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DPT 608 > Spinal Traction > Flashcards

Spinal Traction Flashcards

(104 cards)

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1
Q

is traction a manipulation?

A

no it is much slower

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2
Q

what are the biomechanical and physiological effects of cervical traction?

A

Increase space bw vertebrae

Decrease amount of herniation

Decrease pain

Increase disc height

Soft tissue stretching

Ms relaxation

Jt mobilization

May improve blood flow

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3
Q

what are the biomechanical and physiological effects of lumbar traction?

A

Increased ms activity (initially)

Increased SLR ROM (when pain is distal to the knee)

Decreased disc material beyond borders of vertebral body

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4
Q

what are the components of the traction table?

A

traction unit

electric motor and control panel

cables attached to traction harness

removable harness

pt control safety switch

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5
Q

what are the parameters we can adjust on traction?

A

duration

cycle times

tension levels

progressive/regressive steps in tension

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6
Q

t/f: split tables help reduce friction

A

true

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7
Q

t/f: the pt must be comfortable and relaxed during tx

A

true

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8
Q

what is involved in prep of mechanical traction?

A

adjust the harness to accommodate the pt

increase/decrease flexion

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9
Q

increased flexion of the traction target what cervical segments?

A

lower cervical segments

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10
Q

a more neutral flexed position targets what cervical segments?

A

upper cervical segments

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11
Q

what are the indications for traction?

A

radicular complaints

cervical or lumbar spine pain with radiculopathy

presence of sx distal to the knee, worsened with extension along with crossed SLR and neuro deficits

pts who have reduction in sx with manual traction

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12
Q

what radicular sx would be an indication for traction?

A

scapular pain, shoulder, arm, distal UE pain, numbness, paresthesia, motor changes

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13
Q

would traction be the first choice tx for neck pain and loss of motion?

A

no

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14
Q

do we start with mechanical or manual traction?

A

manual traction to trial for PT response and reactivity

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15
Q

is mechanical traction with exercise and mobs or stand alone manual traction more effective?

A

mechanical traction with exercise and mobs

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16
Q

how many lbs of force should we start with in cervical traction?

A

10 lbs

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17
Q

how much should we inc the force by at a time with cervical traction?

A

3lbs

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18
Q

what is the max force to use in cervical traction?

A

20-25 lbs

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19
Q

t/f: with shorter hold times in traction, more movt is performed within a tx session

A

true

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20
Q

what is the typically on/off hold with traction?

A

30-60 sec on, 10-30 sec off

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21
Q

should we inc or dec on/off time as the pt gets better?

A

decrease it

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22
Q

what tx time should we start with?

A

10 min and work up to 20 based on pt response

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23
Q

what are the typical starting parameters for cervical traction?

A

10-15 lbs for 10 min and inc force and duration in subsequent tx

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24
Q

when would we put a pt in prone?

