Traction Indications and Contraindications
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Questions and Answers

What is the recommended weight for the first treatment in cervical therapy?

  • 10# (correct)
  • 12#
  • 14#
  • 15#

For joint distraction in cervical therapy, what is the maximum weight that should be applied?

  • 20#
  • 25#
  • 35#
  • 30# (correct)

What is the recommended hold/rest time for treating disc herniation?

  • 5:5
  • 10:10
  • 3:1 (correct)
  • 2:1

During the vertebral artery test, what does it indicate if there is pupil dilation?

<p>Positive test result (B)</p> Signup and view all the answers

What is the typical duration for cervical treatment related to facet pain?

<p>20 minutes (B)</p> Signup and view all the answers

Which of the following is NOT a contraindication for lumbar and cervical traction?

<p>Joint hypermobility (A)</p> Signup and view all the answers

In which position is cervical traction ideally performed?

<p>Supine position (D)</p> Signup and view all the answers

What is the ideal angle for vertebral separation in the cervical spine during traction?

<p>25 degrees (D)</p> Signup and view all the answers

What force percentage of body weight is generally applied for muscle spasm or guarding during lumbar traction?

<p>25% BW (D)</p> Signup and view all the answers

What should be observed in the setup of lumbar traction to ensure the pull is effective?

<p>Rope pulling centrally (D)</p> Signup and view all the answers

Which of the following conditions typically requires a light force during traction treatment?

<p>Muscle guarding (B)</p> Signup and view all the answers

For cervical traction, what is a critical factor that should not exceed 35 degrees?

<p>Angle of pull (C)</p> Signup and view all the answers

What is the primary purpose of applying higher forces during traction treatment?

<p>To achieve vertebral separation (A)</p> Signup and view all the answers

Match the weight recommendations for cervical traction with their indicated conditions:

<p>10# = First treatment 11-15# = Muscle spasm, disc herniation 20-30# = Joint distraction 30# = Maximum limit for traction</p> Signup and view all the answers

Match the cervical traction hold/rest times with their relevant conditions:

<p>3:1 = Disc herniation 10:10 = Facet pain/dysfunction 1:1 = General treatments 2:1 = Muscle relaxation</p> Signup and view all the answers

Match the duration of cervical traction with the condition being treated:

<p>20 min = Facet pain 10 min or less = Disc herniation 15 min = General cervical therapy 30 min = Extended pain treatment</p> Signup and view all the answers

Match the symptoms indicating a positive vertebral artery test with their descriptions:

<p>Dysphasia = Difficulty speaking Drop attack = Passing out Double vision = Visual disruption Pupil dilation = Change in pupil size</p> Signup and view all the answers

Match the vertebral artery test procedure steps with their corresponding actions:

<p>Passive extension = Testing head movement Passive rotation = Holding for 30 seconds Side flexion = Lateral head movement Test repetition = Opposite side movement</p> Signup and view all the answers

Match the following indications with their descriptions for lumbar and cervical traction:

<p>Disc herniations = Separation of vertebrae to relieve pressure Joint hypomobility = Reduced range of motion in a joint Nerve root impingement = Pressure on nerve roots causing pain Muscle guarding/spasms = Involuntary muscle contraction impacting movement</p> Signup and view all the answers

Match the following contraindications with their descriptions for lumbar and cervical traction:

<p>Spinal cancer = Presence of malignancy in the spine Pregnancy = Condition that requires special care during treatment Acute inflammation = Recent swelling or irritation in tissues TMJ disorder = Jaw condition that can complicate cervical treatment</p> Signup and view all the answers

Match the following traction setup positions with their appropriate uses:

<p>Supine = Most common position for lumbar traction Neutral pull = Preferred angle for upper cervical traction Prone = Used for disc herniation cases Flexed position = Position to enhance separation of facets and IVF</p> Signup and view all the answers

Match the following percentages of body weight with their purposes in lumbar traction:

