Agents - 19 - Traction

T

T/F: traction use has been on the decline due to conflicting research results

traction

________ is a mechanical force applied to the body to separate the joint surfaces and elongate the surrounding soft tissue

• manually

• mechanically

• self traction

what are three ways that traction can be applied:

joint distraction

the main effect of traction is ______________

25

lumbar traction for soft tissue stretch should be ___% of body weight 

50

max lumbar traction for joint distraction should be no more than ___% of body weight

7-10%

cervical traction for joint distraction should be a max of ___-___% body weight

“withdraw”

the theory around traction for disc protrusion is that it allows the disc to _______ back in

specific 

the effects of traction on soft tissue are NOT _____________!!

gate control theory

intermittent traction decreases pain through the _______________ to stimulate mechanoreceptors with oscillating movements

stretch response with GTOs

static traction decreases pain through the ______________ to inhibit alpha motor neurons

MORE

mechanical traction mobilizes (more/less) joints than manual techniques

nerve root impingement (radiculopathy)

the major clinical indication for traction is ____________________

• nerve root impingement / radiculopathy

• disc bulge or herniation

• joint hypomobility

• subacute joint inflammation

• paraspinal muscle spasm

additional indications for traction are: (5) - read

shortly after the onset of symptoms

for nerve root impingement, traction is best applied when:

T

T/F: lumbar traction may improve radicular symptoms and decrease the size of hernation

F; SX SHOULD NOT BE WORSE 

T/F: it’s okay if there are worse symptoms with traction 

slow, rhythmically, and intermittently

for joint hypomobility, it is best if traction is applied _______, ________, and __________

static, low-load intermittent

traction for paraspinal muscle spasms is either ________ or _____________

F; NO DIFFERENCE

T/F: lit review for cervical traction found that there was a difference in neck disability score

T

T/F: lit review for lumbar traction found that traction improved pain and segmental movements 

• acute cervical trauma, incl whiplash

• osteoporosis, osteopenia

• RA, CT disorders/hypermobility/instability

• ankylosing spondylitis

• chronic steroid use

• spine surgery hx

• pregnancy

• when motion is contraindicated

• nonmechanical pain

• malignancy

• uncontrolled HTN

• PERIPHERALIZATION OF SYMPTOMS WITH TRACTION

contraindications for traction: (many) but ONE KEY ONE:

• claustrophobia

• COPD/respiratory disorders

• decreased cognition

• GERD

• displaced annular fragments

• medial disc protrusion

• inability to tolerate supine or prone position

precautions for traction:

TMJ, dentures 

a cervical chin strap cannot be used for traction if a pt has ______ or ______

INCREASE

excessive traction forces may actually _________ symptoms

TRANSITIONS

__________ after traction are very important and should be done gradually

*go read through traction procedure slides

*go read through traction procedure slides

F; OVER sessions, NOT within session

T/F: for lumbar traction, when increasing the force, start gentle and gently increase within the session

5-15

from one session to another, lumbar traction can be progressed ___-___ lbs

30-40, 50%

using lumbar traction for facet/disc/joint problems, begin with ___-___ lbs, then increase to ___% of body weight max

60-20

duration and on/off cycles for disc issues are ___-___ “

15-15”

duration and on/off cycles for joint distraction are ___-___ “

50%

during the off time of a traction cycle, the force is at ___% of the on time

20-30 min

lumbar: after the first treatment, total treatment time is generally ___-___

5-10 min

lumbar: for the first treatment, treatment time should begin at ___-___

8-10

cervical traction force should start at ___-___ lbs

7-10%

cervical traction force can progress to ___-___% of body weight

3-5

progression of cervical traction force should increase by ___-___ lbs at a time

30

cervical traction SHOULD NOT exceed ___ lbs 

intermittent, 15 min

_________ traction is best for cervical, and ___min is the most common treatment time

0-5

positioning for cervical traction: upper cervical spine/disc involvement should be ___-___ deg of flexion

10-20

positioning for cervical traction: mid cervical involvement should be ___-___ deg of flexion

25-35

positioning for cervical traction: lower cervical involvement should be ___-___ deg of flexion

• can be static or intermittent

• more affordable than electronic machine

• no set up time

• no belts, claustrophobia, etc

advantages to manual traction: (4)

• not as reproducible or graded as machine

• clinician dependent (not just your talent but also your arm strength) 

disadvantages to manual traction: (2)

lumbar 

self/positional traction can only be used for (lumbar/cervical) spine