Question 1

Which of the following is an appropriate guideline regarding the patient's response to traction?&#10;A) Some discomfort is expected during traction and may temporarily increase afterward.&#10;B) Traction should relieve pain in an extremity but may increase neck or back pain.&#10;C) Pain increases during traction are common but should diminish afterward.&#10;D) The patient should not have an increase in symptoms during or after traction.

Accepted Answer

The patient should not experience an increase in symptoms during or after traction. If symptoms worsen, it may indicate that the traction is not being applied correctly or that it is not the appropriate treatment for the patient's condition. Traction is intended to alleviate pain and discomfort, not exacerbate it.

Question 2

Your patient is considering purchasing an inversion device for her back pain. Which of the following medical problems would preclude her use of this device?&#10;A) Osteoarthritis of the spine&#10;B) Temporomandibular joint dysfunction&#10;C) Spinal stenosis&#10;D) Hypertension

Accepted Answer

Inversion therapy, which involves being upside down or at an inverted angle, can increase blood pressure and intraocular pressure, making it potentially dangerous for individuals with hypertension. This is because the body's need to work harder to pump blood upwards against gravity can exacerbate hypertension symptoms or lead to complications.

Question 3

Clinical effectiveness of traction appears to be best when performed&#10;A) Alone, without other interventions&#10;B) Combined with heat and massage&#10;C) Combined with manual therapy and exercise&#10;D) Combined with ultrasound and epidural injections

Accepted Answer

Combining traction with manual therapy and exercise has been found to be the most effective approach for clinical effectiveness. This combination can improve pain, function, and quality of life in patients with musculoskeletal conditions such as low back pain. Heat and massage may provide some additional benefits, but they are not as essential as manual therapy and exercise. Ultrasound and epidural injections are not typically used in conjunction with traction therapy.

Question 4

How can the friction provided by the patient's superincumbent body weight be significantly reduced during lumbar traction?&#10;A) Unlock the table so segments can be separated.&#10;B) Place the legs on a stool in the 90/90 position.&#10;C) Increase the force of the traction to greater than body weight.&#10;D) Place the patient in prone position with a pillow under the pelvis.

Accepted Answer

Unlocking the table allows for the segments to be separated, which reduces the friction provided by the patient's superincumbent body weight. This increases the effectiveness of lumbar traction.

Question 5

Which of the following is correct with regard to cervical traction?&#10;A) Approximately 30 to 45 pounds of traction force is required to achieve vertebral separation in the cervical spine.&#10;B) Patients always have better outcomes when the traction force is as high as they can tolerate.&#10;C) Cervical traction applied with the patient sitting requires more force to achieve the desired effect than when applied with the patient supine.&#10;D) A person with a history of temporomandibular joint problems should not have any form of cervical traction.

Accepted Answer

Cervical traction applied with the patient sitting requires more force due to the effects of gravity and muscle tension compared to when the patient is supine.

Question 6

How much traction force is required to overcome friction of the lower body when doing lumbar traction?&#10;A) One-half to three-quarters of body weight&#10;B) Approximately 20 pounds&#10;C) Up to approximately one-half of body weight&#10;D) Greater than 150 pounds

Accepted Answer

The amount of traction force required to overcome friction of the lower body during lumbar traction varies based on several factors, such as the weight of the patient and the position of the traction unit. Generally, it is recommended to use up to approximately one-half of the patient's body weight as the amount of traction force. This ensures that the traction is effective but not excessive, which could cause discomfort or injury. Option A is too broad of a range and does not give a specific answer, option B is too low and may not provide enough traction force, and option D is too high and could be dangerous.

Question 7

Which of the following is an indication for traction?&#10;A) Distraction of facet joints to relieve pain from degenerative joint disease&#10;B) Stretching of cervical spine ligaments to relieve pain from acute grade two ligament sprain&#10;C) Increasing bone density of the cervical vertebral bodies for a patient with osteoporosis&#10;D) Alleviation of bilateral upper extremity paresthesias secondary to cervical spinal cord compression

Accepted Answer

Traction can help relieve pain from degenerative joint disease by distracting facet joints, which can reduce pressure and alleviate symptoms.

