Cervical Spine Traction Guidelines

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Questions and Answers

What age criterion is included in the CPR criteria for cervical spine pain?

Age between 40 and 50 years

Age greater than 65 years

Age greater than or equal to 55 years (correct)

Age less than 65 years

Which of the following predictors indicates a positive outcome probability of 89% when treated with cervical manipulation?

Demonstrating cervical stiffness

Exhibiting unilateral involvement pattern

Having a Neck Disability Index score of < 11.50 (correct)

Performing sedentary work for less than 4 hours/day

What is the probability of treatment success for patients demonstrating four or more predictors according to the CPR criteria?

79%

95%

85%

89% (correct)

Which of the following factors is NOT included in determining which patients will benefit from cervical spine manipulation?

Length of time in therapeutic exercise Signup and view all the answers

What does a + LR of 23.1 indicate for patients with a score of 4 or more in the study findings?

High likelihood of treatment success Signup and view all the answers

What effect does cervical traction have on derangement?

Flattens nuclear protrusion Signup and view all the answers

Which condition may benefit from cervical traction for temporary relief?

Cervical stenosis Signup and view all the answers

What is a necessary condition to effectively use cervical traction on hypomobility?

Adequate force to separate joint surfaces Signup and view all the answers

What is a contraindication for cervical traction treatment?

Joint hypermobility Signup and view all the answers

How effective are the results from cervical traction typically described?

Temporary decrease in symptoms Signup and view all the answers

What is the primary purpose of performing manual traction before mechanical traction?

To assess effectiveness and appropriateness Signup and view all the answers

Which of the following would NOT be a reason to apply cervical traction in muscle spasm?

To increase muscle tone Signup and view all the answers

What aspect of cervical traction treatment limits its focus?

Spinal levels cannot be isolated Signup and view all the answers

What is the maximum recommended dosage of mechanical traction as a percentage of a patient's body weight?

7% Signup and view all the answers

What effect does increased flexion have on vertebral separation?

It increases vertebral separation. Signup and view all the answers

Which patient position is associated with the most relaxation of the cervical spine?

Supine Signup and view all the answers

How long is the typical duration for mechanical traction treatments to achieve relaxation?

20-30 minutes Signup and view all the answers

Which mode of traction combined with exercise has shown superior results for cervical radiculopathy?

Mechanical traction in supine position Signup and view all the answers

What is a crucial factor influencing vertebral separation during traction treatment?

Amount of force applied Signup and view all the answers

What determines the appropriate duration of mechanical traction for a patient?

Mode of traction and treatment goals Signup and view all the answers

What was the successful outcome defined in the study for cervical spine traction?

A change of +6 or greater in the GROC scale Signup and view all the answers

What is the primary cause of cervical spine stenosis?

Trauma resulting in narrowing of the vertebral foramen Signup and view all the answers

In which sports is cervical spine stenosis most likely to occur?

Football and ice hockey Signup and view all the answers

What might happen to patients experiencing severe cervical stenosis with retraction and extension?

Peripheralization of symptoms Signup and view all the answers

Which test is NOT positive for relief of symptoms in cervical spine stenosis?

Cervical Distraction Test Signup and view all the answers

What is recommended for treating cervical spine stenosis?

Repeated cervical spine flexion exercises Signup and view all the answers

What does the typical range of motion finding 'Min / Mod ERP' indicate?

Minimal pain during retraction/extension Signup and view all the answers

Which of the following exercises should be included in a treatment plan for cervical spine stenosis?

Muscular endurance training for cervical spine flexors Signup and view all the answers

What should clinicians monitor when treating with repeated cervical retraction?

Increased symptoms with the exercise Signup and view all the answers

What percentage of patients was found to meet the criteria for considering the treatment outcome successful in the initial study?

39% Signup and view all the answers

What was the increase in the success rate for manipulative therapy when patients met at least 3 of the specified inclusion criteria?

90% Signup and view all the answers

Which of the following is NOT one of the inclusion criteria for the clinical prediction rule for cervical spine manipulation?

Prior surgery on the cervical spine Signup and view all the answers

In the study comparing thoracic and cervical spine manipulation, which factors were assessed for improvement?

Pain and function Signup and view all the answers

What conclusion was drawn about patients with cervical spine pain who met the thoracic spine CPR criteria?

