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Orthopedic II > Traction > Flashcards

Flashcards in Traction Deck (12):
1

3 things to do BEFORE putting someone on traction for the first time:

1. Ask about contraindications
--> VA for CS (5 D's)
--> CE for LS

2. Perform manual traction & assess response

3. Check integrity of the ligaments
--> anterior shear test (LS)

2

Contraindications to Traction

1. VA
2. CE
3. RA
4. structural disease secondary to tumor or infection
5. TMJ dysfunction
6. any condition where movement is contraindicated (fusion, cord compression)

3

Intensity/Traction force

Lumbar spine
- 25-50% of BW (25% on first trtmt)
- increase wt if no response, decrease wt if symptoms are worse, and stop if no response after 2-3 visits

Cervical spine
- Upper: 10-15lbs
- Lower: 20-40lbs

4

Duration

first treatment = 3-5 minutes

Build up tolerance to 10-15 minutes

Consider SINS

5

Static vs. Intermittent

Same for LS and CS

Static - acute, moderate severe/highly irritable conditions

Intermittent - chronic, low irritability conditions

6

Patient & Cable Position

Lumbar spine - supine or prone
- posterior pull --> flexion; cable higher, w/ legs on pillow or bulster
- anterior pull --> extension; cable straight, w/ legs on pillow

Cervical spine - always supine
- Upper: lower angle
- Lower: higher angle

7

Effects of spinal traction

1. distraction of vertebral bodies
2. combination of distraction & gliding of facet joints
3. widening of IV foramen
4. Tensioning of ligaments
5. straightening of spinal curves
6. stretching of spinal musculature

8

Herniated Discs
- why
- ideal position & settings

traction seperates vertebra allowing the NP to migrate back towards the center of the disc w/n boundaries

best treated w/ static or long hold-rest periods (60sec hold, 20 sec rest) of intermittent

- 5-10 min treatment time
- posterior best for unloading the spine in 90/90

9

DDD
- why
- ideal settings

traction lowers interdiscal pressure & increases nutrition to the disc

optimal stimulus for disc = intermittent comp/decomp

- respond best to short hold-rest periods

10

Joint hypomobility
- why
- ideal settings

traction passively moves the joints, increasing mobility

best to use short hold-rest periods of intermittent

11

Facet impingement
- why
- ideal settings

traction releases restriction of facet joints

MANUAL traction ideal b/c it can be applied segmentally

12

Muscle Spasm
- why
- ideal settings

Traction decompresses or separates painful joint structures

--> if pain is relieved the muscle spasm will be relieved as a result of relaxation of nociceptive reflexes