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What does joint distraction do?
may reduce pain originating form joint injury or inflammation or from nerve root compression
Percentage of body weight needed for lumbar and cervical tracion.
lumbar 50% body weight
cervial 7% body weight
How does traction stretch soft tissue?
can increase the length of the soft tissues in the area
increasing the length of soft tissues can help with
spinal joint distraction or reduction of disc protrusion
increasing spinal ROM
decrease pressure on the faccet joints
How does traction relax muscles?
Facilitates reaxation of the paraspinal muscles
How does traction increase joint mobility?
traction is a means tot mobilize joints in order to increase joint mobility or decrease joint related to pain
joint mobility increased due to stretching of the surrounding soft tissue
Indication for Traction
Disc duldge or herniation
nerve root impingment
joint hypemobility
subacute joint infalmmation
papaspinal muscle spasm
Contraindications for Tracion
where motion in contraindicated
with acute injury or inflammation
joint hypermobility or instability
peripheralization of symptoms with traction
uncontrolled hypertension
spinal infections or caner
spinal cord pressure
rheumatoid arthritis
osteoporosis
prolonged steroid use
recent frature
Precations for Traction
ligamentous strains and joing hypermobility
acute stages of injury
traction anxiety
cardiac or respiratory insufficiency
pregnancy
displacement of annular ligametn
medial disc protrusion
severe pain fully relieved by treaction
dentures
Conditions to look for when first applying traction
symptoms become more severe
peripheralize
increase in distribution
progress to other domains
pain changed to weakness numbness or tingling
Positive reaction to Traction
decreased pain with decreased neurological signs usually are an indication that the condition is resolving
increased central pain decreased peripheral pain
Negative response to Traction
Decreased pain but increased in neuroligical signs indicate increased pressure to a nerve root, causing sensory deficits motor weakness or both
Decreased central pain with increased peripheral pain indicate increased nerve root irritation
Application Techniques of Tracion
Use of electric and weighted mechanical devices
self traction
positional traction
manual tracion
inversion techniques
auto traction
cottrell 90/90 tracion
Mechanical tracion
can be applied to the lumbar and cervial spine
electric mechanical traction units can apply atatic or intermittent traction
Define Static
same amount of force is applied throughout the treatment session
Define Intermittent
Tracion force alternated between two set point every few seconds thourghtout the treatment session
Leg position that focuses on the upper spine for lumbar tracion?
Flexion
upper lumbar and lower thoracic
Leg position that focuses on lower lumbar
neutral or extension
Patient positioning for cervical spine while sitting
flexion, rotation and side bending can be adjusted for patient comfort and to direct forece to disiered area
flexed focuses on the lower cervical spine
extendes focuses on the upper cervial spine
max elongation of posterior structures is achieved with 25-30 degrees of flexion
Coefficent of Friction
force resisting motions between 2 surfaces
amoutn of resistance depends on magnitude of force compressing objects togeher
to overcome friction a forece of 1/4 the body weight is nexissary with lumbar traction
split tractin table eliminates friction
Advantages to Mechanical Tracion
force and time well controlled readily graded and replicable
once applied does not require the clinician to be with the pt
electrical mech traction devices like over the door treaction are inexpensive and convenient for independent use by the pt at home
Disadvantages of mechanical traction
expensive electric machanical devices
time consuming to set up
lack of pt control or participation
restriction by belds or halter poorly tolerated by some
mobilized broad regions of the spine rate than individual spinal segments potentially creating hypermobility in normal joint
Define Self Traction
a form of traction tat uses gravity and the weight of the pt body or foece exterted by the pt to exert a distractive force on the spine
Self Traction options
sitting
between corner counters
overhead bar
door
supine
Advantages of Self Traction
minimal or no equipment needed
easy for pt to perform
easy for pt to control
can be performed in many environments and thus many times during the day
Disadvantages of Self Traction
low maximum force therefore may not be effective
requires strong injury free upper extremities
can't be performed on the cervical spine
no research data to support
pt my have good posture awareness
Positional Tracion
involves prolonged placement of the pt in a postion that places tension on one side of the lumbar spine only
doesn't cause joint distraction it may help with muscle spasm and stretch soft tissue
Advantages of positional traction
requires no equipment or assistance
inexpensive
can be applied by the pt at home
low force not likely to aggravate an irritable condition
position easily adjustable
Disadvantages of positional traction
low force not likely to be effective here joint distaction is required
requires agility and skill by the pt to perform correctly
no research
Manual Traction
the application of force by the therapist in the direction to distract the joints
used on cervical and lumbar
classified as manual therapy
allows the therapist to feel the patients reaction
exact amout of force can't be quantified or aniticipated by the pt
can be limited by therapist strength and fatigue
Advantages of of manual traction
no equipmetn required
short setup time
force can be finely graded
clinicaian is present throughout trreatment
can be applied briefly to determine if mechanical traction should be used
can be used with pt who do not tolerate being placed in halters or belts
Disadvantages of Manual traction
limited max traction force
amount of force can't be easily replicated or specifically recorded
can't be applied for prolonged period of time
required a skilled clinician
Time and Frequency
Intermittent tractin is usually performed for 20-30 mins
Sustained traction is done for 3-30 mins at low weights
may be done daily, twice daily, or 2-3 times a week
Documentation
type
area
position
type of halter
max force
total treatment time
response to treatment
in intermittent used hold and relax times
Author
hgienau
ID
50979
Card Set
Traction
Description
traction for PTA
Updated
2010-11-22T03:44:47Z
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