distraction, what position, how much pull, and what time parameters? |
Joint distraction – supine, position for comfort, up to 50% of body weight, 15sec. on/15sec. off for 20 to 30 minutes
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Lumbar Traction Parameters
to decrease muscle spasm, what position, how much pull, time parameters? |
Decrease muscle spasm – supine, position for comfort, 25% body weight, 5sec. on/5sec. off for 20 to 30 minutes
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Lumbar Traction Parameters
for disc problems or to stretch soft tissue, what position, how much pull, and what time parameters? |
Disc problems or stretch soft tissue – prone or supine, 25% BW, 60sec on/20sec. off for 20 to 30 minutes
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Cervical Traction
during the acute phase, how much pull and what are the time parameters? |
Acute phase – 7-9 lbs, static, 5-10 min
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Cervical Traction
for joint distraction, how much pull and what are the time parameters? |
Joint distraction – up to 7% of BW, 15sec. on/15 sec. off, 20-30 minutes
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Cervical Traction
to decrease muscle spasm, how much pull and what are the time parameters? |
Decrease muscle spasm – 10-20 pounds,5sec. on/5sec. off for 20 to 30 minutes
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Cervical Traction
for disc problems or to stretch soft tissue, how much pull and what are the time parameters? |
Disc problems or stretch soft tissue – 10-20 pounds, 60sec. on/20sec. off for 20 to 30 minutes.
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Cervical Traction
for static home traction units, how much pull and what are the time parameters? |
Static home traction units – 6-15 pounds, 5 to 30 minutes.
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Traction Guidelines
what must you always give the patient? |
Always give the patient the safety switch !
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Traction Guidelines
how should you monitor your patient? |
monitor your patients closely
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Traction Guidelines
what are some relevant sign to look out for? |
Relevant signs
Centralized symptoms Increased flexibility Decreased paresthesias / numbness |
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Traction Guidelines
what role does patient education play in long term success? |
Education to prevent re-occurrence of symptoms
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