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Cox Flexion Distraction > Final Lab Exam > Flashcards

Flashcards in Final Lab Exam Deck (27)
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1

Effects of distraction

1. Decreased intradiscal pressure
2. Increased IVD height
3. Increased IVF size
4. Restore facet joint ROM

2

Normal L3 disc pressure; recumbent to sitting

25-275 mmHg

3

Position 5 for 150-200 lbs then...

go up or down one lighted position for each 25 lbs more or less

4

Distraction LOD

2/3 I-S and 1/3 P-A

5

SCP

SP above the involved disc

6

CP

Softest part of thenar eminence

7

Joint play

Intrinsic movements that cannot be produced through the action of voluntary muscles

8

Table prep

Check thoracolumbar drop and caudal section release
Adjust table elevation
Ask patient weight and set spring tension

9

Patient prep

Patient unbuckles belt
Instruct patient on hoop tension and mounting table
Assist patient onto table
Position ASIS 2" above bottom of thoracolumbar cushion
Adjust ankle rest for slight plantar flexion
Adjust tiller bar for doctors arm length
Patient permission to expose lumbar region
Stabilize and release caudal section of table
Fine tune spring tension

10

Doctor prep

Position height of table at doctor's mid thigh
Doctor stance one thigh on each side of patients knee
Extend and lock superior arm 30-45 degrees

11

Tolerance testing

1. Central (hold for 4 seconds and release)
2. Lateral (hold ankle uninvolved side first; hold for 4 seconds then release)
3. Central w/ restraints (hold for 4 seconds and release)

12

Protocol 1 candidates

For sciatic patients (issues with a radicular component)

13

Protocol 1

3 x 20 second decompression
[5 x (2 sec down/2 sec up)]
Treat for trigger points between decompression sessions

14

Protocol 1 patient management

Treatment daily.
With 50% improvement treatment every other day
50% more improvement treatment 2x /week
50% more improvement treatment 1x /week

15

Clinical finding needing referral

Progressive loss of motor function

16

Acute low back patient should not...

SIT (not until 50% improvement)

17

Getting patient off table

Adjust table height, secure caudal section, secure lateral flexion, LOWER TILLER BAR, remove ankle cuffs, offer to assist patient, advise patient it may take them same as in the morning

18

Protocol 2 candidates

Patients without a radicular component

19

Switch from protocol 1 to 2

When patient has made 50% improvement

20

Protocol 2

10 x 2 second pumps (1 sec up/1 sec down) in the following ROM
flexion, lateral flexion, circumduction, extension

21

Protocol 2 extension LOD

2/3 PA, 1/3 IS

22

Protocol 1 variation used when...

1. Pain prevents patient from lying prone
2. Patient fails tolerance test
3. Pregnancy

23

Protocol 1 variation

Patient chooses which side to lay on, their whole pelvis rests on caudal section, patient feet stabilized with tiller bar, doctors superior hand index and middle finger contact and stabilize SP above involved disc, doctors inferior hand stabilize SP below involved disc. Doctors inferior arm pulls patients pelvis into flexion. (Follow protocol 1 guidelines)

24

Protocol for spondylolisthesis

Patient lies prone, form fulcrum under segment via foam roll or elevated lumbar section, doctor contacts SP of segment ABOVE spondy (less force is needed due to fulcrum)

25

Spondylolisthesis fulcrum distraction...

1. Prevents further anterior displacement of involved vertebral body
2. Reduces lumbar lordosis allowing access to SP contact

26

Scoliosis

Introduce forces into the convexity of the curve only

27

Cox for scoliotic patients

1. Scoliosis with a disc/radicular lesion (protocol 1 presentation)
2. Scoliosis with a non-disc/radicular lesion (protocol 2 presentation)
3. Scoliosis: general stabilization and correction