PAMANTASAN NG LUNGSOD NG MAYNILA

TRACTION
COLLEGE OF PHYSICAL THERAPY
 1. Biomechanical and Physiological Effects

2. Indications, Contraindications, and

TOPIC Precautions
TRACTION

3. Components

OUTLINE
KEY POINTS
4. Application Techniques

5. Parameters

6. Adverse Effects

7. Documentation
BIOMECHANICAL &

PHYSIOLOGICAL EFFECTS
TRACTION
 Mechanical force applied

to the body in a way that

separates the joint

surfaces and elongates

TRACTION surrounding soft tissues.

Can be applied manually

by the clinician or

mechanically by a

machine.
CERVICAL SPINE
There is evidence that intervertebral foramina dimensions increase

during traction application.

Limited evidence suggests that disc herniation extension tends to

be reduced when measured immediately after traction.

Evidence is conflicting as to the effects of traction on the activity of

cervical spine musculature.

The duration of any observed biomechanical or physiological effect

is not known.
LUMBAR SPINE
During passive traction, intradiscal pressures can reduce or become

negative.
The expanse of herniated disc material is suggested to reduce in

some subjects during traction. Most single-observation studies

suggest the effect is temporary. A cumulative effect with repeated

traction sessions may occur.

Nucleus pulposus - soft center

Annulus fibrosus - tough, fibrous

 JOINT DISTRACTION
REDUCTION OF DISC

PROTRUSION
EFFECTS OF
SOFT TISSUE

TRACTION STRETCHING

MUSCLE RELAXATION

JOINT MOBILIZATION
CLINICAL INDICATIONS,

CONTRAINDICATIONS, &

PRECAUTIONS
TRACTION
 Disc bulge or

herniation
Nerve root

impingement

INDICATIONS Joint Hypomobility

Subacute Joint

Inflammation
Paraspinal Muscle

Spasm
Disc Herniation

Forward slippage

of vertebrae

Disc Degeneration
 Disc bulge or

herniation
Nerve root

impingement

INDICATIONS Joint Hypomobility

Subacute Joint

Inflammation
Paraspinal Muscle

Spasm
 Where motion is

contraindicated
Acute injury or

inflammation

CONTRA Joint hypermobility

or instability

INDICATIONS Peripheralization of

symptoms with

traction
Uncontrolled
hypertension
 Structural diseases or conditions
affecting the spine
When pressure of the belts may

be hazardous
Displaced annular fragment
Medial disc protrusion

PRECAUTIONS When severe pain fully resolves

with traction
Claustrophobia or other

psychological aversion to

traction
Inability to tolerate the prone or

supine position
Disorientation
 Structural diseases or conditions
affecting the spine
When pressure of the belts may

be hazardous
Displaced annular fragment
Medial disc protrusion

PRECAUTIONS When severe pain fully resolves

with traction
Claustrophobia or other

psychological aversion to

traction
Inability to tolerate the prone or

supine position
Disorientation
 FOR USE OF CERVICAL

TRACTION

PRECAUTIONS Temporomandibular

joint (TMJ) problems

Dentures
COMPONENTS OF TRACTION

TABLE
TRACTION
TRACTION TABLE
TRACTION TABLE
TRACTION CONTROL PANEL
CERVICAL HARNESS
LUMBAR BELT/HALTER
PATIENT-CONTROLLED SAFETY SWITCH
APPLICATION TECHNIQUES
TRACTION
MECHANICAL TRACTION
Lumbar or cervical
Continuous (static) or intermittent

ADVANTAGES DISADVANTAGES

• Force and time well controlled, readily

• Expensive electrical mechanical devices
graded, and replicable. • Time-consuming to set up
• Does not require the clinician to be with
• Lack of patient control or participation
the patient throughout treatment. • Restriction by belts or halter poorly

• Allow the application of static or

tolerated by some patients
intermittent traction. • Mobilizes broad regions of the spine rather

• Static weighted devices, such as over-the-

than individual spinal segments, potentially

door cervical traction, are inexpensive and

inducing hypermobility in normal or

convenient for independent use. hypermobile joints

ELECTRICAL

MECHANICAL

TRACTION UNITS
OVER-THE-DOOR

CERVICAL

TRACTION
DEVICES
OTHER HOME

TRACTION
DEVICES
MECHANICAL LUMBAR TRACTION
Indications:
Static - for inflammation, symptoms aggravated by motion,

and symptoms caused by a disc protrusion.

Intermittent - for symptoms caused by a disc protrusion or

joint dysfunction.
MECHANICAL LUMBAR TRACTION
MECHANICAL LUMBAR TRACTION
Spinal position: (90-90 position)
Vertebral separation between L5-S1: 45°-60° of hip flexion
Vertebral separation between L4-L5: 60°-75° of hip flexion
Vertebral separation between L3-L4: 75°-90° of hip flexion
MECHANICAL CERVICAL TRACTION
MECHANICAL CERVICAL TRACTION
Spinal position: (20°-30° of flexion)
Vertebral separation between C1-C5: 0°-5° of flexion
Vertebral separation between C5-C7: 25°-30° of flexion
For disc dysfunction: 0°
For spinal stenosis: 15°
SELF-TRACTION
Form of traction that uses gravity and the weight of the

patient’s body, or force exerted by the patient, to exert a

distractive force on the spine.

Appropriate for home use by the patient whose symptoms

are relieved by low loads of mechanical traction, or that are

associated with mild to moderate compression of spinal

structures.
POSITIONAL TRACTION
Involves prolonged placement of the patient in a position

that places tension on only one side of the lumbar spine.

May be used to treat unilateral symptoms originating from

the lumbar spine.

MANUAL TRACTION
Application of force by the therapist in the direction of

distracting the joints.

Can be used for the cervical and lumbar spine, as well as for

the peripheral joints.

 Prior symptoms may be

increased by the

application of lumbar

ADVERSE
traction exceeding 50% of

the patient’s total BW, or

EFFECTS by the application of

cervical traction exceeding

50% of the weight of the

patient’s head.
DOCUMENTATION
When applying traction,

• Total treatment time

document the following:
• Response to treatment
• Type of traction
• With intermittent traction, also

• Area of the body where traction

document the following:

is applied
- Hold time
• Patient position
- Relax time
• Type of halter if one is used
- Force during the relax time
• Maximum force
THANK YOU!