<p>25% BW = For muscle spasm or guarding 50% BW = For vertebral separation Light force = Applied in initial treatments Higher force = Applied for conditions requiring greater decompression</p> Signup and view all the answers

Match the following traction angles with their correct spinal regions:

<p>10° - 20° = Mid cervical traction 25° - 35° = Lower cervical traction Neutral = Upper cervical traction Flexed position = Not applicable for C-spine traction</p> Signup and view all the answers

Match the following treatment types with their characteristics:

<p>Static traction = Used with over-the-door cervical equipment First treatments = Utilize light forces for patient comfort Higher forces = Target vertebral separation for serious conditions Irritable conditions = Require lighter, longer duration forces</p> Signup and view all the answers

Match the following clinical observations with their importance during lumbar traction setup:

<p>Rope pulling centrally = Ensures even force application Angle of the rope = Affects the target for spinal separation Spine position adjustment = Maintains patient comfort and effectiveness Observation of head in halter = Keeps neck in neutral during treatment</p> Signup and view all the answers

Match the following critical components with their definitions in cervical traction:

<p>25 degrees = Ideal angle for vertebral separation 35 degrees = Maximum angle recommended to avoid complications Supine position = Provides relaxation and optimal force adjustment Angle adjustment = Essential for effective treatment delivery</p> Signup and view all the answers

For treating muscle spasm, the recommended weight for cervical traction is between 11-15# or 7-10% BW.

<p>True (A)</p> Signup and view all the answers

A hold/rest time of 10:10 is typically recommended for disc herniation.

<p>False (B)</p> Signup and view all the answers

During the vertebral artery test, a positive result can include symptoms such as double vision or pupil dilation.

<p>True (A)</p> Signup and view all the answers

A weight of 30# should be exceeded for effective joint distraction in cervical therapy.

<p>False (B)</p> Signup and view all the answers

A typical duration for facet pain treatment is 10 minutes or less.

<p>False (B)</p> Signup and view all the answers

Spinal cancer is an indication for lumbar and cervical traction.

<p>False (B)</p> Signup and view all the answers

The ideal angle for vertebral separation in the cervical spine is 25 degrees.

<p>True (A)</p> Signup and view all the answers

Lumbar traction should not exceed 50% of body weight for vertebral separation.

<p>True (A)</p> Signup and view all the answers

Using a light force during the first treatment is recommended for both cervical and lumbar traction.

<p>True (A)</p> Signup and view all the answers

A seated position is preferable for performing cervical traction.

<p>False (B)</p> Signup and view all the answers

Facet impingement is a common indication for applying traction therapy.

<p>True (A)</p> Signup and view all the answers

Pregnancy is only a contraindication for cervical traction.

<p>False (B)</p> Signup and view all the answers

Cervical traction should always be applied with sustained extension to be effective.

<p>False (B)</p> Signup and view all the answers

Flashcards

Lumbar Traction Indications

Conditions like disc herniations, joint hypomobility, muscle guarding and nerve root impingements are treated with lumbar traction.

Cervical Traction Indications

Cervical traction treats conditions such as disc herniations, joint hypomobility, nerve root impingement and facet impingement in the neck area.

Lumbar Traction Contraindications

Conditions like spinal cancer, infection, osteoporosis, spinal cord pressure & pregnancy are reasons not to use lumbar traction, as well as acute inflammation, sprains/strains, spinal fractures etc.

Cervical Traction Contraindications

Conditions like a positive vertebral artery test, positive alar ligament test or RA/TMJ and excessive neck extension are contraindications in cervical traction.

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Cervical Traction Position

Supine position for Cervical traction is preferable for relaxed adjustment of angle force. If seated, use a face traction.

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Lumbar Traction Position

Supine position (90/90 degree) is the common position for lumbar traction. Other positions include neutral or prone for disc herniations.

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Traction Force Parameters

Initial traction force should be low (light) for first treatments and muscle guarding. Higher force is used for vertebral separation.

