PAM Mechanical Modalities & Traction Therapy 2 — Questions and Answers
Question 1: What patient position is recommended for lumbar traction to reduce lumbar lordosis and paraspinal muscle tension?
- Prone with a pillow under the abdomen
- Supine with hips and knees flexed to 90 degrees (Correct answer)
- Side-lying with legs extended
- Sitting upright in a chair
Correct answer: Supine with hips and knees flexed to 90 degrees
Supine with hips and knees at 90 degrees (hook-lying or 90/90) flattens the lumbar lordosis and reduces paraspinal guarding, optimizing traction effectiveness.
Question 2: The typical maximum recommended force for cervical mechanical traction is:
- 5–10 lbs
- 15–25 lbs (Correct answer)
- 30–40 lbs
- 50–60 lbs
Correct answer: 15–25 lbs
Cervical traction force is typically limited to 15–25 lbs maximum, as the cervical spine's delicate structures are at risk with higher forces.
Question 3: Intermittent traction is preferred over sustained traction when the primary treatment goal is to:
- Achieve maximum vertebral separation
- Reduce acute paraspinal muscle guarding and spasm (Correct answer)
- Treat severe disc herniation
- Maximize reduction of intradiscal pressure
Correct answer: Reduce acute paraspinal muscle guarding and spasm
The cyclic on/off phases of intermittent traction create a pumping effect that reflexively reduces acute muscle guarding more effectively than sustained traction.
Question 4: Intermittent pneumatic compression (IPC) is contraindicated in patients with:
- Post-surgical extremity edema
- Congestive heart failure-related peripheral edema
- Acute deep vein thrombosis (DVT) (Correct answer)
- Chronic venous insufficiency
Correct answer: Acute deep vein thrombosis (DVT)
DVT is a contraindication for IPC because compressive force could dislodge the thrombus, potentially causing a life-threatening pulmonary embolism.
Question 5: A cervical traction halter is designed to transmit traction force primarily through the:
- Cervical spinous processes
- Occiput and mandible/chin (Correct answer)
- Temporal bones bilaterally
- Mastoid processes only
Correct answer: Occiput and mandible/chin
The cervical halter applies traction force through the occiput posteriorly and the mandible/chin anteriorly to distract the cervical vertebral segments.
Question 6: Positional traction achieves vertebral distraction primarily through which principle?
- Mechanical pulleys and calibrated weights
- Manual force applied by the therapist
- Gravity and body weight acting on positioned segments (Correct answer)
- Electrical muscle stimulation inducing distraction
Correct answer: Gravity and body weight acting on positioned segments
Positional traction positions the patient so that gravity and the patient's own body weight naturally create distraction forces on the targeted spinal segments.
Question 7: Which on:off ratio is most commonly used for intermittent cervical or lumbar traction?
- 1:1 (e.g., 30 sec on / 30 sec off) (Correct answer)
- 1:3 (e.g., 15 sec on / 45 sec off)
- 3:1 (e.g., 45 sec on / 15 sec off)
- 1:5 (e.g., 10 sec on / 50 sec off)
Correct answer: 1:1 (e.g., 30 sec on / 30 sec off)
A 1:1 on:off ratio is the most commonly used protocol, providing equal duration for the traction and rest phases, though ratios are adjusted based on patient tolerance.
PAM Mechanical Modalities & Traction Therapy 2
What patient position is recommended for lumbar traction to reduce lumbar lordosis and paraspinal muscle tension?