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Traction - Coggle Diagram
Traction
Is the application of a pulling force to a part of the body, and it may be either a direct or indirect pull.
2.MOA
• Increases the separation of the vertebrae and decreases the central pressure of intervertebral disc spaces
• The rationale for traction is based on elongation of the spine, relaxation of spinal ms, opening of the neural foramen, and relief of nerve root compression.
• The reduction of compressive forces theoretically serves to create space for the inflamed or compressed nerve root, thereby diminishing structural impingement and improving fluid dynamics
- To restore bone or limb length or if it has been reduced by fracture or disease.
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- To maintain correct limb length, & overcome ms spasm which may be the case of limb shortening after a fracture
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- To correct deformity in a jnt
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- To reduce a dislocated jnt
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- To immobilize a jnt
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- To relieve pain preoperatively
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- To promote rest n healing postoperatively
- Ligamentous instability (prior trauma or rheumatoid arthritic patients)
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- Spinal infections such as osteomyelitis or discitis,
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- severe OP or osteopenia
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- Primary bone or spinal cord and metastatic tumors
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- Myelopathies
.
- Uncontrolled HTN or vertebral basilar artery insufficiency (for cervical traction)
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- The very young and the very old frail patients
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- Acute or subacute spinal fractures
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- Pregnancy
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- Abdominal or inguinal hernias
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- Aortic aneurysms
1.Manual traction
- A technique where the therapist uses their hands to perform spinal decompression
• Cyriax has written most extensively about manual application of spinal traction primarily as an adjunct or precursor to spina manipulation.
• Adequate pull with weights and pulleys or a motorized/hydrolic device to achieve vertebral distraction also can be attained in the spine with the proper apparatus
• Adequate pull for the cervical spine is achievable by using a head or chin sling attached to a system that can provide pull in a cephalad direction
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a. Cervical
b. lumbar
• Lumbar traction can be accomplished with upright body suspension, but chest discomfort from the harness is often a limiting factor
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c. inversion
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d.Autorotation
Autotraction devices allow patient to provide tractive forces by pulling with their arms on a specially designed
• In cervical traction, the choice of sitting versus supine positioning should be based on patient comfort and ability to relax.
• The maximal effect of distraction seems to occur between 20 & 30 degrees of flexion with no accompanying rotation or side bending.
• Nearly all studies report difficulties with the cervical spine in extension, thus neck extension during traction should be avoided.
a. Time
• A larger improvement in ROM with less accompanying pain was noted in patients subjected to
- intermittent traction of 11.4 kg (25lbs)
- peak (10s on, 10s off, total 15 mins)
• Cyriax has reported that
continuous traction
is necessary to
fatigue the muscles
& allow strain to fall on the joints
• Despite this claim, no statistical difference in X-rays was noted for normal subjects treated with either
- continuous traction
of 45.4 kg (100 lb)
for 5 mins or
- intermittent traction of
45.4 kg (100 lb) peak for
25 mins (10s traction, 5 secounds rest)
b. Weight
Cervical
• If cervical traction is performed with the patient in the sitting position,
abt 4.5 kg (10 lb) is required to counterbalance the patient’s head.
• Amnts less than this may be used initially to condition the patient to the feel of the halter and pull.
• An initial “test dose” of 2.3 or 4.6 kg (5 or 20lb) of traction followed by a gradual increase in weight to 20.4 or 22.7 kg (45 or 50 lb) has been advocated.
c. Duration
-
cervical
• intermittent traction with
the neck in flexion
for a total traction time of 15 mins, or 20mins, or 25 mins has produced physiologic effects.
• A duration of 25 to 25 minutes, if tolerated by patients, is commonly prescribed.
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d. frequency
- Then every other day (or 3 x per week)
- for a total treatment time of 3 or 4 weeks