UNIT_2_ DIAGNOSTICS- UNIT II BIOMECHANICAL THERAPEUTIC EQUIPMENT

BIOMECHANICAL
THERAPEUTIC EQUIPMENT

1. UNIT II BIOMECHANICAL
THERAPEUTIC EQUIPMENT

2. Electrodiagnosis, Therapeutic radiation,
Electrotherapy, Electrodes, Stimulators for Nerve
and Muscle, Functional Electrical Stimulation.
peripheral nerve stimulator, ultrasonic
Stimulators, Stimulators for pain and relief -
Inferential Therapy Unit, TENS. GAIT Assessment
and Therapy. Continuous Passive Motion unit,
Cervical / Lumber Traction Machine -Traction
Table

3. 1.Electrodiagnosis
•When normal muscle cells are stimulated with adequate
current they contract.
•Dysfunctionalityof the tissues alterations will occur in
response to the electrical stimulus.
•variation in the current may be either high or low when its
diseased. This is used in the determination of degenerative or
regenerative process of nerves or muscle tissues.
•The current intensity and time of the duration of application
of the current gives an idea of the condition of the muscle or
nerve tissue.

4. Intensity-Time Curve (i-t Curves)
i-t curves based on the intensity of the stimulus and its duration

5. •i-t Curves gives a good picture of the
degeneration and regeneration process of neuro-
muscular units,
•These curves are determined by applying
rectangular and triangular pulses at progressively
decreasing stimulation durations.
•The i-t curves have characteristic shapes and
deviations from the standard form which lead to
an indication of the state of the tissues
•.

6. •First it is stimulated with a long pulse of duration of 1s
duration and then it is made shorter and shorter until
0.05ms.
•impulse duration is usually varied in stages such as
1000–300–l00–10–3–1–0.05 ms
•At each duration the current intensity is increased until
the muscle tissue responds.
•With degenerated muscle, the curve obtained is shifted
to the right and upwards.
•The intermediate stages of degeneration and
regeneration are characterized by curves lying in
between these two limits

7. •Rheobase: This is the minimum intensity of current
needed to bring the stimulation for a pulse of infinite
duration i.eusually 100ms.
•Chronaxie: The chronaxieis the minimum duration of
impulse that will produce a response with a current of
double the rheobase.
•For example if the rheobaseis 6 mA, the chronaxieis the
duration of the shortest impulse that will produce a
muscle contraction with a current of 12 mA.
•Accommodation: Accommodation is the property of a
neuro-muscular unit to exhibit a lower excitability and a
higher stimulation threshold.

8. Electrodiagnosis-waveforms
1.Galvanic current for qualitative and quantitative
determination of the galvanic excitability
2.Rectangular pulses for checking nervous
conduction
3.Exponentially progressive current for checking
the accommodabilityor degree of degeneration
and for prognosis of degenerated muscles
4.Faradic current for qualitative and quantitative
determination of the faradic excitability

9. 2. Radiotherapy,
•Three modalities are used to treat cancer patient.
•Radiotherapy,
•Chemotherapy
•surgery.
•Radiotherapy is classified into
•External Beam Radiotherapy (EBRT) : In EBRT the
source of radiation is enclosed in the machine head
placed outside the patient body at some distance,
•Brachytherapy (BT): brachytherapy radioactive
source is either inside or in close proximity to the
body.

11. MEDICAL LINEAR ACCELERATOR MACHINE
Linear accelerators are a type of high energy
emitting X ray machine used for radiation therapy
two modes, emits electrons and photons of
energies in few MeV

15. •The Accelerator: The heart of the radiotherapy
linear accelerator machine is the accelerator.
•accelerators have four major components: the
(i)modulator, (ii)electron gun, (iii)RF power
source, and (iv)accelerator guide
•The electron accelerator is a wave guide structure
which is energized at microwave frequency, of
3000 MHz.
•The microwave radiation is supplied in short
pulses, a few micro-seconds long.

