Maxwell-UNIT 1_Traction

kms013's version from 2016-02-01 14:52


Question Answer
Pushing is _____ and pulling is ____compression, traction
traction became popular via ______ (who) in _______ (date) to address what 2 things?James Cyriax, 1950/60, LE radiculopathy & lumbar p!
Currently, traction is an _________ modality due to its conflicting research resultsunderused
Are there any current studies w high-quality trials to discern the effectiveness of tx?No
efficacy is...mechanistic: the ability to produce a desired or intended result
effectiveness is...clinical evidence
tx is...fx applied to the body in a way that separates the jt surfaces and elongates surrounding soft tissues
traction can be applied in what ways?Manually, mechanically, self traction ( gizmos that go home with pt)
traction can be applied to _ or ___spine, peripheral jts
application technique of traction:static and intermittent
what is static traction?aids with inflammation (acute) p! w mvmts disc issue
what is intermittent traction?mm spasm, disc issue, jt dysfx
Advantages of mechanical tractionfx and time readily controlled, graded, and replicable 2. does not require continuous supervision 3. static weighted devices inexpensive and convenient for independent us
Disadvantages of mechanical traction?expensive electrical devices, time consuming setup, lack of pt control or participation, restriction by belt or halters, mobilizes broad regions of the spine
Pertinent spinal anatomy: Spine consists of _ vertebrae and _____ IV discs24, 24
discs are made of tough outer bands of ______ and soft center called ____annulus fibrous cartilage, nucleus pulposus
primary jt of spine are ____facet jts (zygapophyseal jts)
Nerve roots emerge through the _________ from the __________foramina, SC
Effects of spinal traction: 5 things we are trying to do?1. jt distraction 2. reduction of disc protrusion 3. soft tissue stretching 4. mm relaxation 5. jt mobilization
jt distraction definitionthe separation of 2 articular surfaces perpendicular to the plane of articulation (reduces jt compression)
what does jt distraction reduce?jt compression
what does jt distraction widen?intervertebral foramina
Jt distraction requires enough fx: _% of body weight for lumbar jts and _-% of body weight for cervical jts50, 7
Reduction of disc protrusion: Theory:Allows disc to "withdraw" back in
disc protrusion indication:any nerve related sx down leg in specific dermatome (paresthesia or numbness, tingling, burning, etc)
goal of disc protrusionto centralize sx
soft tissue stretching may contribute to...spinal jt distraction, reduction of disc protrusion, or incr spinal ROM
Mm relaxation of soft tissue stretching is due to ...reduced pressure on p! sensitive structures or gating by intermittent traction
jt mobs theorygetting Dr. Fontenot's WD40 into the jt by high force traction or repetitive intermittent traction
Jt mobs mechanical: mobilizes many jts at once
Manual techniques for jt mobs are....more localized
Clinical indications for spinal traction (5):disc bulge or herniation 2. nerve root impingement 3. jt hypomobility 4 subacute jt inflammation 5. paraspinal mm spasm
Disc Bulge/herniation: Lumbar traction can/may improve....and and clinical findings (paresthesia down leg); decrease size of herniated/bulging discs
Disc Bulge/herniation: best applied...soon after injury 2. in combination w other techniques for reducing stresses on the spine! (Posture, body mechanics, lumbar stabilization ex)
Nerve root impingement: associated with:1. disc bulge 2. lig encroachment 3. foraminal stenosis 4. osteophyte 5. nerve root swelling 6 spondylolisthesis
Nerve root impingement: traction best applied:shortly after onset of sx 2. in pts w worse sx w spinal loading and decr sx w decr spinal loading
Jt hypomobility theoryidea is to get the jts moving
Jt hypomobility: traction can ____ and ____ spinal facet jts to increase synovial fluid mvmtglide, distract (Effect is nonspecific, affecting multiple jts)
Joint hypomobility traction is best applied....slow and rhythmic, intermittently (on/off)
Subacute jt inflammation theoryreduce pressure on inflammed jt surfaces
Subacute jt inflammation: small mvmts may gat ____ and help ____p!, help maintain normal fluid exchange in the jts
Subacute jt inflammation traction best applied _________very gently (Grace I, II)
Paraspinal Mm spasm theory1. get the mm to calm down 2. address the underlying cause (jt/nerve issue)
Paraspinal Mm spasm = ____ traction or _____ tractionstatic, low load intermittent (may interrupt p!-spasm- p! cycle)
Paraspinal Mm spasm Higher load traction may reduce...underlying cause of p! (nerve impingement, bulging disc, facet dysfx)
What does the research say about lumbar traction? can reduce ____spinal disc protrusions (if only slightly)
Research says to get the disc, you must _ the soft tissueelongate
Need ____ % of pts body weight to distract the lumbar apophyseal (facet jts) per research50; some evidence support at lease 25 % (However: NOTE: only need min amt to decr sx)
lumbar traction at _______ can reduce disc prolapse, reduce the size of dis herniation, and cause a reduction of the herniation60-120 lb
contraindications to traction (12)Recent whiplash injury or cervical trauma w acute p! 2. CT disorder like RA that cause jt hypermobility 3. acute vertebral fx 4. ankylosing spondylitis 5. OP/OA 6. hx of long term steroid use 7. pts w surgical stabilization/fusion 8. Always start w a low F and monitor for adverse effects 9. where motion is contraindicated 10. Acute injury or inflammation 11. Jt hypermobility/instability 12. Peripheralization of sx w traction (sx should centralize) 12. uncontrolled HT
Precautions to tractionsimple lumbar discectomy; 2. structural dis/conditions affecting spine 3. When belt pressure may be hazardous (pregnancy) 4. displaced annular fragment 5. medical disc protrusion 6. claustrophobia/disorientation 7. inability to tolerate prone or supine position 8. pt w COPD may find harnesses uncomfortable
adverse effects of traction: excessive F may incr sx; Rebounding incr in p! (be careful about this) start low, incr slowly (lumbar radicular discomfort after cervical traction)