1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular...

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Traction

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Effects of Spinal Distraction

Joint Distraction– Separation of two

articular surfaces– Can treat facet joint &

spinal nerve root symptoms

– Distraction force - 50% of BW for L-spine & 7% for C-spine

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Effects of Spinal Distraction

Reduction of Disc Protrusion– Suction due to

decreased intradiscal pressure

– Force of 60-120 #’s have been shown to reduce lumbar disc protrusion

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Effects of Spinal Distraction

Soft Tissue Stretching– Muscles, tendons,

ligaments, discs– Increase soft tissue

length & increase joint mobility

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Effects of Spinal Distraction

Muscle Relaxation– Can facilitate muscle

relaxationMay be due to

reduction of painMay be due to

prolonged stretch (may fire the GTO)

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Effects of Spinal Distraction

Joint Mobilization– Stretching of soft

tissues with traction can increase joint mobility

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Effects of Spinal Distraction

Patient Immobilization– Very low-load traction

(10-20 #’s) has been used to immobilization pts with spinal disorders (Bucks Traction)

– Presently, not as popular

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Clinical Indications for the Use of Spinal Traction

Disc Bulge or Herniation– Traction may be more beneficial for disc bulge than

herniation– The greater the damage to the disc, the less

effective traction may be.

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Clinical Indications for the Use of Spinal Traction

Nerve Root Impingement

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Clinical Indications for the Use of Spinal Traction

Joint Hypomobility– Traction cannot isolate a local area of

hypomobility– Traction can improve mobility throughout the

treated area (c-spine, l-spine)

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Clinical Indications for the Use of Spinal Traction

Subacute Joint Inflammation– Traction may reduce strain on injured

tissues &/or joints

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Clinical Indications for the Use of Spinal Traction

Paraspinal Muscle Spasm– Can reduce muscle spasm by reducing by &/or firing

the GTO

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Clinical Indications for the Use of Spinal Traction

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Contraindications for the Use of Traction

Where motion is contraindicated– Example – unstable fracture, spinal cord

compression, or shortly after spinal surgery

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Contraindications for the Use of Traction

With an acute injury or inflammation– Example – shortly after trauma, surgery, RA, OA

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Contraindications for the Use of Traction

Joint hypermobility or instability– Example – fractures, dislocation, surgery,

pregnancy, lactation, RA, Down’s syndrome

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Contraindications for the Use of Traction

Peripheralization of symptoms with traction

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Contraindications for the Use of Traction

Uncontrolled hypertension (for inversion traction)

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Precautions for the Use of Traction

Structural diseases or conditions affecting the spine(tumor, infection, rheumatoid arthritis, osteoporosis, or prolonged systemic steroid use)

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Precautions for the Use of Traction

When pressure of the belts may be hazardous (pregnancy, hernia, vascular compromise, osteoporosis)

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Precautions for the Use of Traction

Displacement of annular fragment– Traction is not likely to change the position

of the fragment

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Precautions for the Use of Traction

Severe pain relieved by traction– May indicate the spinal nerve root becoming

more compressed as a result of the traction intervention

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Precautions for the Use of Traction

Claustrophobia

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Precautions for the Use of Traction

Patients who cannot tolerate the prone or supine position– Pain in prone or supine position or acid

reflux

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Precautions for the Use of Traction

Disorientation

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Precautions for the Use of Traction

Temporomandibular joint (TMJ) problems and dentures

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Adverse Effects of Spinal Traction

Worsening of symptoms New symptoms (radiculopathy due to

excessive strain on the spinal cord dura)

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Application Technique: Mechanical Traction

Mechanical Lumbar Traction Procedure

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Application Technique: Mechanical Traction

Mechanical Cervical Traction Procedure

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Application Techniques: Self-Traction

Examples of Self-Traction– Sitting Self-Traction– Self-Traction Between

Corner Counters– Self-Traction With

Overhead Bar

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Application Techniques: Positional Lumbar Traction

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Application Techniques: Manual Traction

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Traction

MRI results before and after cervical traction

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VAX-D

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VAX-D

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Sari et al. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-

Mar;21(1):3-11.

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