16. •These pulses are generated by supplying high voltage
pulses of about 5 kV from the modulator to the
microwave generator, which is most commonly a
magnetron valve (4-6 megavolt beams).
•In higher energy (15-25 megavolt beams) accelerators,
a klystron valve is used as the microwave power
source.
•The electron gun is also pulsed so that high velocity
electrons are injected into the accelerating wave guide
at the same time as it is energized.
•

17. MEDICAL LINEAR ACCELERATOR MACHINE
1.Modulator–The primary function of the modulator circuit
is to supply high voltage pulses to the microwave
generator. The modulator contains a thyratronwhich is a
high power switching device needed to direct the high-
voltage pulses generated by the modulator to the electron
gun and the RF power source
2.RF Power Source( Magnetron/Klystron)–The RF power
source is either a magnetron or a klystron. Klystrons are
generally used in high-energy accelerators and
magnetrons in low-or medium-energy accelerators. The
microwave power from klystron directs the energy to a
waveguide. A water cooling system is needed to provide
thermal stability

18. MEDICAL LINEAR ACCELERATOR MACHINE
•3. Electron Gun –. The electron gun is pulsed by
the modulator and injects pulses of electrons of a
few micro-seconds duration into the accelerator
guide at energies of about 15-40 keV.
•The electron gun can be a diode device with
either direct or indirect heatingof the cathode,
•The electrons are subsequently accelerated in the
accelerator guide to the required energy level.

19. MEDICAL LINEAR ACCELERATOR MACHINE
•4. Wave Guide –Carries microwave power from
magnetron or klystron through the accelerator
structure.
•5.Accelerator Wave Guide: The charged particle
travelling along the axis of a series of conducting
tubes which are connected to an alternating
voltagegets accelerated and acquires energy as it
passes through each gap between the tubes.
•6. Treatment Head–Directs, collimates, shapes,
and monitors the treatment beam

20. RF Power Source( Magnetron/Klystron
•These devices employ a number of RF cavities either in a circle
(magnetron) or in a straight line (klystron).
•An electron beam from a cathode is used to excite RF power in
these cavities.
•The amplified RF power is fed into a wave guide—a special hollow
metallic tube used to transport microwaves, that is connected to
the accelerator.
•The RF power source, also pulsed by the modulator, provides high-
frequency electromagnetic waves (3000 MHz) that accelerate the
electrons injected from the electron gun down the accelerator
guide.
•The electrons injected into the accelerator guide are captured and
bunched by the accelerating electric field at exactly the optimum
phase of the RF wave cycle so that they get accelerated

21. RF Power Source( Magnetron/Klystron
Magnetron Klystron

22. RF Power Source( Magnetron/Klystron
•There's a heated cathode (a solid metal rod) at the centerof the
magnetron. Here it's coloredorange.
•A ring-shaped anode surrounds the cathode (coloredred).
•If you switched on a simple magnetron like this, electrons would
boil off from the cathode and zip across to the anode in straight
lines (shown by the black arrow) much like the electron beam in a
TV set. But there are two added extra bits in a magnetron that
change things completely.
•First, the anode has holes or slots cut into it called cavities or
resonant cavities. Second, a powerful magnet is placed underneath
the anode to generate a magnetic field along the length of the tube
(parallel to the cathode and, in this diagram, going directly into the
computer screen away from you).

23. RF Power Source( Magnetron/Klystron
•Now when the electrons try to zip from cathode to anode, they are
traveling through an electric field (stretching between the anode
and cathode) and a magnetic field (produced by the magnet) at the
same time. So, like any electrically charged particles moving in a
magnetic field, they feel a force and follow a curved path (blue
circle) instead of a straight one, whizzing around the space between
the anode and the cathode.
•As the electrons nip past the cavities, the cavities resonate and emit
microwave radiation. Think of the electrons passing energy to the
cavities, making then resonate like someone blowing on the open
end of a flute—only producing microwaves instead of sound waves.
•The microwave radiation that the cavities produce is collected up
and channeledby a kind of funnel called a waveguide, either into
the cooking compartment of a microwave oven or beamed

