Traction Flashcards
(26 cards)
Theorized Effects of Spinal Traction
Joint Distraction (increase space only during tx) Reduction of Disc Protrusion (Neg P) Soft Tissue Stretching Muscle Relaxation Joint Mobilization
You are seeing a patient who was in a recent MVA yesterday and is having sx of radiculopathy. She has a positive crossed straight leg raise. What is the most appropriate modality?
NONE. Pt has contraindication of acute injury w/in 72 hours. If this has occurred a week ago, traction would be appropriate.
Contraindications of Traction
- Where motion is contraindicated
- Acute injury/inflammation
- Joint Hypermobility/instability (spndy)
- Peripheralization of sx w/traction
- Uncontrolled HTN
- Osteoporosis
- Prego
- Hx of surgical intervention w/ or w/o instrumentation
- RA/Marfan Syndrome/Downs/AS
Your patient is a 62 y/o female. She has hypomobile L4/5 segments with hypermobility in L2/3 and has nerve root impingement. Her BP is 135/88. What are the contraindications?
- Hypermobility
- Possible osteoporosis
- Uncontrolled BP
Precautions for Traction
Structural Disease Pressure (hernias) Displace annular fragment Severe pain Claustrophobia Inability to tolerate positioning Disorientation
According to the Clinical Practice Guidelines for Lumbar Spine, who will benefit from intermittent traction in PRONE?
Pt’s w/ radiculopathy and a + crossed straight leg raise. Requires more than one treatment.
What do the clinical PRACTICE guidelines say about cervical traction?
There is poor evidence for cervical traction as a stand alone intervention. Intermittent is better than static….
What is the clinical PREDICTION rule for cervical spine?
Peripheralization w/lower cervical mobs \+ Shoulder Abd Test >55 y/o \+ ULTT \+Distraction Test
What is the clinical PREDICTION rule for lumbar spine?
s/s of nn root compression
no movements centralize sx
Name the different types of traction
- ) Mechanical
- ) Manual
- ) Positional
You want to do full lumbar distraction on your patient. How do you position their legs?
90/90 hip knee angle
You patient has a hypo-mobile L4/5 segment. How should you position them?
Decrease the angle of the hip and knees to ehlp distract lumbar spine at lower levels
What are the landmarks for the lower lumbar strap?
Top goes along illiac crest
Middle at ASIS
Lower border above g. troch of femur
Upper stap position
Below the widest lateral dimensions of ribcage
Why would you choose prone position over supine for lumbar traction?
Greater distraction force, easily perform extension exercise and manual therapy following tx, directional preference
You pt has a hypomobile C3/4 segment. Where should you place the angle of the machine?
Lower the angle of inclination=the higher up cervical spinal segments get distracted
(Larger angle of inclination=lower cervical spine segment distraction)
Your patient is “acute” and is having cervical traction for the first time. What are your parameters?
7-9lbs, static hold, 5-10mins
Your patient has a cervical disc pathology or a mm spasm. What are your parameters?
11-15 lbs, 60/20 hold, 20-30 mins
Your patient is getting traction for the purpose of cervical distraction. What are your parameters?
7%BW (NEVER EXCEED THIS), 60/20 hold, 20-30 mins
Your patient is getting lumbar traction for “acute” first time session. What are the parameters?
30-45 lbs, static, 5-10mins
Lumbar traction for disc path or mm spasm parameters include
25% BW, 60/20 hold, 20-30 mins
Lumbar traction for distraction purpose, what are the parameters?
50% BW, 60-20hold, 20-30 mins
What should you do as a screen before and after?
Check sensation UE and LE
You are seeing a patient who is excited to get lumbar traction since her doctor told her that it could help with her radicular symptoms. She had back surgery 6 months ago but no fixation/fusion occurred. What parameters will you use for lumbar traction on this pt?
NONE. A contraindication of lumbar traction includes hx of surgical intervention w/ or w/o instrumentation.