They showed better improvement with cervical manipulation. Signup and view all the answers

In the final study, what was found regarding the comparison of treatment outcomes between mobilization and manipulation for mechanical neck pain?

Both treatments were equally effective. Signup and view all the answers

After receiving manipulative therapy, patients in both the thoracic and cervical manipulation groups participated in what type of exercise?

Cervical ROM exercises Signup and view all the answers

How many criteria did patients need to meet for thoracic spine manipulation to be eligible for the comparative study?

4 of 6 Signup and view all the answers

Study Notes

Cervical Spine Traction Treatment Guidelines

Cervical traction is used to treat various cervical spine conditions, including derangements, stenosis, and flexion bias conditions.
Traction can help alleviate symptoms associated with these conditions by flattening nuclear protrusion, opening intervertebral foramina, and elongating tight muscles and ligaments.
Traction can be beneficial for conditions affecting multiple spinal levels, but not always effective in isolating a single spinal level.
Muscle spasm may be addressed by treating the underlying cause.
Traction's effects are typically temporary.
Specific precautions include conditions where movement is contraindicated, acute strains or sprains, joint hypermobility, malignancy, infection, and TMJ dysfunction.
No established standardized protocols or best practice guidelines for traction exist.

Basic Cervical Traction Procedures

Initial manual traction is used to assess the effectiveness and suitability of traction.
Proper positioning is vital for maximizing the benefit of traction.
Appropriate traction mode (manual or mechanical) should be selected based on the patient's condition.
Dosage (weight) and duration of traction should be carefully determined based on individual needs and adjusted if needed.
The duration of traction is dependent on the treatment goals. (Typically 20-30 minutes).
The maximum dosage of traction should typically not exceed 7% of the patient's body weight.

Factors Influencing Vertebral Separation

Increased flexion increases vertebral separation.
Optimal flexion angle is 35 degrees.
Cervical flexion should be used judiciously to avoid contraindications.
A maximum force of 7% of the patient's body weight is often used in mechanical traction for relaxation.
Different types of mechanical traction approaches are available.
- Over-the-Door Traction
- Pronex Traction / Saunders Traction
- Mechanical Traction Machine

Evidence-Based Practice Guidelines

Combined exercise and supine mechanical traction is superior to other types for decreasing neck pain, arm pain, and neck disability scores for cervical radiculopathy.
86 patients participated in this study following the initial 4 weeks and the follow up period of 6 and 12 months.

CPR for Traction to Treat Cervical Spine Pain

A clinical prediction rule (CPR) is used to identify patients likely to benefit from mechanical cervical traction.
Criteria for the CPR include age, reported peripheralization of symptoms with lower cervical spine mobility, positive shoulder abduction test, positive brachial plexus test (Elvey's test), and positive cervical distraction test.
Patients who exhibit four or more of these factors have a high probability of successful treatment.

Cervical Spine Manual Therapy Research

Initial score on the Neck Disability Index and factors like bilateral involvement, sedentary work, preference for movement, and absence of radiculopathy affect the outcome of the therapy intervention.
Patients reaching four or more criteria have an 89% probability of a successful manipulative therapy outcome.
Different studies show varying success rates in different groups—a success rate of 39% when specific parameters weren't met and 90% improvement for those who met 3 inclusion criteria.
A thoracic spine manipulation study was performed to compare it with cervical manipulation in patients with mechanical neck pain.

Cervical Spine Stenosis

Cervical stenosis is less common than lumbar stenosis due to different weight-bearing responsibilities.
Cervical stenosis is often caused by repeated spinal trauma, resulting in narrowing of the vertebral foramen.
This condition is common in collision sports, such as football, ice hockey, and lacrosse.
Typical range of motion findings include issues with extension, and flexion and retraction alone or together, varying intensities.

Treatment of Cervical Stenosis

Treatment should include postural education, repeated cervical spine flexion exercises, strengthening and endurance training for cervical flexors, extensors, and scapular stabilizers.
Repeated cervical retraction should be used with caution as increased peripheral symptoms may occur.
Patients experiencing cervical spine stenosis, and who sustain axial loading injury, are more likely to suffer spinal cord injury and paralysis, so retirement from collision sports may be necessary.

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Description

This quiz explores the treatment guidelines and procedures for cervical spine traction. It covers conditions treated by cervical traction, precautions, and the temporary nature of its effects. Perfect for healthcare professionals interested in spinal therapy.