24. 3. Electrotherapy,
•Electrotherapy: Process of applying low-volt, low-
frequency impulse currents to the affected parts
of the body, through pads
•These electrical impulses block the impulses
going to the brain and the spinal cord and relieve
the pain.
•improves the blood supply. stimulates the
production of endorphins(natural pain killers)
•is used in treatment of partial or total paralysis,
muscular pain, muscular spasm and disturbance
in peripheral circulation

25. Electrotherapy Equipment

26. Electro-diagnostic Therapeutic
Stimulator-working
•A variable rate multi-vibrator (M1) to set the
basic stimulus frequency.
•This free running multi-vibrator M1 produces
triggering pulses for a monostablecircuit M2.
•The output of this is used as an interrupted
galvanic output, whose rate as well as duration
can be independently controlled.
•M4 another multi vibrator produces faradic
pulses of short duration. The faradic pulses are
modulated at M3 to produce surged faradic
pulses.

27. Electro-diagnostic Therapeutic
Stimulator-working
•The monostableoutput of M2 is given as input
to produce triangular pulse generator.
•The output is a constant current output stage.
•Isolation techniques will be used for safety of
the patient. A floating ground or isolation
transformer will be used at the output stage.
•A selection switch will enable proper input
selection for the particular application

28. Electro-diagnostic Therapeutic current
waveforms
•Galvanic Current: In this procedure a direct current of the
order of 0.3 to 0.5 mA/sq.cm. of the electrode area is made
to flow through the skin.
•The ions are collected underneath the skin where the
electrode is placed.
•this results in a higher blood flow, the area becomes red
and this is Hyperaemia.
•Galvanic current may be used for treatment of atonic
paralysis and for the treatment of disturbance in the blood
flow.
•It is also used for iontophoresis, which means the
introduction of drugs into the body through the skin by
electrolytic means.

29. Electro-diagnostic Therapeutic current
waveforms
•Faradic Current: Faradic current is a sequence of pulses
with a defined shape and current intensity.
•The pulse duration is about 1 minutes with a triangular
waveform and an interval duration of about 20
minutes.
•Faradic current acts upon muscle tissue and upon the
motor nerves to produce muscle contractions.
•There is no ion transfer and consequently, no chemical
effect.
•This may be used for the treatment of muscle
weakness after lengthy immobilization and of disuse
atrophy.

30. Electro-diagnostic Therapeutic current
waveforms
•Surging Current: If the peak current intensity applied to
the patient increases and decreases rhythmically, and
the rate of change of the peak amplitude is slow, the
resulting shape of the current waveform is called a
surging current.
•Faradic surge current is used in the treatment of
functional paralysis.
•The surge rate is usually from 6-60 surges per minute
•The ratio of interval to the duration of the surging is
adjustable -graded exercise may be administered.
•This type of current is usually required for the
treatment of spasm and pain

31. Electro-diagnostic Therapeutic current
waveforms
•Exponentially Progressive Current: useful for the
treatment of severe paralysis.
•possibility of providing selective stimulation
for the treatment of the paralysed muscles.
•the surrounding healthy tissues even in the
immediate neighbourhood of the diseased
muscles are not stimulated.
•The slope of the exponential pulse is kept
variable

32. Electro-diagnostic Therapeutic current
waveforms
•Biphasic stimulation: To hasten the cell recovery ,
immediately after applying the stimulus current an
opposite polarity current of low intensity for
prolonged duration is passed. So that the net quantity
of electricity is zero.
•Such a combination of positive and negative pulses is
called biphasic stimulation.
•This helps in neutralizing the electrodes as well as the
skin surface.
•the stimulating pulse followed by a pulse of opposite
polarity of one-tenth the amplitude and 10 times the
width

33. Electro-diagnostic
Therapeutic current
waveforms

34. 4.Types of Electrodes for Electro-
diagnostic/Therapeutic Applications
•The mono-polar technique :
•Stimulation purpose : small active stimulation electrode.
The indifferent or dispersive electrode is of larger area and
is placed near to the active electrode. This technique is
used for testing of the galvanic and Faradic excitability and
for determining the chronaxie.
•diagnostic purpose: a ball or plate electrode which is
provided with a small thick muslin strip is mounted on a
special handle. The handle carries a finger-tip switch to
facilitate convenient control of output.
•Similarly, a small metal electrode can be secured on the
motorpoint, particularly for therapeutic applications.

