Traction

Question 1

spinal traction

Answer 1

applying distraction forces to the spine to separate articular surfaces btw vertebral bodies and elongate the spine

Question 2

methods of traction

Answer 2

manual
mechanical
pneumatic
positional 
gravity assist
inversion

Question 3

goals for traction

Answer 3

decrease:
joint stiffness
meniscoid blocking
muscle spasm
disc protrusion 
discogenic pain
joint pain
nerve root impingement

Question 4

indications

Answer 4

presently lack of agreement

• cervical or lumbar spine pain with radiculopathy
• pts who have reduction of symptoms with manual traction

Question 5

contraindications

Answer 5

acute strains, sprains and inflammation
spondylolisthesis
fx
increased peripheralization with traction 
increased nerve root symptoms 
joint hypermobility or instability
pregnancy
pt who have received surgical stabilization or decompression, spine implants or prosthetic disks

Question 6

precautions

Answer 6

claustrophobia
hiatal hernia
impaired cognition
any disease or condition that can compromise the structure of the spine

Question 7

joint distraction effects

Answer 7

relieves pressue on nerve root

decreases compressive forces on facets

Question 8

reduction of disc protrusion does what

Answer 8

separation of vertebral bodies occurs at higher forces –> decreased intradiscal pressure creating suction like effect on nucleus, drawing it back centrally –> ligaments are taut

Question 9

soft tissue stretching does what

Answer 9

surrounding spinal muscles, ligaments, tendons and discs cant be stretched

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

Question 10

muscle relaxation with traction does what

Answer 10

gate control theory

Question 11

variables for cervical traction

Answer 11

static or intermittent
angle of traction
dosage

Question 12

what is the dosage of cervical traction determined by

Answer 12

goals and pt tolerance

the amount of weight is to start light, not exceed 30-40 lbs

Question 13

treatment time for cervical traction with acute conditions and disc protrusions

Answer 13

5-10 mins

Question 14

treatment time for cervical traction for other conditions

Answer 14

15-30 mins

Question 15

when do you do static traction - with cervical traction

Answer 15

disc protrusions or when symptoms aggravate by movement

Question 16

when do you do intermittent traction - with cervical traction

Answer 16

disc protrusion 3:1 hold/rest ratio

joint distraction/mobility 1:1 hold/rest ratio

Question 17

post traction what should u look out for in general

Answer 17

rebound effect –> muscles spasm and lock up

relax for 5 mins after before getting up

Question 18

what improves with the intervertebral foramen with cervical traction

Answer 18

decrease pressure within and increase in dimensions while in flexion

Question 19

variables for lumbar traction

Answer 19

supine or prone position
positioning of lower extremities
static or intermittent 
angle of traction 
dosage

Question 20

how much hip flexion needed to free space in the intervertebral space for L5/S1

Answer 20

45-60

Question 21

how much hip flexion needed to free space in the intervertebral space for upper lumbar region

Answer 21

75-90

Question 22

where do u put the thoracic harness for lumbar traction

Answer 22

inferior to widest lateral dimension of rib cage

two straps that will be attached to the end of table

Question 23

where do u put the lower harness for lumbar traction

Answer 23

at or below iliac crest but superior to greater trochanter

two straps that will attach to a metal V shape rod that then attaches to unit

Question 24

amount of force for acute phase for lumbar traction

Answer 24

less force

30-40lbs

Question 25

amount of force for disc protrusion, spasm, elongation of tissue for lumbar traction

Answer 25

25% of body weight

Question 26

amount of force for joint distraction for lumbar traction

Answer 26

50% body weight

Question 27

treatment time for lumbar traction

Answer 27

ranges depending from 5-30 mins

Question 28

home traction for cervical

Answer 28

pneumatic pump with gauge quantifying tension
adjustable head rest, similar positioning
sustained traction

Question 29

home traction for lumbar

Answer 29

pneumatic pump, harness to stabilize
less tension produced than clinic
positioning on floor required