Therapeutic Modalities: Mechanical Agents And Massage

Question 1

What is mechanical spinal traction?

Answer 1

A distraction force applied to the spine to separate articular surfaces between vertebral bodies and elongate spine structures

Question 2

List 5 effects of traction.

Answer 2

1. Joint distraction decreases compressive forces on the nerve root
2. Joint mobilization
3. Reduction of disc protrusion
4. Soft tissue stretching
5. Muscle relaxation

Question 3

What percentage of force is needed to cause separation in the lumbar versus the cervical spine when using traction?

Answer 3

Lumbar = 50% of patient’s body weight 
Cervical = 7% of patients body weight (~20-30 pounds)

Question 4

True or False: Lumbar traction is NOT effective in treating acute or chronic non-specific low back pain.

Answer 4

True

Question 5

List 8 contraindications to use of manual traction.

Answer 5

1. Acute strains, sprains and inflammation
2. Spondylolisthesis
3. Fractures
4. Post op spinal surgery
5. Spinal joint instability/hypermobility
6. Spinal cord compression
7. Hypertension
8. Parenthesis or increased peripheralization of pain

Question 6

What position should the neck be in when performing cervical traction?

Answer 6

20-30 degrees of flexion

Question 7

What position is the patient typically placed in when using lumbar traction?

Answer 7

Placed on a split table to reduce friction between the body and the table

Supine with pillow under the knees or small bench under the legs to open the intervertebral foramen and facet joints

Question 8

What is intermittent mechanical compression?

Answer 8

Pneumatic device that applies pressure to an extremity through an inflatable appliance (sleeve)

Cold can be applied simultaneously with intermittent compression

Question 9

List 4 indications for the use of intermittent mechanical compression.

Answer 9

1. Decrease lymphedema and edema
2. Decreased risk for DVT
3. Stasis ulcer healing
4. Venous insufficiency

Question 10

List 5 contraindications associated with use of intermittent mechanical compression.

Answer 10

1. Acute inflammation, trauma or fracture
2. Acute DVT, thrombophlebitis, or pulmonary edema
3. Arterial disease or insufficiency
4. Impaired sensation and mentation
5. Cancer

Question 11

What should be done prior to using intermittent mechanical compression?

Answer 11

Check the patients blood pressure

Question 12

Describe the inflation to deflation ratio used with intermittent mechanical compression. On/off time?

Answer 12

Inflation to deflation ratio ~3:1

45-90 sec on
15-30 sec off

Question 13

What is continuous passive motion (CPM)?

Answer 13

Uninterrupted passive motion of the joint through a controlled ROM.

A mechanical device provides continuous movements for extended periods of time.

Question 14

List 4 physiological effects of continuous passive motion.

Answer 14

1. Increase joint ROM and circulation
2. Increase healing time
3. Decrease post operative pain
4. Decrease edema and joint effusion

Question 15

When is continuous passive motion typically used?

Answer 15

Post immobilization fracture, tendon or ligament repair

Question 16

What is a tilt table?

Answer 16

Mechanical or electrical table designed to elevate patient from horizontal (0 degrees) to vertical (90 degrees) position in a controlled, incremental manner.

Question 17

List 5 indications for the use of tilt table.

Answer 17

1. Prolonged bed rest/immobilization
2. Spinal cord injury
3. Traumatic brain injury
4. Orthostatic hypotension
5. Spasticity

Question 18

What needs to be monitored during the use of a tilt table?

Answer 18

Vital signs

Question 19

List 5 different types of massage techniques.

Answer 19

1. Stroking (effleurage)
2. Kneading (pectoris sage)
3. Friction
4. Tapping (tapotement)
5. Vibration