35. Bi-polar electrode-significance
•Bi-polar electrode technique :
•For recording i-t curves, this is preferred.
•Both the electrodes are fixed to the body.
•The active electrode have large surface area as we deal with higher
current intensities. small area electrode may cause unpleasant heat
sensations.
•Suitably sized metal sheets are used as electrodes in this system.
•The electrodes are fastened to a moistened pad of about 1 cm.
•Thickness and 1 cm wider than the electrode sheet on all sides.
•The material used for pads is of good absorbancyand ordinary
water can be used to moisten the electrodes.
•The electrodes are held in position by rubber straps.

37. 5.Functional Electrical Stimulation
Functional electrical stimulation involves
artificially inducing a current in specific motor
neurons to generate muscle contractions.
Components of FES
•◦Electrodes
•◦stimulator
•◦controller

39. Electrodes:
1.transcutaneous-placed on the skin surface
2.percutaneous (placed within a muscle),
3.epimysial-placed on the surface of the muscle),
4.Cuff (wrapped around the nerve that innervates the
muscle of interest
•Surface (transcutaneous) electrodes:
•Placed on patient’s skin over target nerves.` Adhesive or
non-adhesive.` Electric signals passed through skin to
stimulate nerves
•Implanted (percutaneous) electrodes: Electrode attached
to nerves or to muscles close to nerves ` Invasive `

40. Stimulator:
•Stimulator
•Implanted stimulator receives signals from controller via
radio waves
•External stimulator can receive radio waves or be directly
connected to the controller via wires
•Controller
•Stationary version-Usually large and bulky-A computer-
Controlled by another person or automated-◦Often used
for short term rehabilitation
•Portable version-Often worn on hip -Convenient for long
term use
•Manual and automated-versions available

41. FES-working
•The neuron receives a series of short electrical
pulses that are delivered using electrodes.
•` Pulses create an electric field near the target
nerve and depolarize it -> action potential
•` Action potentials spread down axon and
stimulate target muscle
•` Tetanization(muscle contraction) requires at
least 20 pulses per second
•The tension produced in electrically stimulated
muscle depends on the intensity and frequency
of stimulation

42. The stimulation intensity is a function of the total charge
transferred to the muscle, which depends on the pulse amplitude,
duration, and frequency as well as the shape of the pulse train
Typical pulse parameters:
Biphasic 20-30 pulses/sec
Duration of primary signal: 100-200 μsec
Current: 25 –35 mA
Amplitudes: 25 –35V

43. Control in FES
•The resulting torque about the joint that is
actuated by the muscle depends on the
tension in the flexor and extensor muscles as
well as factors such as the biomechanics of
the joint.
•, the joint angle or joint torque can be
controlled by modulating the pulse amplitude,
pulse duration, or frequency of stimulation

45. 5.Peripheral nerve stimulation,
•Peripheral nerve stimulation, frequently referred to as PNS,
is a commonly used approach to treat chronic pain.
•It involves surgery that places a small electrical device (a
wire-like electrode) next to one of the peripheral nerves.
•The electrode delivers rapid electrical pulses that are felt
like mild tingles
•Placement of Electrodes:
•The electrodes should be placed over the path of the
peripheral nerve. The negative (black) electrode is the
activating stimulating electrode, The positive electrode
(red) is placed 2cm proximally

