Week 10 Review

Question 1

Patients with indications for lumbar traction (meaning they could benefit from the effects of traction), who also have claustrophobia may benefit more from:

Answer 1

Manual lumbar traction

Question 2

Which of the following is an advantage of positional traction therapy?

Answer 2

It can be used as part of home therapy when symptoms are severe and irritable

Question 3

The force of traction:

Answer 3

Should not exceed 30 lb. in the cervical spine

Question 4

Which of the following is NOT a contraindication to the use of static traction?

Answer 4

Chronic injury or pain

Question 5

If a patient has peripheralization of symptoms while being treated with mechanical traction, what should you (the therapist) do FIRST:

Answer 5

Immediately stop the treatment

Question 6

In which of the following situations is spinal traction NOT appropriate?

Answer 6

To provide relief from pain directly after a cervical spine fracture

Question 7

Traction may help patient’s whose symptoms are ____ by joint loading and are ____ by distraction or reduction of joint loading.

Answer 7

aggravated; relieved

Question 8

To minimize the risk of adverse consequences, traction should be applied with a ____ at first, while monitoring the patient’s response. If the response is positive, traction force can then be gradually ____ until maximum benefit is obtained.

Answer 8

low force; increased

Question 9

For mechanical lumbar traction, when the intermittent setting is used, meaning there are hold and relax times where the force varies, the relaxed force should be approximately ____ of the maximum force or ____. Total release of the force during the relaxed phase of intermittent traction ____ recommended because this can cause rebound aggravation of the patient’s symptoms.

Answer 9

50%; less; is not

Question 10

The greatest difference between the parameters used for lumbar and cervical traction is the:

Answer 10

amount of force

Question 11

You have a patient who has pain related to joint dysfunction (meaning the apophyseal joints of the lumbar vertebrae are not moving as they should). As such, you decide that they are a perfect candidate for intermittent lumbar traction with short hold and relax times.

This is not the patient’s initial use of traction during this episode of care, the patient weighs 200 lbs, and you have appropriately decided to set the max force for the hold time at 100 lbs.

Using what you know about the recommendations for the relaxed force for intermittent lumbar traction what is the most appropriate force to be used during the relax time (the minimum force).

Answer 11

The relaxed force can safely be set on the machine at 50 lbs (meaning the patient drops from 100 lbs down to 50 lbs of force during the relax time)

Question 12

Mechanical traction is unlikely to be effective in achieving which of the following?

Answer 12

Permanent reduction of herniated nucleus pulposus

Question 13

What is the evidence on the effect of cervical traction on intervertebral foramina dimensions?

Answer 13

Increase during traction application

Question 14

How much traction force is required to overcome friction of the lower body when doing lumbar traction?

Answer 14

Up to approximately one-half of body weight

Question 15

How can the friction provided by the patient’s body weight against the traction table be significantly reduced during lumbar traction?

Answer 15

Unlock the table so segments can be separated.

Question 16

The most commonly used maximal force parameter for mechanical cervical traction is which of the following?

Answer 16

10-25 pounds

Question 17

Which of the following is an indication for traction?

Answer 17

Distraction of facet joints to relieve pain from degenerative joint disease

Question 18

Which of the following lists contains only contraindications or precautions for traction?

Answer 18

Spinal instability, pregnancy, claustrophobia

Question 19

Which of the following is an appropriate guideline regarding the patient’s response to traction?

Answer 19

The patient should not have an increase in symptoms during or after traction.

Question 20

Which of the following is the most important parameter to consider when the goal of traction is separation of lumbar vertebral bodies?

Answer 20

Selecting an appropriate force

Question 21

Which of the following is correct with regard to cervical traction?

Answer 21

Cervical traction applied with the patient sitting requires more force to achieve the desired effect than when applied with the patient supine.

Question 22

Clinical effectiveness of traction appears to be best when performed

Answer 22

Combined with manual therapy and exercise

Question 23

A recently published clinical prediction rule for cervical traction includes which of the following?

Answer 23

Positive shoulder abduction test

Question 24

Which of the following is true regarding lumbar spine decompression units?

Answer 24

There is lack of evidence in the literature to validate the effectiveness of these units.

Question 25

Your patient is considering purchasing an inversion device for her back pain. Which of the following medical problems would preclude her use of this device?

Answer 25

Hypertension

Question 26

According the the Neck Pain CPG, patients with acute neck pain with radiating arm pain should receive the following interventions. (Select all that apply)

Answer 26

-Mobilizing exercises
-short term use of a cervical collar
-laser
-Stabilizing exercises

Question 27

According to the Neck Pain CPG, patients with chronic neck pain with radiating arm pain should receive the following interventions. Select all that apply.

Answer 27

-stretching and strengthening exercises
-cervical and thoracic mobilization/manipulation
-mechanical intermittent cervical traction

Question 28

In the Neck Pain CGP, which of the following group of patients was cited as appropriate for intermittent cervical mechanical traction, with strength of evidence level B?

Answer 28

Chronic neck pain with mobility deficits

Question 29

In the LBP CPG, the evidence states, “There is conflicting evidence for the efficacy of intermittent lumbar traction for patients with low back pain. There is preliminary evidence that a subgroup of patients with signs of nerve root compression along with peripheralization of symptoms or a positive crossed straight leg raise will benefit from intermittent lumbar traction in the prone position.

Answer 29

true

Question 30

In the LBP CPG, the evidence states, “There is moderate evidence that clinicians should not utilize intermittent or static lumbar traction for reducing symptoms in patients with acute or subacute, nonradicular low back pain or in patients with chronic low back pain.”

Answer 30

true