Welcome back. Now we'll talk about the cervical traction unit. This
unit is the same unit and you have this attachment here and we'll
kind of talk about how that goes on and off because there's a little bit of a
trick of getting it locked in there and setting your patient up. This is what
I was talking about, this has the occipital halter so that it takes the
pressure off of the jaw which is really great so you don't get any of those
issues that we used to get with the old halter style one. Usually we put a
little towel in here just for hygienic sake and also in here. You want to
just tighten this up till it's just a little bit snug. The angle here you'll be
able to it'll be able to show you where you're at. So again the more flexion
you're in the farther down the cervical spine, the more neutral this is the more
the upper cervical spine you're going to target . Here's the parameters for both.
This also is in Cameron and we'll have this in the lab as well for you to kind
of help you to start to solidify what parameters you use for what type of
goals. In that initial acute phase which we talked about is after about day
three with the lumbar spine ,so realize this is the lumbar spine that we're
talking about it's about somewhere between 29 and 44 pounds. It's static
and it's total treatment time is five to ten minutes. You also need to realize
that when we're talking about this if you have a very tiny person you're going to
adjust this weight but this is for the average weighted person.If you want
joint distraction ,so those would be those apophyseal joints that we talked
about, you need about fifty percent of their body weight. This
one you're going to do that on/off, it is going to be about the same time period.
So it is going to be about 15 seconds on and 15 seconds off and the treatment time is
anywhere from twenty to thirty minutes. We generally start out with five to ten
minutes and depending on the patient's response to that we can increase that to
somewhere between twenty and thirty minutes. I don't usually do more than 20
minutes in the clinic, but you can talk to Dr. Smith and Professor Eckert to
see if they do 30-minute treatments and why they would do that.
We can also use traction to decrease muscle spasms. With that we're not going
to have quite the same force. Remember we're going to just be trying to
thinking about that gentle stretching motion so this is going to be that 25%
of the body weight. This is more of five seconds on five seconds off. So this is
kind of more that oscillation like we get when we're trying to facilitate the
mechanoreceptors with those grade 1 & 2 joint mobilizations we do with the
peripheral joints. Again this is 20 to 30 minute treatment. For disc
problems or soft tissue stretch again the force is going to be the same as
with muscle spasms ,less than the joint distraction. It's about
25% of their body weight, but with this one you want a longer hold time .
We're wanting to hold that for 60 seconds and then you're going to relax for
20 seconds. You're going to hold for 60 seconds and you are going to relax for 20
seconds to get the effect on the disk or the soft tissue. Again that's 20 to
30 minutes. With cervical traction obviously those are smaller joints
you're not going to need as much force and so you want to start again we want to make
sure we ruled out that there's no vertebral artery or alar ligament
instability before we put somebody on cervical traction. That initial phase
they're going to be static again for five to ten minute trial and that's
somewhere between 7 & 9 pounds and again I believe you to look at the size of
your patient if you have somebody who is fairly petite you're going to want to be a
little bit more conservative with them. With joint distraction it's 7 percent of
their body weight so that can vary a little bit between person to person.
Again the parameters are going to be the same when you're doing joint distraction
for the lumbar spine it has to be 50 percent of your body weight but for the
cervical it's 7 percent of your body weight. They're still going to be a 15 /15
hold/ relax time for both of them and the treatment time is exactly the same.
For decreased muscle spasm again the hold /relax time is the same but here
you're doing 11 to 15 pounds and because the head averages around 10 pounds
I think so you're just doing a little bit more than that in
order to just get a little bit of relaxation and you're doing more that
oscillation five-on-five off. With the disc problems or soft tissue again it's
that long hold of 60 seconds on / 20 seconds off and the weight is the same(11-15 lbs).
We're feeling that is about the right amount for a person.
You're just wanting a little bit more than what the head may weigh. The
guidelines, so here they are, we're just reiterating the force is 25% of the
patient's body weight increases the length of the lumbar spine right. So then
when we look back. Those are the ones where you get the decreased muscle
spasm or the disc problems or soft tissue. When we're doing the 50% that's when
you're getting that joint distraction of the apophyseal joints. With the cervical
spine it's 7% of the patient's body weight to distract the cervical vertebra
and then again it's about 11 to 15 pounds to get that increase in length of
the cervical spine.
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