48. Patterns of stimulation

49. monitor the effect of the stimulus
•Electromyography uses electrodes to record the
evoked electrical response of the muscle.
•Stimulating electrodes are placed over the nerve and
recording electrodes over the muscle being stimulated.
•Stimulation of the nerve results in depolarisation of
the muscle and the amplitude of the compound muscle
action potential is recorded and expressed as a
percentage of control or as a TOF ratio.
•Typically the ulnar nerve is used and the electrodes
are placed over the muscle of adductor pollicis.
•This is easily accessible but a drawback is that small
movements of the hand may affect the response

50. 6.Ultrasonic Stimulators
•ultrasonic stimulator -device that utilizes ultrasonic
waves for therapeutic purposes.
•Ultrasonic stimulation involves the use of high-
frequency sound waves above the audible range
(above 20 kHz) to generate specific effects in biological
tissues
•Principle of Operation: Ultrasonic transducers convert
electrical energy into mechanical vibrations, which
then produce the ultrasonic waves.
•The waves can be focused on a specific target area or a
broader region, depending on the application.

51. Ultrasonic Stimulators
•Parameters and Control: Ultrasonic
stimulators offer control over various
parameters, including frequency, intensity,
waveform, and treatment duration.
•These parameters can be adjusted based on
the desired therapeutic application .
•Safety features, such as timers and intensity
limits, are often incorporated to prevent
excessive exposure or tissue damage

52. Ultrasonic Stimulators

53. Therapeutic Applications of Ultrasonic
stimulation
•Physical Therapy: Ultrasonic waves are used for deep
tissue heating to promote relaxation, improve blood
circulation, and facilitate the healing of injured
muscles, tendons, or ligaments.
•Pain Management: Low-intensity pulsed ultrasound
(LIPUS) has been employed to alleviate pain associated
with conditions like osteoarthritis and fibromyalgia.
•Bone Healing: Ultrasonic stimulation has shown
potential for accelerating fracture healing by
promoting cell activity and the production of bone
matrix proteins

54. 7.Interferential Current Therapy IFC
•Interferential currents are produced by using two-channel
stimulators and four electrodes.
•The electrodes are used in a quad-polar arrangement and
the AC frequencies are set at slightly different frequencies
but at similar amplitudes.
•interferential circuits uses two different frequencies. one
fixed carrier at 4000 Hz., and another adjustable
frequency between 4001-4400 Hz.
•The currents from the two waveforms interfere with each
other in the tissue, giving constructive pattern (when the
two waveforms add to each other) or destructive pattern
(when the circuits tend to cancel each other) interference

55. Interferential Current Therapy IFC
•These two frequencies are heterodyned to produce the
desired beat frequency.
•The two frequencies produces interference at the point of
intersection of electrodes deep under the tissue.
•The current perfusesto a greater depth and covers larger
volume of tissue than any other electrical therapy.
•Current intensity can be varied and the perfusion depth
can be controlled.
•When current is applied to the skin, the capacitive skin
resistance decreases as pulse frequency increases, this
allows higher interferential current to flow through the
body

57. The two channels at two
different frequencies one
fixed at 4000 Hz and
variable is shown at 4100
Hz.
The two different
frequencies create a net
interference pattern shown
in fig. c This will be the
current intensity in the deep
tissues.
The benefit of this method
is that the interferential
current is generated within
the tissues and this gives the
therapeuticaleffect.

58. 8.TENS (Transcutaneous Electrical
NeuroStimulator )
•pain control theories
•Gate Control Theory :electrically stimulating
sensory nerve receptors, a gate mechanism is
closed in a segment of the spinal cord, preventing
pain-carrying messages from reaching the brain
and blocking the perception of pain
•EndorsphinRelease Theory: electrical impulses
stimulate the production of endorphin and this
block pain messages from reaching the brain

59. TENS (Transcutaneous Electrical Neuro
Stimulator
•Transcutaneous electrical nerve stimulation (tens)
is the application of low frequency current square
wave and the spike wave through surface
electrodes on the patient’s skin to reduce pain.
•A small battery operated machine is generally
used to generate current, which have specific
stimulatory effect
•The effect and use of TENS depends upon gate
control theory and pain modulation

60. TENS (Transcutaneous Electrical Neuro
Stimulator
•Transcutaneous Electrical Nerve Stimulator-
generates the square wave and the spike wave
amplitude (intensity) of stimulation is controlled
by controlling voltage, current and the width
(duration) of each pulse.
•Electrodes are placed at specific sites on the body
for treatment of pain.
•The current travels through the electrodes and
into the skin stimulating specific nerve pathways
to produce a tingling or massaging sensation that
reduces the perception of pain.

