Mechanical Traction

Question 1

Traction

Answer 1

a drawing or separating tension applied to a body segment
A separating force
Ancient treatment technique
Enough force to cause physical movement

Question 2

Physical effects of traction

Answer 2

Spinal movement
Bone
Ligaments
Disks
Articular facets
Muscles 
Nerves

Question 3

Spinal movement

Answer 3

Facilitates movement
Separation 1-2mm per intervertebral space - enough to centralize the np
Transient change - coming off of traction everything can go back but feels good while traction on (disc herniation can see sustained effects though)

Question 4

Effects on bone

Answer 4

limited effect

Facilitation of movement may reduce immobilization related to bone density loss

Question 5

Effects on ligaments

Answer 5

Elongating force - if up to 20 minutes can see creep and elongation of ligaments
Proprioceptive effect - use gate control theory to reduce pain

Question 6

Effects on disk

Answer 6

most widely supported
Dec central disc pressure
Encourages np to centralize

Question 7

Effects on articular facet joints

Answer 7

Separates joint surfaces
Improves synovial fluid exchange
Proprioceptive effect

Question 8

Effects on muscles

Answer 8

Provides muscle stretch

Relaxation effect - inhinit muscle tone and reduce mm spasm

Question 9

Effects on nerves

Answer 9

Relieves pressure on nerve roots
Proprioceptive effect
Induction of movement - Dec inflammatory soup

Question 10

Common indications for spinal traction

Answer 10

Nerve root impingement
Disc herniation
Spondylolisthesis
Stenosis
Joint hypomobility
Subacute pain
Muscle spasm or guarding

Question 11

Contraindications for spinal traction

Answer 11

Acute inflammation
Fractures
Vertebral joint instability 
Tumors
Osteoporosis
Bone or joint infection
Pregnancy
Cardiovascular or pulmonary concerns

Question 12

Traction techniques

Answer 12

Positional
Inversion
Manual
Mechanical

Question 13

Parameters of traction

Answer 13

Body position
Force utilized
Intermittent vs Sustained
Progressive vs Regressive
Duration of tx
Assessment of effectiveness

Question 14

Parameters - Body position

Answer 14

Most often supine but prone is good too for example if you have patient with disc herniation you don’t want to be pulling them into flexion

Question 15

Parameters - force utilized

Answer 15

Depends on if cervical or lumbar

50% of body weight for lumbar

Question 16

Parameters - Intermittent vs sustained

Answer 16

on and off vs a static pull for duration of treatment

Question 17

Parameters - progressive vs regressive

Answer 17

Slowly ramp up the pull and regressive is slowly ramp down

Question 18

parameter - Duration of treatment

Answer 18

total of how long they will be on traction

Question 19

Assessment of effectiveness

Answer 19

Both duringa nd after
Check on the frequently
Kill switch if needed

Question 20

Positional lumbar traction

Answer 20

Knees to chest (inc space btw facets)
Childs pose
Traction over a therapy ball
Sidelying with rotation and towel

Question 21

Manual lumbar traction

Answer 21

Unilateral leg pull
Segmental lumbar flexion
Assisted sidelying with rotation

Question 22

Mechanical lumbar traction - patient position

Answer 22

Neutral spine position is ideal
Prone vs supine depending on dx
Consider patient comfort

Question 23

Mechanical lumbar traction - force

Answer 23

65-200 pounds is therapeutic - depends on their body weight though
50% of pt bodyweight

Question 24

Mechanical lumbar traction - intermittent vs sustained

Answer 24

Sustained preferred for herniated disc

All other indications PT may choose

Question 25

Mechanical lumbar traction - progressive vs regressive

Answer 25

Based on patient comfort

Question 26

Mechanical traction lumbar - duration

Answer 26

8 - 30 minutes Typically start with 8 and then can add time and move up to 15-20 minutes Need at least 8 minutes of sustained pull to get therapeutic effect

Question 27

Herniated disc - lateral malleolus fracture - what are your parametes

Answer 27

Prone 50% of their body weight Static 8 minutes

Question 28

Manual cervical traction - bilateral vs. unlateral

Answer 28

if bilateral problem go bilateral | if unilateral go unilateral

Question 29

Manual cervical traction - force

Answer 29

less than 20 pounds

Question 30

Mechanical cervical traction - patient position

Answer 30

Supine with neck flexed 20-30 degrees | Force on occiput vs chin (most from occiput) because chin can cause force on TMJ

Question 31

Mechanicalcervical traction - force

Answer 31

20-50 pounds is safe | Start with the 7-8 pounds and then can increase it from there to 20/25 pounds

Question 32

Mechanical cervical traction - intermittent vs. static

Answer 32

Intermittent with at least 7 seconds on | Intermittent more common for cervical than static

Question 33

Mechanicsl cervical traction - progressive vs regressive steps

Answer 33

Patient comfort

Question 34

Mechanical cervical traction - duration

Answer 34

20-25 minutes

Question 35

herniated cervical disc btw C4 and C5 - position

Answer 35

``` Supine Pull at 20-30 degree angle Start force at 20 pounds Use static for disc could start with 8-10 or 20 depending on if you did manual traction beforehand ```