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Traction Force for Separation

For vertebral separation, forces up to 50% body weight may be used, while muscle-spasm may require 25%.

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Cervical Weight for Treatment

Weight applied to the neck during treatment. Different weights are used for different conditions (muscle spasm, disc herniation, etc).

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Disc Herniation Treatment Weight

11-15 pounds (or 7-10% of body weight) is a typical treatment loading for muscle spasms and disc herniation

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Vertebral Artery Test

A test to assess the health of the vertebral artery, which supplies blood to the brain. Used to evaluate for potential problems during neck/head movement.

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Positive Vertebral Artery Test

Symptoms such as dizziness, fainting, double vision, or difficulty speaking. These are signs of potential vertebral artery issues.

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Neck Hold/Rest Time for Disc

Typically, a 3:1 hold time (apply weight) to rest time is recommended for disc herniation problems.

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Cervical traction weight: Muscle spasm

For muscle spasm, use 11-15 pounds (or 7-10% of body weight) for cervical traction.

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Cervical traction weight: Joint distraction

Use 20-30 pounds (13-20% of body weight) for joint distraction during cervical traction.

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Cervical traction weight: Maximum

The maximum recommended weight for cervical traction is 30 pounds.

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Cervical Traction Hold/Rest Time: Disc Herniation

For disc herniation, use a 3:1 hold/rest time during cervical traction (3 seconds holding the weight, 1 second rest).

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Vertebral Artery Test: Positive Signs

Positive signs during the Vertebral Artery Test include: dizziness, fainting, double vision, difficulty speaking.

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What is traction used for?

Traction is a therapeutic technique that involves applying a controlled pulling force to a body part, primarily the spine, to achieve separation of vertebrae and relieve pressure on nerves and soft tissues.

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What are some common indications for lumbar traction?

Lumbar traction is indicated for conditions like disc herniations, joint stiffness, muscle spasms, nerve root compression, and facet joint pain.

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What are some common indications for cervical traction?

Cervical traction is indicated for similar conditions as lumbar traction but specific to the neck, including disc herniations, neck stiffness, muscle spasms, nerve root compression, and facet joint pain.

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What are some contraindications for lumbar traction?

Contraindications for lumbar traction include spinal cancer, infections, osteoporosis, spinal cord pressure, instability, pregnancy, acute inflammation, sprains, fractures, and claustrophobia.

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What are some contraindications for cervical traction?

Contraindications for cervical traction include a positive vertebral artery test, positive alar ligament test, rheumatoid arthritis, TMJ dysfunction, sustained neck extension and rotation, and signs of vertebrobasilar insufficiency like dizziness, double vision, and speech difficulties.

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What is the ideal position for cervical traction?

The ideal position for cervical traction is supine (lying on the back), as it allows for more relaxed positioning and easier adjustment of the angle of force. A neutral pull is generally used for the upper cervical spine, while a 25-35 degree angle is recommended for the lower cervical spine.

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What is the ideal position for lumbar traction?

The most common position for lumbar traction is supine with the hips and knees bent at 90 degrees (90/90). Other positions include neutral, prone, or 90/90 for disc herniations.

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What is the significance of traction force?

The force of traction should be carefully chosen based on the patient's condition and goals. Lighter forces are used for initial treatments, muscle guarding, and irritable conditions, while higher forces are applied for vertebral separation in conditions like disc herniations.

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Cervical Traction Weights

The amount of weight used in cervical traction varies depending on the condition being treated. For muscle spasm or disc herniation, 11-15 pounds (or 7-10% of body weight) is recommended. For joint distraction, 20-30 pounds (13-20% of body weight) may be needed, but never exceeding 30 pounds.

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Cervical Traction Hold/Rest Time

The duration of weight application (hold) and rest intervals during cervical traction are adjusted based on the condition. For disc herniation, a 3:1 hold/rest ratio (e.g., 3 seconds hold, 1 second rest) is commonly used. For facet pain or dysfunction, a 10:10 ratio (10 seconds hold, 10 seconds rest) is typical.