61. TENS-stimulation waveforms
•Spike pulse: the stimulator is based around a 500
msspike pulse, having an adjustable amplitude of
0 to 75 mA and an adjustable frequency of 12 to
100 pulses per second.
•Square waveform :, have a pulse frequency
range of 20–200 Hz, pulse width from 0.1 to 1.0
msand pulse amplitude of 0–120 V with
maximum output current as 25 mA.
•The instrument powered by three standard
flashlight batteries of 1.5 V each gives about 100
hours of continuous operation

62. TENS (Transcutaneous Electrical NeuroStimulator )
•Electrodes
•The skin impedance should be constant, this can be
provided by avoiding movements and also providing
maximum surface contact.
•Transcutaneous electrical nerve stimulation (TENS)
electrodes are commonly moulded from an
elastomer such as silicon rubber, loaded with carbon
particles to provide conductance. Conformability is
achieved by making the electrode thin.
•Useful carbon-loaded silicon rubbers have a
minimum resistivity near 10 Ω-cm.

64. Specifications of TENS
•Frequency: conventional TENS, it is 10 to 100 Hz and in
modern TENS it may vary from 2 to 600 Hz.
•Pulse width: The pulse width varies from 50 to
300 microseconds.
•Pulse shape: Pulse shape modified rectangular.
•Output intensity: It varies from 0 to 60 mA
•high frequency and low intensity TENS; frequency is above
50 Hz. used for acute pain
•low frequency and high intensity TENS. frequency is below
50 Hz. It is used for chronic pain
•Applications : Joints pain, Acute pain , Muscle pain, Nerve
disordersetc..

65. 9. GAIT Analysis
•DEFINITION:-
•Gait analysis can range from simply observing
a patient’swalk to using fully computerized
three dimensional motion analysis with
energy measurements
•Gait is the medical term to describe human
locomotion. Every individual has a unique gait
pattern.

66. •Gait cycle
•Describes the complex activity of walking, or
our gait pattern.
•This cycle describes the motions from initial
placement of the supporting heel on the
ground to when the same heel contacts the
ground for a second time.
•Defined as the period of time from one heel
strike to the next heel strike of the same limb.

67. Gait Cycle =
–Single sequence of functions by one limb
–Begins when reference foot contacts the ground
–Ends with subsequent floor contact of the same foot on
the ground
One gait cycle consists of two phases
1) STANCE PHASE (60%)
2) SWING PHASE (40%)

73. Events in Stance Phase:-
•Heel strike phase: Begins with initial contact & ends
with foot flat.Itis beginning of the stance phase when
the heel contacts the ground.
•Foot flat:Itoccurs immediately following heel strike.It
is the point at which the foot fully contacts the floor
•Mid stance: It is the point at which the body passes
directly over the supporting extremity.
•Heel off: The point following mid-stance at which time
the heel of the reference extremity leaves the ground.
•Toe off: The point following heel off when only the toe
of the reference extremity is in contact with the
ground.

74. Events in Swing Phase
•Acceleration phase:
•It begins once the toe leaves the ground & continues
until mid-swing, or the point at which the swinging
extremity is directly under the body.
•Mid-swing:
•It occurs approximately when the extremity passes
directly beneath the body, or from the end of
acceleration to the beginning of deceleration
•Deceleration:
•It occurs after mid-swing when limb is decelerating in
preparation for heel strike.

