06-12: Cervical Traction

Question 1

Vertebral Artery Tests (3)

Answer 1

• Classic: Extension, Sidebending, Rotation
• Full backward bending (extension) for bilateral occlusion
• Seated with full rotation - hold for 10 seconds (Australian Protocol)
• Red flags: Episodes of syncopy (fainting, blackout); nausea and dizziness; blurred vision

Question 2

Alar Ligament Test

Answer 2

• Palpate SP of C2, move head passively side to side

- Movement of SP of C2 should be detected with palpating fingers

Question 3

Sharp-Purser Test

Answer 3

• Therapist uses twi fingers to make contact with lamina of C2 on each side of SP
• Contact pt’s forehead or cradle entire head for stability. Pt performs active FB. Therapist pushes C2 anteriorly.
• Disruption of cruciate ligament will produce “clunk” sound or perceived back glide of atlas on axis.

Question 4

Cervical Traction - Position

Answer 4

• Pt supine
• Neck flexion 20˚-30˚ (Use goni to verify)
• Harness: Placed on occiput, not chin

Question 5

Cervical Traction - Parameters

Answer 5

• Intermittent: Incorporates rest period
• Force: Up to 10 lbs 1st session, can increase in increments. 7-10% of body weight (BW) for soft tissue stretch, muscle spasm or disc protrusion. 13-20% of BW (20-30 lbs, max is 30 lbs) as tolerated for separation of vertebrae.
• Phases: Traction time = 7 sec. Rest time = adequate for patient (at least 10 sec.)
• Total Treatment: 20-25 minutes
• Ensure: Head rest in open position prior to patient lying down
• Provide: Call bell and panic control