traction

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Author:
jsanders4
ID:
78906
Filename:
traction
Updated:
2011-04-11 16:50:06
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traction
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traction
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  1. traction
    • a drawin (pulling) tension applied to a body segment; a distraction
    • used to reduce signs or symptoms of cervical or lumbar spinal compression and to help bones or tissues to realign
  2. spinal movement
    seperations of 1-2 mm per interveterbral space
  3. bone changes
    Wolff's Law
    bones grow according to the stresses and strains placed on them
  4. ligamentous changes
    • promotes stretch
    • fast-may overload the ligament
    • slow- provides gradual stretching
  5. disc change
    • dec central pressure
    • encourage disc bulge to resume a more central positon
    • better fluid exchange
  6. facet joints
    • distraction of jt surfaces
    • inc mobility
    • dec pain
  7. muscle effects
    • stretch muscle tissues
    • cause reflex relaxation
    • inc blood flow
    • dec pain
  8. nerve effects
    dec pressure on the nerve roots by opening up intervetebral foramen
  9. types of traction
    • continuous
    • static
    • intermittent
    • manual
    • positional
    • inversion
  10. continuous traction
    • aplied with constant force
    • several hours daily
    • reduce muscle spasm and muscular pressure on lumbar spine
    • little or no intervertebral seperation
  11. static traction
    • a.k.a sustained traction
    • more wt
    • short duration
    • achieves seperation of intervertebral discs
    • relax muscle
    • stretches soft tissue
  12. intermittent mechanical traction
    • applies traction with on/off timing
    • 15-60 sec cycle
    • 20-30 min duration
    • seperates bony surfaces
    • stretches muscle and ligaments
    • mobilize jt
  13. manual traction
    • usually done to cervical but can be applied to lumbar
    • applied by therapist
    • 15-60 sec duration
  14. positional traction
    • positioning the body in a way that will affect bony relationships
    • usually lateral trunk bending to open vertebral foramen on one side
  15. inversion traction
    • traction by force of gravity
    • pt hang upside down from upper thighs/pelvis
    • 5-15 min duration
    • monitor for abnormal blood pressure/HR
  16. indications for traction
    • nerve root impingement
    • subacute pain
    • DJD
    • jt hypomobility
    • paraspinal muscle spasm
  17. contraindications for traction
    • absolute- spinal infection, spinal cancer, spinal cord pressure, RA, osteoporosis
    • relative- ligamenous strain, acute stages of injury, traction anxiety, cardiac or respiratory insufficiency, pregnancy, tempero-mandibular jt dysfunction
  18. general traction concepts
    • friction- mvmt
    • direction- mobility
    • position- realign
  19. lumbar mechaniclal traction
    • split table reduces friction
    • harness requires pelvic and rib belt
    • neutral spine allows for most intevertebral opening
    • no seperation w/o 1/4 of pt body wt
  20. lumbar mechanical traction time and duration
    • <10 sec- min seperation; inc facet mvmt; activate jt and muscles receptors
    • >10 sec- longer lasting seperation; stretch muscles and ligaments
    • disc protocal- 60 on 20 off
    • 5-30 min
    • disc 8-10 min
  21. cervical mechanical traction
    • allow for some head flexion- maximizes pull from occiput
    • rope angled 15-30 degrees
    • supine position
    • 25-40 lbs
    • intermitent (if they have mvmt) 60 hold 10-15 restor static ( no mvmt)
    • treatment time 5-10 min disc 20 min other problems
  22. home cervical traction
    over door sitting positon and static
  23. disc bulging
    • prone- static- none- 8-10 min
    • supine- static- none 8-10 min
    • prone or supine- intermittent- long hold short rest- 15-20 min
  24. reduction in intervertebral foramen
    supine or prone- static- none if intermittent long hold short rest- 15 min
  25. facet entrapment
    supine 90/90- static (fixed) intermittent (mobility)- none or 15-15 on/off- 15-20 min
  26. structural scoliosis; unilateral lumbar muscle spasm; unilateral facet entrapment
    supine, prone, or sidelying- static or inter- long hold short rest, short hold short rest if mobility needed- 15-20 min
  27. bilateral muscles spasm
    supine 90/90- inter- mobility or short hold long rest for irratation- 15-20
  28. extension limitation
    prone- inter- mobility 15/15- 15-20 min
  29. flexion limitatin
    90/90- fixed static; mobility inter 15/15- 15-20 min

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