75. GAIT TERMINOLOGIES
•Temporal Variable
•Stance time
•Single limb & double
limb time
•Swing time
•Stride & Step time
•Cadence
•Walking Speed
•Distance Variable
•Stride length
•Step length
•Step Width
•Degree of toe-out

78. Gait Analysis in the Motion Analysis
Laboratory
•Kinematics: Kinematics measures the dynamic range of
motion of a joint.
•Kinetics: Kinetics describes the forces acting on a
moving body.
•Muscle Activity: measured using EMG
•Energetics: Energetics is the measurement of energy
expenditure..
•One method is to collect and measure the carbon
dioxide and oxygen expired during ambulation
•.Another method is to take the patient’spulse when a
steady state has been achieved while walking

79. 10. Continuous Passive Motion (CPM)
unit
•A Continuous Passive Motion (CPM) unit is a
medical device used in physical therapy and
rehabilitation to facilitate passive movement of a
joint, typically after orthopedicsurgery or injury.
•The CPM machine is designed to provide
controlled and repetitive motion to the joint
without requiring the patient's active
participation.
•This can help prevent joint stiffness, improve
range of motion, reduce pain, and aid in the
healing process.

80. Continuous Passive Motion (CPM) unit
•The CPM unit moves the joint through a
predetermined range of motion in a controlled and
gradual manner. This passive movement helps prevent
the formation of scar tissue, maintain joint lubrication,
and enhance circulation.
•CPM units allow healthcare professionals to customize
the speed, range of motion, and duration of the
movement based on the patient's condition and
surgical procedure.
•They typically include padded supports or braces to
secure the limb and prevent slippage during
movement.

81. Specifications of CPM

82. Continuous Passive Motion (CPM) unit
•CPM therapy promotes early joint mobilization,
which can contribute to a quicker recovery and
reduced risk of complications.
•Post-Surgical Use: CPM units are commonly used
following various orthopedicsurgeries, such as
knee replacement, hip replacement, and
arthroscopy. They are particularly beneficial
during the initial recovery stages when patients
may experience pain and stiffness.

84. (i)fixed frame unit
(ii)asymmetrical frame unit

85. 11.Cervical and lumbar traction
machines
•Cervical and lumbar traction machines are
medical devices used to apply traction to the
spine in order to relieve pressure on the spinal
discs, nerves, and surrounding structures.
•Traction involves the gradual stretching and
decompression of the spine, which can help
alleviate pain, improve mobility, and promote the
healing of certain spinal conditions.
•These machines are commonly used in physical
therapy and rehabilitation setting

86. Goals of Traction
•Separate spinal segments
•Relieve joint dysfunction
•Release pressure on soft tissues (discs,
ligaments)
•Reduce pain
•Relieve nerve compression

87. •Mechanism: Traction machines use a
combination of mechanical components, such as
ropes, pulleys, weights, or pneumatic systems, to
create controlled and gradual stretching forces
along the spine.
•Traction aims to create space between spinal
structures, reduce pressure on nerves, and
potentially promote the retraction of herniated
discs. It can also help improve blood flow, reduce
muscle spasms, and provide pain relief.

88. •Cervical Traction Machine:
•Cervical traction is focused on the neck (cervical
spine) and is often used to treat conditions such
as herniated discs, cervical radiculopathy
(pinched nerve), neck pain, and cervical
osteoarthritis.
•Lumbar Traction Machine:
•Lumbar traction is applied to the lower back
(lumbar spine) and is used to address conditions
such as herniated discs, sciatica, spinal stenosis,
and lower back pain

91. 11(a).Types of Lumbar Traction
•Continuous Traction -Continuous or bed traction uses
low weights for extended periods of time (up to several
hours at a time).
•Sustained Traction -This type of traction involves
heavier weights applied steadily for short periods of
time (for periods from a few minutes up to 1 hr).
Sustained traction is sometimes referred to as static
traction.
•Intermittent Mechanical Traction -Intermittent traction
is similar to sustained traction in intensity and duration
but utilises a mechanical unit to alternately apply and
release the traction force at presetintervals

92. •.
•Autotraction-Autotractionutilises a specially designed table
that is divided into two sections that can be individually tilted
and rotated. The patient provides the traction force by pulling
with the arms and/or pushing with the feet.
•Positional Traction -This form of traction is applied by placing
the patient in various positions using pillows, blocks, or
sandbags to effect a longitudinal pull on the spinal structures.
It usually incorporates lateral bending and is only affected to
one side of the spinal segment
•Gravity lumbar traction -This involves using a chest harness to
secure the patient as the treatment table is tilted to a vertical
position, thereby using the weight of the lower half of the
body to provide a traction force.

