IPHREHAB : CERVICAL TRACTION & POSITIONING

IPHREHAB

Traction

Goal

Reduction of signs or symptoms of C or L spinal compression

Utilize maximal traction with minimal force

PARAMETERS

• Body position:prone, supine,hip position, bilateral, or unilateral direction of pull
• Force used
• Intermittent traction:traction time and rest time
• Sustained traction
• Duration of treatment
• Progressive steps
• Regressive steps

Patient instruction

Explain to patient

Position Pt.

C spine can be done in sitting or supine.Supine provides increased relaxation, vertebral separation and easier countertraction

L traction can be done supine or prone

Angle of Pull

C spine Occiput ( C1-C2) 0-5 degrees flexion

• Mid. Cervical (C2-C5) 10-20 flexion
• Low cervical (C5-C7) 25-30 flexion

Effects on Cervical Flexion

Rope Angle

– To effect 25-30 degrees of flexion on the neck the rope angle will need to approach 45 degrees due to the flexibility of the rope resulting in a sagging with the weight of the head

– The angle is 0, or flat for atlanto-occipital and atlanto-axial traction

Inter vertebral Encroachment

Flex, and SB toward unaffected side and rotation toward affected side

Disc- C spine neutral.  Want ligaments to be lax and allow better distraction

Cervical Traction

Application of a longitudinal force to the C-spine & structures

Tension applied can be expressed in pounds or % of patient’s body weight.

At 7% of patient’s body weight, vertebral separation begins 

Human head accounts for 8.1% of body weight (8-14 lbs.)

Greater amount of force is needed widen areas

You want force to be about 20% of body weight

Cervical Traction Positioning

Seated – a greater force is needed to apply the same pressure (due to gravity) than if supine

Supine – support lumbar region (bend knees, use knee elevator, or hang lower legs over end of table & place feet on chair); allows musculature to relax 

Effects of Cervical Traction :

• Reduces pain & paresthesia associated w/ n. root impingement & m. spasm
• Reduces amount of pressure on n. roots & allows separation of vertebrae to result in decompression of disks.

Effectiveness of Cervical Traction:

Cervical traction has been linked to 5 mechanical factors

• Position of the neck
• Force of applied traction
• Duration of traction
• Angle of pull
• Position of patient