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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)
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
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?
does joint distraction increase or decrease the load on a joint?
Joint distraction decreases the load on the joint.
with joint distraction, what happens to the size of the foramen in regards to nerve root compression?
Through joint distraction, the size of the foramen is increased which decreases nerve root compression.
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
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
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.
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.
4.Muscle Relaxation

how is pressure associated with muscle relaxation?
Through reduction of pressure on pain sensitive structures.
4.Muscle Relaxation

how is traction associated with the gate effect?
Through stimulation of mechanoreceptors causing a gate effect
4.Muscle Relaxation

how are the GTOs associated with muscle relaxation?
Through stimulation of GTO’s to inhibit ms guarding
Joint Mobilization:

what is the result of high force traction on the surrounding soft tissue?
High-force traction may stretch surrounding soft tissues
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
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
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
Spinal Cord Pressure

if bilateral neurologic signs, is traction indicated?
Bilateral neurologic signs

dont use traction!
Spinal Cord Pressure

what kind of prolapse is not indicated with traction?
Large disc prolapse,

dont use traction!
Spinal Cord Pressure

what is the likely result of using traction with severe osteophytes?
TRACTION MAY AGGRAVATE!
Spinal Cord Pressure

is traction indicated with a tumor?
no, traction may aggravate!
Clinical Indications

what kind of muslce spasms?
Muscle spasm noted to palpation
Clinical Indications

what kind of neurologic sign?
+ Neurologic signs of altered sensation, strength, or reflexes
Clinical Indications

what kind of feeling in an extremity?
Signs of numbness, pain , or tingling in an extremity
Clinical Indications

what kind of mobility?
Spinal hypomobility, lack of spinal ROM
Contraindications

where is motion contraindicated?
Fracture
Post surgical
Contraindications

which phase of injury?
Fracture
Post surgical
Contraindications

what kind of joint mobility and what kinds of syndromes?
Post surgical Joint hypermobility/instability
Marfan’s or Down’s Syndromes
Contraindications

vascular issues?
Uncontrolled hypertension
Contraindications

would centralization or peripheralization of symptoms be a contraindication?
Peripheralization of symptoms
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
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.
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
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.
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
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
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
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
Cervical Traction

during the acute phase, how much pull and what are the time parameters?
Acute phase – 7-9 lbs, static, 5-10 min
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
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
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.
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.
Traction Guidelines

what must you always give the patient?
Always give the patient the safety switch !
Traction Guidelines

how should you monitor your patient?
monitor your patients closely
Traction Guidelines

what are some relevant sign to look out for?
Relevant signs
Centralized symptoms
Increased flexibility
Decreased paresthesias / numbness
Traction Guidelines

what role does patient education play in long term success?
Education to prevent re-occurrence of symptoms