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Traction.ppt
- 2. OUTLINE OF LECTURE Introduction to traction Types of application of traction Modes of traction Effects of traction Indication of traction Contra-indication of traction Procedure of traction Summery 2 Dr.Sudeep Kale
- 3. INTRODUCTION Definition : it is process of pulling / drawing in which force is applied perpendicular to treatment plane of joint so that articular facets are separated 3 Dr.Sudeep Kale
- 5. TYPES OF TRACTION Skin traction Skeletal traction 5 Dr.Sudeep Kale
- 6. TYPES OF TRACTION APPLICATION Dr.Sudeep Kale 6 TRACTION STATIC Continuous / Prolonged Sustained INTERMITANT
- 7. I. STATIC / CONSTANT TRACTION : Definition : Steady force is applied & maintained for extended time interval. a. Continuous / prolonged b. Sustained 7 Dr.Sudeep Kale
- 8. a) Continuous / Prolonged Definition : Static traction in which force is applied for several hours at a time to several days Constant tension Small / Limited weight tolerated due to long duration Normally applied with suspended weights Use : Primarily for immobilization Limitation : Ineffective in separation spinal structures 8 Dr.Sudeep Kale
- 9. b)Sustained Definition : Static traction in which force applied with constant tension for several minutes up to ½ / 1hour May be applied via suspended weights or a mechanical device Use : for prolonged stretch to spinal structure 9 Dr.Sudeep Kale
- 10. II. INTERMITTENT TRACTION Definition : Traction in which force is alternately applied & released @ frequent intervals via a mechanical device in rhythmic manner Termed hold and rest Hold and rest times usually vary from a few seconds up to 1 minute Greater forces can be tolerated Works well for joint hypomobility and degenerative disc disease with shorter rest and hold times (mobilizing effect) 10 Dr.Sudeep Kale
- 12. MODES OF APPLICATION Traction modes Mechanical Manual Positional 12 Dr.Sudeep Kale
- 13. MECHANICAL : Traction is applied through the motorized & mechanical device /gravity traction frames 13 Dr.Sudeep Kale
- 14. MANUAL Traction applied by the therapist grasping the patient with hands and utilizing his or her own force to create traction. Advantage : Allows tx to be applied to a specific level as it is palpated Disadvantage : Amount of force can’t be measured Limited by strength and endurance of therapist Better suited for cervical than lumbar traction Allows constant adjustments by the therapist based on constant feedback 14 Dr.Sudeep Kale
- 15. POSITIONAL Sustained traction is applied to specific segments by keeping the patient in different positions Allows gravity to effect a traction force on the patient’s body weight Normally has a unilateral effect Creates unilateral separation on the opposite side of the spine Normally sideling over a bolster / blanket / pillows / blocks Well suited for scoliosis treatment and other long term treatments Can be performed at home by the patient 15 Dr.Sudeep Kale
- 17. EFFECTS Mechanical elongation of the spine Separation of vertebral bodies Facet joints mobilization Muscle relaxation Reduction of pain 17 Dr.Sudeep Kale
- 18. MECHANICAL ELONGATION OF THE SPINE Whenever force is applied to spine,It : Stretches the spinal muscles Tenses the ligaments & facet joint capsules Widens I.V. foramina Straightens the spinal curves Slides the facet joints Flattens the nuclear disc protrusion 18 Dr.Sudeep Kale
- 19. FACET JOINT MOBILIZATION Traction causes : Separation of facet joint surfaces Compression & approximation of facet surfaces 19 Dr.Sudeep Kale
- 20. MUSCLE RELAXATION It occurs because of : Stretching of muscles Greater vertebral separation Decrease in spasm & pain 20 Dr.Sudeep Kale
- 21. REDUCTION OF PAIN (MECHANICAL EFFECTS) : Increase in circulation : Movement of region ↑ blood flow 2 that area Helps in ↓ stenosis from circulatory congestion Separation of vertebras : Temporary ↑ size of foramina ↓ pressure from impinged nerve root Mechanical streching of tight structure : ↑ movement of segment ↓ pain from restricted structures 21 Dr.Sudeep Kale
- 22. REDUCTION OF PAIN (NEURO-PHYSIOLOGIC EFFECTS) : Stimulation of mechanoceptors blocks transmission of nociceptive stimuli @ spinal cord / brainstem level Inhibition of reflex muscle guarding 22 Dr.Sudeep Kale
- 24. JOINT HYPOMOBILITY ↓ Rom : traction is indicated Mobilization, passive joint movement Pain control by synovial fluid exchange to facet capsules and the meniscus for nutrition, and proprioceptive response from moving facet structures gives a gate control response 24 Dr.Sudeep Kale
- 25. MUSCLE TIGHTNESS, SPASMS, GUARDING Stretching tight muscle fibers Decreases load on other structures (nerve root, facets, disc) that may result in spasms Fluid exchange Improved circulation, nutrients 25 Dr.Sudeep Kale
- 27. Traction causes separation of articular surfaces Increases I.V Foraminal space, ↓I.V. pressure & pressure on bulged disc Creates suction force / sucking effect on herniated disc 27 Dr.Sudeep Kale
- 28. NERVE ROOT IMPINGEMENT From bulging disc, osteophytes narrowed foramen Tingling usually associated with nerve compression Muscle spasms may develop in paraspinals with the same innervation level Traction : Widens foramen Decrease pressure Decreases spasms that may be the cause of compression 28 Dr.Sudeep Kale
- 29. DEGENERATIVE DISC DISEASE Narrowing of intervertebral spaces Pressure on nerve roots, increased load on facets Traction: Widens space and decreases pressure temporarily May result in realignment that decreases pressure 29 Dr.Sudeep Kale
- 30. Scoliosis – Pulls towards a more correct alignment – Stretches out tight musculature or other joint structures Pain – Traction may decrease pressure on sensitive structures and give a gate control effect with movement of these structures 30 Dr.Sudeep Kale
- 32. CONTRAINDICATIONS Acute conditions Tx to acute sprains and strains may overwhelm already weakened soft tissue Joint instability / hyper mobility Structural disease secondary to infection, tumor etc. Fractures Tumors Bone disease or infection 32 Dr.Sudeep Kale
- 33. RELATIVE CONTRAINDICATIONS Pregnancy Osteoporosis Hiatal hernia 33 Dr.Sudeep Kale
- 35. LIMITATION OF TRACTION Effect of vertebral column separation is temporary No consistent protocols exists. (doses depends upon clinical experience) Longitudinal force is nonspecific as to vertebral level (it affects entire region) 35 Dr.Sudeep Kale