Question 8

Which of the following is true regarding lumbar spine decompression units?&#10;A) Research has demonstrated that these units are more effective than standard traction tables.&#10;B) There is lack of evidence in the literature to validate the effectiveness of these units.&#10;C) These units are effective in relieving back pain but not radiculopathy.&#10;D) Space-age technology is applied to reduce bulging and herniated discs effectively.

Accepted Answer

There is currently a lack of evidence in the literature to support the effectiveness of lumbar spine decompression units. While some studies have shown promising results, overall the evidence is limited and further research is needed to fully understand the potential benefits of these devices.

Question 9

Which of the following is the most important parameter to consider when the goal of traction is separation of lumbar vertebral bodies?&#10;A) Using heat before and during traction&#10;B) Selecting an appropriate force&#10;C) Using the supine position with the legs supported on a small stool&#10;D) Using an intermittent setting

Accepted Answer

Selecting an appropriate force is the most important parameter to consider when the goal of traction is separation of lumbar vertebral bodies. Adequate force is needed to create separation between the vertebral bodies and relieve pressure on the spinal nerve roots. Using heat before and during traction may provide additional comfort but does not contribute to separation. The use of the supine position with the legs supported on a small stool and an intermittent setting may also be helpful, but the force setting is the most critical parameter.

Question 10

Which of the following lists contains only contraindications or precautions for traction?&#10;A) Spinal instability, uncontrolled hypertension, claustrophobia&#10;B) Infection, osteoarthritis, hiatal hernia&#10;C) Rheumatoid arthritis, facet joint capsulitis, upper extremity radiculopathy&#10;D) Spine cancer, hiatal hernia, herniated nucleus pulposus

Accepted Answer

Spinal instability, uncontrolled hypertension, and claustrophobia are all conditions that can be contraindications or precautions for traction therapy. Spinal instability and uncontrolled hypertension pose risks of worsening the condition or causing harm, while claustrophobia can make the experience intolerable for the patient.

Question 11

What is the evidence of the effect of lumbar traction on intradiscal pressures?&#10;A) Intradiscal pressures increase during traction then gradually decrease after traction.&#10;B) Intradiscal pressures decrease during traction then rapidly return to normal after traction.&#10;C) There is no effect on intradiscal pressure during or after traction.&#10;D) The effect on intradiscal pressure during traction is unpredictable.

Accepted Answer

The answer of What is the evidence of the effect...

Question 12

What is the evidence on the effect of cervical traction on intervertebral foramina dimensions?&#10;A) Decrease during traction application&#10;B) Correction of intervertebral foraminal impingement&#10;C) Increase during traction application&#10;D) No effect on foramina dimensions

Accepted Answer

The answer of What is the evidence on the effect...

Question 13

Mechanical traction is unlikely to be effective in achieving which of the following?&#10;A) Separation of vertebral bodies&#10;B) Distraction of vertebral facet joints&#10;C) Stretching of soft tissues of the spine&#10;D) Permanent reduction of herniated nucleus pulposus

Accepted Answer

The answer of Mechanical traction is unlikely to be effective...

Question 14

A recently published clinical prediction rule for cervical traction includes which of the following?&#10;A) Positive shoulder abduction test&#10;B) Age of 50 years or younger&#10;C) Negative upper limb tension test&#10;D) Increased symptoms with manual distraction

Accepted Answer

The answer of A recently published clinical prediction rule for...

Question 15

The most commonly used parameters for cervical traction are which of the following?&#10;A) Neutral cervical spine, intermittent, up to 50 pounds&#10;B) Cervical flexion of 15 to 35 degrees, constant, no more than weight of the head (about 10 to 15 pounds)&#10;C) Extension of the upper cervical spine, intermittent, 15 to 30 pounds&#10;D) Cervical flexion, intermittent, 10 to 25 pounds

Accepted Answer

The answer of The most commonly used parameters for cervical...

Deck 7: Spinal Traction