93. 11(b)Cervical Traction
•Manual Cervical Traction
•Manual traction is mainly for diagnostic purposes
•The head and neck are held in the hands of the
practitioner, and then gentle traction of a pulling force
is applied.
•Intermittent periods of traction can be applied, holding
each position for about 10 seconds.
•It also allows the performer to apply controlled
pressure on pressure points, which helps alleviate the
patient's pain. Ideally, it is done at a 20-degree angle of
flexion,

94. •Mechanical Cervical Traction
•Mechanical traction includes pinning, with the placement
of a Halo device around the head; where anterior pins are
placed 1 cm above each of the eyebrows, and two posterior
pins are placed on the opposite end of the skull.
•A harness attaches to the head and neck of the patient
while he is laying down on his back.
•Traction is to be applied with a torque pressure of 0.9 kg to
1.8 kg in the pediatricpopulation, and up to 3.6 kg in
adults.
•Mechanical traction requires a 0-degree angle pull for C1
and C2 pathologies, and a 20-degree angle flexion for
below C2 cases.

95. •Over-the-Door Traction
•This is a more practical way of applying cervical
traction, that is more accessible to outpatient
practices.
•Over-the-door traction entails strapping a
harness to the head and neck of the patient that
is in a seated position.
•The harness is connected to a rope in a pulley
system over a door. The force is applied using
weights attached to the other end of the rope.

96. •intermittent traction -repeated sequence of rest and
traction is applied.
•It is believed to increase blood flow to the nerve roots
and spine parenchyma.
•intermittent traction is the method of choice for
degenerative disc disease
•, sustained traction is most often used for neck pain of
muscle or soft tissue
•Cervical traction can be applied while the patient is
supine or seated. The supine position is preferred,
allowing for more posterior pressure loading.

98. 12. Traction Table

99. •Design Principle-Reduce the press burden of
lumbar and cervical vertebra to normal
degree.
•Adaptation diseases: Cervical spondylosis;
Cervical disc herniation ; Cervical muscle
spasm; Lumbar disc herniation;• Lumbar
vertebra functionality side bending.

100. •Function: Two output channels with independent operation
and two patients can be treated at the same time without
interference.
•Continuous traction, main & sub traction and interval
traction.
•The traction force range is 0-99Kg which can be adjusted
during treatment without system closing down.
•Automaticalcompensation: the micro computer will control
the driven motor to compensate the force immediately
when the traction force deviates the presetvalue caused by
patient’s accident motion. Thus, the traction force is
constant which guarantees patient’s safety.
•Adopt steel wire drive system which is durable.

101. •Presetvalue locking function: The set traction
force and traction time can be locked. Thus, the
set value will not be changed since misoperation.
•Automaticalfault detect :•The fault is showed by
different codes and the treatment will be
stopped. Treatment cannot be started again
until the fault is removed.
•Heating function:• The neck and waist can be
heated when traction.• The heating parts of neck
and waist are recognized intelligently.• The
heating temperature can be adjusted accurately.

102. •A traction is a treatment option that is based on the
application of a longitudinal force to the axis of the spinal
column.
•In other words, parts of the spinal column are pulled in
opposite directions to stabilize or change the position of
damaged aspects of the spine.
•The force is usually applied to the skull through a series of
weights and requires that the patient is kept in bed .
•Traction is a manual technique designed to reduce pressure
on affected vertebral discs that are causing pain.
•Traction is a manual ‘stretching’ of the spine which reduces
pressure on the discs and therefore reduces the individual’s
pain.