TA UNIT 1-- Week 5 (Traction+ laser)

kms013's version from 2016-02-08 14:36


Question Answer
Why would you do traction?1. disc bulge/herination 2. nerve root impingement 3. jt hypomobility 4. subacute jt inflammation 5. paraspinal mm spasm
Disc bulge/herniation: lumbar taction can and may improve _________ and decrease __________improve sx & clinical findings (parasthesia down leg), decr size of herniated/bulging discs
Disc bulge/herniation: lumbar traction is best applied if used when and in combination with _________soon after injury, in combo w other techniqes for reducing stresses of spine (posture, body mechanics, lumbar stabilization excercises)
Nerve root impingement: what are 6 examples of this?Disc bulge 2. lig encroachment 3. foramen stenosis, 4. osteophyte 5. nerve root swelling 6. spondylolisthesis
jt hypomobility: THEORY?idea is to get jts moving; traction can glide and distract spinalf acet jts to incr synovial fluid movmt; effect is nonspecific, affecting multiple jts; best applied: slow & rhythmic/intermittently (on/off)
Nerve root impingement: traction best applied when?shortly after onset of sx and in pts with sorse sx w spinal laoding and decr sx w decr spinal loading
Paraspinal mm spasm theory (2)1. get the mm to calm donw 2. address the underlying cause (jt/nerve issue)
static traction/low-load intermittent traction may )_______interrupt p! spasm-p! cycle
Higher load traction may reduce ____underlying cause of p! (nerve impingment, bulging disc, facet dysfx
what does the research say about lumbar tractionspinal traction can reduce spinal disc protrusions (if only slightly) 2. to get the disc one must elongate the soft tissue...(need 50% of pts BW to distract the lumbar apophyseal jt per research; some evidence to support at least 25% may be needed...however NOTE: only need minimum amt to decr sx); lumbar traction at 60-120 lbs can reduce a disc prolapse, reduce the size of a disc herniation, cause a reduction of herniation
what are the contraindications to use traction?recent whiplash injury/cervical trauma w acute p!, 2. CT disorder (RA) that cause jt hypermobility 3. acute vertebral fx 4. ankylosing spondylitis 5. OP/Osteopenia 6. hx of long term steroid use 7 pt w surgical stabilization/fusion 8. always start w a low fx and monitor for adverse effects 9. where motion is contraindicated 9. acute injury/inflammation 10. jt hypermobility/instability 1. peripheralization of sx w traction (sx should centralize) 12. uncontrolled HT
Precautions to traction1. simple lumbar discectomy 2. structural dis/conditions affecting spine 3. when belt pressure may be hazardous (pregnancy) 4. Displaced annular fragment 5. medial disc protrusion 6. claustrophobia/disorientation 7. inability to tolerate prone/supine position 7. pt w COPD may find harnesses uncomfortable
specific precautions for cervical traction?TMJ probs; dentures
Cold laser deifintionlight amplicication by stimulated emission of radiation
cold laser is effective via...photobiostimulation
cold laser is used at what power level?low power level of 60 mV or less have no hermal response (thus COLD)
There are many materials that go into laser, and depending on what goes in there will produce energy in different...wavelenghts
the material in most cold lasers is____gallium aluminum arsenide (GaAIAs) and gallium arsenide (GaAs)
GaAIAs and GaA produce energy in the ___-(what color) wavelenghtsred to ultraviolet
according to micholovitz text, LLLT can penetrate up to ____ with distribution of the laser influenced by color of skin and microvessels10 mm
what is laser cold?bc used at low power
the electromagnetic spectrum goes from ____ to ____radio waves (large) to gamma waves (super small)
can we see much of the sclae of electromagnetic spectrum wave?NO
what does LASER stand for?light amplicfication by stimulated emission of radiation
what does LLLT stand for?Low-level laser therapy (or cold laser)
how do lasers work?
what does everyone wear when doing laser stuff?glasses
overexposure to the light/infrared is a good idea or bad idea?bad idea
in pt, we use lasers for a number of things: what are they?1. wound healing 2. bone regeneration 3. epicondylitis 4. tendinopathies
what are contraindications to using LLLT?laswer should NOT be applied over immature epiphysial plates, hemorrhaginginfectious lesions or cancers, over areas w decr sensation, over endocrine glands; should NOT be used in proximity to genitalia, over vagus nerve, or meiastimum (thoracic cavity); should NOT be used if pt is pregnant, has uncontrolled epilepsy, or is febrile (showing signs of fever)
what are precautions to using LLLT?pt and therapist must wear protective eyewear
Cold laser parameters?location of application 2. size of treated area in square cm (cm2) 3. energy density in Joules per cm2 4. power in mW per sec 5. type of laser (GaAIAs, GaAs, HeNe) 6. continuous vs pulsed 7. freq, daily for 2 wk or 3x/wk for 3-4 wls
LLLT evidence?evidence for clinical use of cold laser is NOT well developed; few randomized clincial trials in PT
Rat studygave rats acute mm injury --> inflammatory response cascading event --> cytokines show up --> this study looked at a comparision bw LLLT and a topical anti-inflammatory voltarin OR cryotherapy; what they looked for was what happened in terms of interleukin 1 beta; so you have (control of no injury, injury, the topical anti-inflamm, cyrotherapy, and different variations of laser) found that 1 J was better
cytokinesinterleukin 1 beta, interleukin 1 6, tumor necrosis factor alpha
authors say that acute injury ...should be considered in tx of acute mm injury;
rabbit study of woundsintentional wound, 2 days after the wound was created w/o tx showed irregular CT, congested BV, and some infiltrate; the other wound was tx w laser and showed change and growth in collagen, proliferation;
epicondylitis/tendinitis: discussionstarted in 2006; a PT wrote paper trying to determine if she should use LLLT for pts; after her study, decided she it wasn't a good idea; she felt data was not conclusive enough to justify her use of LLLT; following this, another author challenged the paper and decribed why he thought she missed some evidence; then she responded to it; all in all, MAHLER CONCLUDES SHE WILL NOT USE LLT FOR HER PTS; AUTHOR BJORDAHL SUBMITS THAT LLT IS BENFICITAL AND SHOUDL BE CONSIDERED FOR TX OF TENDONITIS
Explaination of laserwatch video--
3 characteristics of LLTmonochromatic, collimated, coherence
to be considered a true laser, it must least 1 diode
super luminous diodes are....superficial lasers
____ is the rate at which energy is producedpower
power is measured in...watts (1 Watt = 1 J/s)
power of the LLLT device is measured in....milliwatts (mW)
positive physiological effects of LLLTacceleration of tissue healing, incr circulation, p! reduction, decr inflammation
key pts on application of LLT:cleaned skin w alcohol prior; no coupling media is used during the delivery of LLLT; no lotions, gels, oitments shoudl be b/w the paplicator and pts skin; stationary technique should be used; maintain firm direct contact w intack skin; both pt and clinician must use eyewear