Traction

Question 1

Lumbar Force

Answer 1

Full Separation= >50% body weight

Posterior separation=>25% body weight

Question 2

Lumbar Duration

Answer 2

3-5 min for first time

Question 3

Prior to mechanical traction…

Answer 3

check pt’s response to manual traction

Stability of spine

Question 4

Lumbar table splitting

Answer 4

Split after 2-3 cycles during rest phase with intermittent or slowly after 2 min with static traction

Lock again before getting pt up

Question 5

Cervical Force

Answer 5

5-20lbs
(probably closer to 10-12lbs)
Head weighs ~8lbs so judge accordingly

Question 6

Static vs Intermittent

Answer 6

static: severe/irritable
intermittent: non-severe/non-irritable

Question 7

Effects of spinal traction

Answer 7

1. widening intervertebral foramen
2. straightening of spinal curves
3. distraction of vertebral bodies
4. Combo of gliding/distraction of facets
5. Tensing ligaments
6. Stretching musculature
7. Remodeling via creep phenomenon (static) or hysteresis (intermittent)

Question 8

Contraindications to Traction

Answer 8

1. Structural disease 2* to tumor/infection
2. conditions where movement is contraindicated
3. pt with vascular compromise
4. cauda equina syndrome
5. spinal cord compression
6. RA, ankylosing spondylitis
7. unhealed fracture

Question 9

Cautions to Traction

Answer 9

1. acute strain/sprain
2. inflammatory conditions
3. joint instability
4. pregnancy
5. osteoporosis
6. claustrophobia
7. hiatal hernia
8. sciatica with neurological deficits/weakness
9. protrusion in pt >60yo
10. Immediately post-mob/manip
11. if traction causes increase LBP/LEP
12. Anxiety

Question 10

Indications for Traction

Answer 10

1. IDD
2. HNP
3. DDD/DJD
4. Joint hypomobility
5. Spinal Stenosis

Question 11

Time of day

Answer 11

AM: acute disc pt with morning Sx (pn/stiff)
PM: pt with pn later in day (apply prior to onset)

Question 12

Frequency

Answer 12

Acute Disc: 5 days/week

Chronic Disc: 2-3 days/week

Question 13

Positioning Options

Answer 13

Supine w/ post pull
Supine w/ ant pull
Prone w/ post pull
Prone w/ ant pull

Post=flexion
Ant=extension

Question 14

(Tabs out)

Answer 14

(supine w/ post pull OR prone with ant pull)

Question 15

(Tabs in)

Answer 15

(Supine w/ ant pull OR prone with post pull)