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Traction

Traction. 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. Effects of Spinal Distraction. Reduction of Disc Protrusion

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Traction

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  1. Traction

  2. 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

  3. 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

  4. Effects of Spinal Distraction • Soft Tissue Stretching • Muscles, tendons, ligaments, discs • Increase soft tissue length & increase joint mobility

  5. Effects of Spinal Distraction • Muscle Relaxation • Can facilitate muscle relaxation • May be due to reduction of pain • May be due to prolonged stretch (may fire the GTO)

  6. Effects of Spinal Distraction • Joint Mobilization • Stretching of soft tissues with traction can increase joint mobility

  7. 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

  8. 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.

  9. Clinical Indications for the Use of Spinal Traction • Nerve Root Impingement

  10. 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)

  11. Clinical Indications for the Use of Spinal Traction • Subacute Joint Inflammation • Traction may reduce strain on injured tissues &/or joints

  12. Clinical Indications for the Use of Spinal Traction • Paraspinal Muscle Spasm • Can reduce muscle spasm by reducing by &/or firing the GTO

  13. Clinical Indications for the Use of Spinal Traction

  14. Contraindications for the Use of Traction • Where motion is contraindicated • Example – unstable fracture, spinal cord compression, or shortly after spinal surgery

  15. Contraindications for the Use of Traction • With an acute injury or inflammation • Example – shortly after trauma, surgery, RA, OA

  16. Contraindications for the Use of Traction • Joint hypermobility or instability • Example – fractures, dislocation, surgery, pregnancy, lactation, RA, Down’s syndrome

  17. Contraindications for the Use of Traction • Peripheralization of symptoms with traction

  18. Contraindications for the Use of Traction • Uncontrolled hypertension (for inversion traction)

  19. Precautions for the Use of Traction • Structural diseases or conditions affecting the spine(tumor, infection, rheumatoid arthritis, osteoporosis, or prolonged systemic steroid use)

  20. Precautions for the Use of Traction • When pressure of the belts may be hazardous (pregnancy, hernia, vascular compromise, osteoporosis)

  21. Precautions for the Use of Traction • Displacement of annular fragment • Traction is not likely to change the position of the fragment

  22. 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

  23. Precautions for the Use of Traction • Claustrophobia

  24. Precautions for the Use of Traction • Patients who cannot tolerate the prone or supine position • Pain in prone or supine position or acid reflux

  25. Precautions for the Use of Traction • Disorientation

  26. Precautions for the Use of Traction • Temporomandibular joint (TMJ) problems and dentures

  27. Adverse Effects of Spinal Traction • Worsening of symptoms • New symptoms (radiculopathy due to excessive strain on the spinal cord dura)

  28. Application Technique: Mechanical Traction • Mechanical Lumbar Traction Procedure

  29. Application Technique: Mechanical Traction • Mechanical Cervical Traction Procedure

  30. Application Techniques: Self-Traction • Examples of Self-Traction • Sitting Self-Traction • Self-Traction Between Corner Counters • Self-Traction With Overhead Bar

  31. Application Techniques: Positional Lumbar Traction

  32. Application Techniques: Manual Traction

  33. Traction • MRI results before and after cervical traction

  34. VAX-D

  35. VAX-D

  36. 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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