A

when they have an extension bias

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25
when would we put a pt in supine?
most times when they have a flexion bias
26
why do we put pts in 90-90 position?
for relaxation/comfort
27
where do we secure the thoracic harness in lumbar traction?
just under the ribs
28
where do we secure the pelvic harness in lumbar traction?
at the illiac crests
29
t/f: there is limited evidence to support the effectiveness of lumbar traction
true
30
is there universal agreement on the parameters for traction?
nope
31
if the jt is irritable, should we be fast or slow to progress?
slow
32
if adequate improvement isn't maintained, should we be fast or slow to progress duration?
quickly increase duration
33
what increment should we increase the duration for traction at a time?
3-5 min at a time
34
after ___ tx attempts of traction and there is no change in sx, we should consider a dif approach
3
35
with severe sx/high reactivity, should we use longer or shorter holds and rest periods?
longer holds and rest periods
36
as sx become less severe and irritability decreases, should we increase or decrease the hold and rest periods?
decrease holds and rest periods
37
t/f: positioning on the floor is required with a home lumbar traction unit to be stable
true
38
is there more or less tension produced in a home traction compared to a clinical unit?
less
39
what is gravity-facilitated traction?
the body is placed in an inverted position
40
what are the risks of gravity-facilitated traction?
it increases intraocular pressure, causes alterations in BP, and may induce anxiety, dizziness, and vertigo
41
t/f: safety and adverse effects a re major concern with inversion traction
true
42
t/f: there is strong evidence for PT outcomes with traction
false, it is lacking
43
does cervical or lumbar traction have moderately higher evidence?
cervical
44
what do we need to document about traction?
duration tolerance force pain fxn walking tolerance
45
the evidence shows that 50% of _____ pts who regularly use inversion therapy are less likely to need surgery
sciatica
46
what are the PT reports in the literature following inversion therapy?
decreased pain decreased sensory impairment some eliminated analgesic meds increased ROM improved reflexes improved fxnal mobility that was limited by LBP
47
post-traction, what should we do?
have the pt rest for 5 min watch for "rebound effect" measure outcomes
48
what is traction reaction?
as you are releasing the traction, the body goes into a sympathetic response
49
what is "rebound effect"?
decreased sx during traction but increases sx after
50
what outcomes should we measure after traction?
sx ROM/strength ADLs reflexes/sensation
51
what are the contraindications for traction?
Acute spine trauma Joint hypermobility or instability RA and ankylosing spondylitis Hx of osteoporosis or osteopenia (any recent fx=don’t do traction) Hx of steroid use Pts who have received surgical stabilization or decompression, spine implants, or prosthetic discs Pregnancy (lumbar traction) uncontrolled HTN peripheralization of sx with traction pain of non-mechanical/unknown origin when motion is contraindicated (fx, cord compression, post spinal surg) acute injury/inflammation
52
what are the precautions for traction?
COPD claustrophobia
53
what are the types of traction?
cervical/lumbar manual/mechanical auto traction inversion aquatic therapy
54
what is spinal traction?
applying tensile forces to the long axis of the spine
55
t/f: traction can have effects on autonomic fxn
true
56
how many lbs does it take to reduce lumbar discs?
60-120 lbs
57
how many lbs does it take to reduce the cervical spine discs?
15-30 lbs
58
what soft tissue may be stretched by traction?
ms tendons ligs discs
59
what is autotraction?
traction where the pt actively participates and adds resistance by pushing (legs) and pulling (arms)
60
what is the technique for using auto traction for lumbar radiculopathy?
start in the least painful position (protective position) until sx quiet down using just gravity traction, then have them push and pull
61
t/f: auto traction shows superior results in the literature compared to standard traction
true
62
t/f: autotraction is used a lot in the US
false
63
why isn't autotraction frequently used in the US?
bc of the cost, training, time, and ease of other approaches
64
t/f: autotraction is traction used to recover motion without pain
true
65
what pts are we often using auto traction with?
VERY acute pts
66
what is autotraction billed as?
neuromuscular re-ed
67
is inversion therapy available without a prescription?
yes
68
if a pt has an ankle injury, what form of traction would we avoid using?
inversion traction
69
t/f: inversion traction shows increased lumbar IV space post tx
true
70
what does the literature say about the effects of inversion therapy?
it may be effective only for reducing pain in LR short term it is preferred to passive tx like bed rest and meds no sig effects on activity due to LR insufficient data that it given additional benefits when combined with PT tx
71
what is aquatic traction?
aquatic vertical suspension in deep water
72
how long is aquatic traction in duration usually?
10-20 min
73
what does the indirect traction load in aquatic traction do?
removes compressive pre-loading of body weight removes ms forces
74
what does the direct traction load in aquatic traction do?
active tensile forces due to buoyancy and leads placed on the ankles
75
what does the evidence say about aquatic traction?
there is limited evidence for lumbar radiculopathy
76
what is positional traction?
providing traction with different positioning like rotation and lateral flexion in SL
77
what is the manual unloading test (MUT)?
the PT applies low grade lifting force to the pt in standing
78
what is a (+) MUT?
sx reduction
79
if a pt has pain at rest, how should we perform the MUT?
the pt stands with arms crossed PT stands in the painful side and grasps around the pt's lower aspect of the rib cage gradually apply a low grade vertical lifting force until the pts upper body begins to lift
80
if the pt has no pain at rest, but pain with SB, how do we do the MUT?
PT stands on side opposite to the painful direction of SB the pt moves into the pain provoking direction until pain is reproduced PT applied a vertical unloading force (pos or neg)
81
if the pt has no pain at rest, but pain with flex/ext, how do we do the MUT?
PT stands on side of least pain and applies a vertical unloading force
82
what does the evidence say about the MUT?
it is reliable measure with a (+) result found to be moderately to strongly correlated to the immediate response following a single session of mechanical traction
83
what are the neurophysiological effects of traction?
traction stimulates proprioceptors, vertebral ligs, and monosegmental ms traction "shocks" dysfxnal higher centers by relaying u physiological proprioceptive info centrally, "resetting" the dysfxn
84
what traction variables are up to the practioner's discretion in delivery of cervical traction?
static/intermittent traction angle of application dosage supine vs prone positioning of LEs
85
what is the most important consideration in spinal traction?
pt comfort
86
t/f: amount of tension in traction should not produce peripheralization/sx worsening
true
87
what should we do if traction produces peripheralization or sx worsening?
cease tx, reconsider the doe and consider other tx options
88
what is a normal/common response to traction?
a mild stretching or pulling sensation often described as "feels good"
89
what position should we consider for unilateral conditions?
SL
90
with continuous mode traction, ____ tension and duration are used
less
91
what safety measures do we use with spinal traction?
the pt switch bell telling pts not to get up and move for a few minutes after
92
what changes in sx do we hope to see with traction?
centralization/decreased sx increased ROM improved strength/sensation/reflexes/fxn
93
it is common practice to start lumbar spinal traction with what force?
30-45 lbs
94
what % body weight can we get up to wit lumbar traction?
50-60% body weight
95
what is the typical cycle timing used in lumbar traction?
30 sec higher tension, 10 sec lower tension
96
is static mode more frequently used in lumbar or cervical traction?
lumbar traction
97
what is the typical duration of lumbar traction?
10-20 min depending on pt response
98
is the rebound effect more pronounced in the cervical or lumbar spine?
lumbar spine
99
how can we minimize risk of adverse effects with traction?
start with low force monitor pt response
100
when would pressure from the pelvic belt in lumbar traction be hazardous?
Hiatal hernia Compromised femoral arteries Osteoporosis-thoracic belts, ribs Trouble breathing-thoracic belts Compromised circulation to brain
101
what are possible adverse effects of mechanical cervical traction?
HA, dizziness, nausea after tx stretching of baroreceptors in the carotid sinus
102
what are the dif home cervical traction units?
overhead supine
103
when are home traction units indicated?
for short/long term management of sx, implants, and nerve ablation to enhance effects achieved clinically to empower the pt in their own recovery
104
what should a PT do b4 letting a pt use a home traction unit?
take pt through tx set up while still under supervision provide written instructions provide safety instructions-timer, avoid falling asleep review adverse rxns, problem solving

DPT 608 (20 decks)

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