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PTRS 845 Midterm > Traction > Flashcards

Flashcards in Traction Deck (40):

Term: Pulling or drawing



Term: Separation of jiont surfaces moving perpendicular to one another



Term: Used to describe manual traction 

Longitduinal mobilization


6 Effects of Spinal Traction

1. Distraction/separation of vertebral bodies

2. Distraction and gliding of facet joints

3. Widening of the intervertebral foramen

4. Tensing of ligamentous structures

5. Straightening of spinal curves

6. Stretching of spinal musculature


Describe the purpose of unilateral long axis traction

Can be used for protective scoliosis or to open the foramen on one side


Type of Traction: Special table composed of two sections that can be individually angled and rotated allowing the pt. to progress tx

Autotraction (no longer used)


Describe the force placed on the pelvis with Cotrell 90/90 Traction

Creates flexion at the pelvis


Describe 3 positions that unload the spine

1. Supine in 90/90

2. Use of UE to unload the spine in sitting

3. Propping one leg on a step in standing


Type of Traction: Over the door unit that can put to much pressure on TMJ

Head Halter (for c-spine, no longer use)


Describe how the angle of pull is adjusted with using the Saunder's Cervical Traction Device

By adjusted the height of the table


Describe what you can accomplish with manual traction that can't be achieved with mechanical traction

Manual traction allows traction at a single segment, this can't be accomplished with mechanical traction, instead the entire C/T/L-spine is on traction


Describe how traction is generated with portable traction units

With the use of a pressure pump that creates the longitudinal pull


6 General Traction Guidelines

1. The pt. MUST RELAX

2. Continually monitory sx

3. DO NOT leave the pt. unattended for the 1st tx

4. ALWAYS give the pt. the safety button (shut off button)

5. ALWAYS consider SINS

6. Establish before/after subjective asterisks



5 Indications for Spinal Traction

1. Herniated nucleus pulposus


3. Joint hypomobility

4. Facet impingement

5. Muscle spasms


T/F: Traction alone is effective

FALSE: likely unsuccessful when used alone


Describe the effect on traction on HNP and the appropriate dosage

Effect: Can separate vertebra and lead to decrease pressure on the nucleus with a resulting suction force

Dosage: Sustained traction OR Longer hold-rest periods (60 sec hold, 20 rest) of intermittent traction, Tx time of 5-10 min


Describe the effect on traction on DDD/DJD and the appropriate dosage

Effect: Lowers intradiscal pressure which affects the nurtitional state of the nucleus pulposus

Dosage: SHorter hold-rest of intermittent traction


Describe the effect on traction on Joint Hypomobility and the appropriate dosage

Effect: Can be seen as a form of mobilization that involves the passive movements of joint

Dosage: Short hold-rest periods of intermittent traction 


Describe the effect on traction on Facet Impingement

Can release restriction on the facets


Describe the effect on traction on Muscle Spasm

Traction can decompress/separate the painful joint structures.  If the pain is relieved by traction, muscle spasm will be relieved as a result of relazation or nociceptive reflexes


Provide a Summary of the EBP for (Lumbar) Traction

1. Poor evidence for mechanical traction along for acute/subacute/chronic LBP

2. Improvement has been documented when traction is used in combination with exercise and modalities

3. Mechanical effects are effective in the short term (<5 wks), but not in the long term (>12 wk)

4. There is no dose-response relationship for traction but low doses are probably sufficient to achieve benefit


There is more evidence in support of traction for the C-spine


4 Predictors of  Successful response to Mechanical LUMBAR traction

1. Low level fear-avoidance behavior

2. No neurological deficit involvement

3. > 30 yo

4. Non-onvoles of manual work 


Describe a corssed SLR and what it indicates

A SLR on the right reproduces back pain on the left

Indicative of a disc herniation 


4 Predictors of Effective Mechanical Traction (Fritz)

1. Presence of leg sx

2. Signs of nerve root compression

3. Peripheralization with extension movements

4. Crossed SLR +


6 Contraindications for Traction 

1. Structural disease secondary to tumor or infection

2. Patients with vascular compromise.

3. Any condition for which movement is contraindicated.

4. Osteoporosis: precaution

5. RA

6. TMD


7 Cautions for Traction 

1. Acute strains and sprains

2. Inflammatory conditions that might be aggravated

3. Joint instability

4. Pregnancy

5. Osteoporosis

6. Hiatal hernia

7. Claustrophobia


4 Things to determine before beginning traction

1. Traction force

2. Duration

3. Static vs. Intermittent

4. Patient position


Describe how to determine/apply traction force in the L-spine

Start with lighter force.  You want to end up in a force range of 25-50% of the pt.'s BW


The first 25%  of force over comes friction, while the second 25% of force causes separation


Below 20% of force is considered low dose or placebo traction


Describe how you determine the duration of traction

Typically start with 3-5 minutes of traction, based on the SINS slowly progress to 10-15 minutes of traction


Describe when you would use static vs. intermittent traction

Static:Sustained pull -- Used for moderately severe and irritable conditions

Intermittent:Hold/Rest -- Used with less severe and irritable conditions


Describe what movements are created in the spine with anterior and posterior pull

Anterior pull = extension 

Posterior pull = flexion 


Describe what traction forces can be achieved with the pieces of the traction belt close together

1. Supine position with posterior pull

2. Prong position with anterior pull


Describe what traction forces can be achieved with the pieces of the traction belt farther apart

1. Supine with anterior pull

2. Prone with posterior pull


Describe the importance of a stable harness

A stable pevlic belt provides the necessary traction while a stable thoracic belt provides counter traction and prevents the pt. from sliding down the table


Describe the placement of the pelvic belt

Should be secured first

Top should be above iliac crests and across the umbilical line


Describe the placement of the thoracic belt

Should be placed second

Top below xiphoid process with the bottom overlaping the pelvic belt


Describe the effect of rope angle on lumbar traction

Higher angle = posterior pull

Straighter angle = anterior pull


List the 5 D's and why they are important to consider before beginning traction

5 D's: Drop attack, Dizziness, Diplopia, Dysarthria, Dysphagia

They rule in/out of the possibility of vertebral artery involvement


Describe how you determine the amount of traction force for the C-spine

Typically 5-20 lbs

Upper cervical traction can be achieved with 5-15 lb

Lower cervicla traction can be achieved with 20-40 lb


Describe the rope angle needed to target upper vs. lower C-sine with traction

Upper = 10-15 degrees

Lower = 20-30 degrees