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Aparato para Tração Cervical - Maitland, Notas de estudo de Fisioterapia

Australian Journal of Phisiotherapy v2i1

Tipologia: Notas de estudo

2010

Compartilhado em 03/05/2010

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20 Ter AUSTRALIAN JOURNAL OF PHYSIOTHERAPY PHYSIOTHERAPY APPARATUS. By G. D. MAytLAND, Adelaide. It is not my intention at this stage to present an article on treatment, or on the results of treatment, by continuous neck traction, but merely to describe two pieces of equipment which I have modified and have used in private practice. 1 have found them to be very useful by improvmg the efhciency of the work and, as they are teadily adjustable and completely transport- able, they have enabled me to keep down the costs of treatment. A Modification of the Glisson Sling One appliance is a modification oi the ordinary Glisson sling. Although in prin- ciple it is the best one, the Glisson type of sling has two main disadvantages. It does not allow for the variations found in the oceiput-chin relationship without some loss of stability; and the supporting straps are frec to slide in the loops. As a result, the head can slip into a position of excessive extension if it is not kept straight by the muscular effort of the patient. This mus- cular effort is undesirable, for we want good relaxation. In Figure 1 the standard Glisson sling is shown on the left and the modified one is on the right. We know very well that heads vary in size and in shape. More particularly, they vaty both in the horizontal and in the ver- tical distances between the chin and the occipital prottberance, These measure- ments can vary to such a degree that what would give a good head position for one person in the shng could result in too much extension for another unless the height of the chin and kead-straps can be raised or lowered and also be brought closer together or separated further apart, In the original sling the former adjustment can only be made by sliding the straps in the loops As is shown in the illustration, it is pos- sible to get the desired effect in a far more stable way. When a short spreading bar is inserted into each side-strap of the Glisson sling, thus linking adjacent ends of the chin and occipital supports, we have four fixed points, one at each end of each of the side spreading bars, to which we can aftach the four adjustable straps and rings. By this means we obtain a completely adjustable head-piece and eliminate the unwanted sliding in the loops. I have found this to be the most successful way to get con- tinuous traction, Figure 1 An Adjustable Q-Clamp with a Shiding Hook An adjustable Q-clamp with a shding hook is another piece of equipment which I have found to be extremely useful. All the essential measurements are indicated in the diagram (Figure 2). The clamp is made of quarter-inch gutter iron and it is strong ARTEROPLASTY OF YHE Hip Joint 21 enough to stand any weight likely to be used by physiotherapists for neck or lumbar traction. Às it is mobile, 1t can be used im any cubicle and not only in special cubicles easy pop bm] Figure 2 with permanent fixtures; it can be clamped on the top of a partrtion or even on the door of a room in a private house. Some patients find it difficult to relax sufficiently for neck traction in a silting position. I have given some of these patients continuous traction in the lying position, with the body and head supported, by fixing the Q-clamp to the end of the conch and using it as is shown in Figure 3. The Q-clamp can also be used for several other purposes Two Q-clamps, one on esch 1 | end of the couch, can be used as fixed points for lumbar traction, the pressure being applied by means of pulleys and rope, With a Q-clamp fixed on top of a partition and a single pulley containing a rope in the silding hook, we have a means of exercising a shoulder either with weights or with two arms, With a Q-clamp fixed to the par- tition top and a pulley fixed to the floor Figure 3 below, we can set up a wall-bar-weights system for exercising muscles such as the quadrceps. This Q-clamp which I have described has really proved to be a welcome addition to my equipment.