National Physical Therapy Examination (NPTE) Practice Exam

Which condition is a contraindication for mechanical traction of the cervical spine?

1. Muscle spasm

2. Rheumatoid arthritis

3. Hypomobility of the spine

4. Decreased upper extremity sensation

The correct answer is: Rheumatoid arthritis

Rheumatoid arthritis is indeed a contraindication for mechanical traction of the cervical spine due to the unstable nature of the cervical spine that can occur with this condition. Rheumatoid arthritis can lead to joint erosion, instability, and potential atlantoaxial subluxation, particularly in the upper cervical spine. When mechanical traction is applied, the already compromised structures may be further aggravated, leading to increased risk of injury or exacerbation of the condition. In contrast, other conditions listed, such as muscle spasm, hypomobility, and decreased upper extremity sensation, do not universally preclude the use of traction. Muscle spasms may actually respond positively to traction as it can relieve pressure on nerves and reduce muscle tension. Hypomobility can be addressed with traction to help restore motion and decrease pain. Decreased upper extremity sensation indicates a possible neurological issue but does not inherently make traction unsafe if appropriately monitored and applied by a skilled practitioner.