Spinal Traction (wk 4)

Question 1

What are the goals for spinal traction? (7)

Answer 1

To decrease:

1. Joint stiffness (hypomobility)
2. Meniscoid blocking
3. Muscle spasm
4. Disc protrusion
5. Discogenic pain
6. Joint pain
7. Nerve root impingement

Question 2

What are the general indications for spinal traction? (2)

Answer 2

1. Cervical or lumbar spine pain with radiculopathy

2. Patients who have reduction of symptoms with manual traction

Question 3

Contraindication or precaution of spinal traction:

Claustrophobia

Answer 3

precaution

Question 4

Contraindication or precaution of spinal traction:

acute strains, sprains, and inflammation

Answer 4

Contraindication

Question 5

Contraindication or precaution of spinal traction:

Hiatal hernia

Answer 5

precaution

Question 6

Contraindication or precaution of spinal traction:

spondylolisthesis

Answer 6

Contraindication

Question 7

Contraindication or precaution of spinal traction:

fractures

Answer 7

Contraindication

Question 8

Contraindication or precaution of spinal traction:

increase peripheralization with traction

Answer 8

Contraindication

Question 9

Contraindication or precaution of spinal traction:

increase nerve root symptoms with traction

Answer 9

Contraindication

Question 10

Contraindication or precaution of spinal traction:

Impaired cognition

Answer 10

precaution

Question 11

Contraindication or precaution of spinal traction:

joint hypermobility or instability

Answer 11

Contraindication

Question 12

Contraindication or precaution of spinal traction:
Any disease or condition that can compromise the structure of the spine (RA, prolonged steroid use, tumor, osteoporosis, etc.)

Answer 12

precaution

Question 13

Contraindication or precaution of spinal traction:

pregnancy (lumbar traction)

Answer 13

Contraindication

Question 14

Contraindication or precaution of spinal traction:

patients who have received surgical stabilization or decompression, spine implants, or prosthetic disks

Answer 14

Contraindication

Question 15

Joint distraction, the separation of the facet joints occurs with sufficient force, does what two things to the intervertebral foramen?

Answer 15

1. Relieves pressure on nerve root

2. Decreases compressive forces on facets

Question 16

What type of joint distraction traction forces recommended for initial treatment?

Answer 16

Lower traction forces

Question 17

Describe the use of traction to reduce disc protrusion:

Answer 17

1. Separate vert bodies at higher force -> decrease intradiscal pressure creating suction like effect on nucleus potentially drawing it back in centrally
2. Surrounding ligamentous structures taut which also helps push disc in centrally

Question 18

What % of body weight or lbs results in cervical region joint distraction?

Answer 18

7% of body weight or about 20-30lbs results in separation

Question 19

Minimum of what % of body weight results in lumbar region joint distraction?

Answer 19

min of 50% of patient’s body weight

Question 20

Reduction of disc protrusion with traction of the lumbar region requires what % of patients body weigh

Answer 20

up to 50%

Question 21

Reduction of disc protrusion, soft tissue stretching, and muscle relaxation of the cervical region requires how many lbs?

Answer 21

12-15 lbs

Question 22

soft-tissue stretching and muscle relaxation by traction of the lumbar region requires what % of body weight?

Answer 22

25%

Question 23

Soft-tissue stretching of the surrounding spinal muscles, ligaments, tendons, and discs can be stretched with the goal of what?

Answer 23

Decreasing pressure on facets, nerve roots, vertebral bodies and discs without achieving joint separation

Question 24

Describe effect of intermittent traction and static traction on muscle relaxation:

Answer 24

intermittent traction - interrupt the pain-muscle spasm cycle by stimulating mechanoreceptors
static traction - inhibiting neuron firing

Question 25

targeting what region with greater the cervical flexion

Answer 25

lower cervical area

Question 26

T/F Cervical traction generally recommended not to exceed 30-40 lbs and to start light

Answer 26

True

Question 27

In the acute phase of cervical traction, how much weight applied for these goals: 1. Disc protrusion, elongation of soft tissue, muscle spasm - 2. Joint distraction -

Answer 27

1. Disc protrusion, elongation of soft tissue, muscle spasm - 10-15 lbs 2. Joint distraction - 20-30 lbs

Question 28

5-10 minutes of cervical traction for what 2 conditions?

Answer 28

1. acute | 2. disc protrusions

Question 29

If your there is disc protrusions or symptoms aggravated with motion in cervical region, what type of traction do you use? (duty cycle)

Answer 29

Static

Question 30

What is the expert opinion about hold/rest ratio of intermittent traction for cervical region: disc protrusion - joint distraction/mobility -

Answer 30

disc protrusion - 3:1 hold/rest | joint distraction/mobility - 1:1 hold/rest

Question 31

Post traction you must watch for what?

Answer 31

rebound effect - have patient relax for 5 minutes after treatment (can spasm if not)

Question 32

What are positive outcomes you record post traction?

Answer 32

1. ↓ symptoms 2. Centralization of symptoms 3. ↑ ROM/strength 4. Improved ability to perform ADLs 5. Improved reflexes/sensation

Question 33

T/F Research shows that after traction mean area of disc herniation was reduced & disc space increased.

Answer 33

true

Question 34

T/F over-the-door traction showed equal improvements to scores on neck disability, neck pain intensity, and arm pain intensity as mechanical traction

Answer 34

False, patients who underwent mechanical traction reported lower scores on neck disability, neck pain intensity, and arm pain intensity

Question 35

For lumbar spine traction, what vert are you focusing on when hip flexion: 45-60 hip flexion = 75-90 hip flexion =

Answer 35

Closer to L1 45-60 hip flexion = L5/S1 75-90 hip flexion = upper lumbar region

Question 36

How to apply thoracic harness for mechanical traction? Lower harness?

Answer 36

1. Placed inferior to the widest lateral dimension of the rib cage (Two straps that will be attached to the end of the table) 2. At or just below the iliac crests but superior to the greater trochanters (Two straps that will attach to a metal V shapes rod that then attaches to the mechanical unit)

Question 37

Lumbar traction force for: acute phase = lbs disc protrusion, spasm, elongation of soft tissue = % joint distraction = %

Answer 37

acute phase = 30-40 lbs (less force) disc protrusion, spasm, elongation of soft tissue = 25% of body weight joint distraction = 50% of body wieght

Question 38

Treatment time for lumbar traction force for: Herniated disc = Other conditions =

Answer 38

Herniated disc = 5-10 min | Other conditions = 10-30 min

Question 39

T/F Substantially greater reduction of the total area of herniated disc material with lumbar traction vs. use of “other modalities”.

Answer 39

True

Question 40

How can you improve lumbar traction when used with 30 & 60% of body weight?

Answer 40

Straight leg raise

Question 41

T/F Traction can be used alone for the best possible outcomes.

Answer 41

False, traction should be combined with other interventions

Question 42

Describe the home traction unit for cervical region:

Answer 42

1. Pneumatic pump with gauge quantifying tension 2. Adjustable headrest, similar positioning 3. Sustained traction

Question 43

Describe the home traction unit for lumbar region:

Answer 43

1. Pneumatic pump, harness to stabilize 2. Less tension produced than clinical unit 3. Positioning on floor required