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Cervical Traction Duration

The length of time for cervical traction varies between conditions. Disc herniation is typically treated with shorter sessions of 10 minutes or less, while facet pain may benefit from longer sessions around 20 minutes.

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Contraindication

A contraindication is a condition that makes a treatment or procedure unsafe or inappropriate.

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Traction Force for Muscle Guarding

Lighter forces, around 25% of body weight, are used for muscle spasms and guarding to gently stretch the muscles.

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Traction Position: Cervical

Supine position is preferred for cervical traction, allowing for easier adjustments. A neutral pull is used for the upper spine, while a 25-35 degree angle is recommended for the lower spine.

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Study Notes

Traction Indications and Contraindications

  • Indications (Lumbar & Cervical):

    • Disc herniations
    • Joint hypomobility
    • Muscle guarding/spasms
    • Narrowing of intervertebral foramen (IVF)
    • Nerve root impingement
    • Facet impingement
    • Subacute joint pain/inflammation

  • Contraindications (Lumbar & Cervical):

    • Spinal cancer, infection, or disease
    • Osteoporosis
    • Spinal cord pressure
    • Hypermobility/instability
    • Pregnancy
    • Acute inflammation
    • Sprains/strains
    • Spinal fracture or other fractures where movement is contraindicated
    • Claustrophobia

  • Additional Lumbar Contraindications:

    • Pregnancy
    • Cardiac or respiratory insufficiency
    • Aortic aneurysm
    • Hiatal hernia

  • Additional Cervical Contraindications:

    • Positive vertebral artery test
    • Positive alar ligament test
    • Rheumatoid arthritis (RA)
    • Temporomandibular joint (TMJ) dysfunction
    • Sustained extension and rotation causing pupil dilation or nystagmus
    • Other signs of vertebrobasilar insufficiency: diplopia, confusion, dysarthria, sensory changes to the face

Traction Procedure and Setup

  • Positioning:
    • Cervical: Flexed position of spine to separate facets and the IVF; supine is preferred for easier adjustment of angle; face traction in seated position. Extension is NOT used for cervical spine.
    • Lumbar: Supine position (usually 90/90 degree hip and knee flexion) most common; neutral or prone may be used for disc herniation; the rope must pull centrally when the pelvic belt is applied.
  • Angle: As the angle of the rope increases, the target separation point moves away from the pull point.

Traction Parameters

  • Force:
    • Cervical:
      • Initial treatment: 10 lbs
      • Muscle spasm/disc herniation: 11-15 lbs (or 7-10% body weight)
      • Joint distraction: 20-30 lbs (or 13-20% body weight) (Maximum 30 lb)
    • Lumbar:
      • Muscle spasm/guarding: 25% body weight
      • Vertebral separation: 50% body weight
  • Treatment time:
    • Lumbar:
      • Muscle spasm/guarding: 10:10 (hold/rest time)
      • Disc herniation: 3:1 (hold/rest time)
      • Facet pain/dysfunction: 20 minutes
    • Cervical:
      • Disc herniation: 10 minutes or less
      • Facet pain: 20 minutes
  • Force intensity:
    • Initial treatments: Light force is used during initial treatments
    • Muscle guarding: Low load, long-duration stretch for muscle inhibition
    • Irritable conditions: Lighter forces
    • Vertebral separation: Higher forces to separate vertebrae (disc herniation, facet impingement)

Vertebral Artery Test

  • Procedure: Passive extension and side flexion (30 seconds) of the head; Passive rotation to the same side (30 seconds). Repeat by rotating to the opposite side.

  • Positive Test: Dysphagia, drop attack/passing out, diplopia, dysarthria, pupil dilation.

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Description

Explore the vital indications and contraindications for traction therapy concerning lumbar and cervical issues. This quiz covers essential conditions for treatment as well as situations where traction should be avoided for safety. Test your knowledge on what is appropriate for effective patient care.

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