Chapter 16 HVLA Basics Flashcards Preview

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Flashcards in Chapter 16 HVLA Basics Deck (11):

What type of technique is HVLA?

Passive direct


Theories of the neurophysiology of HVLA?

1) Forcefully stretching a contracted muscle sends a barrage of afferents to CNS, causes reflex inhibitory signals to the spindles
2) Forcefully stretching contracted muscle activates the golgi tendon and reflexively relaxes muscle


When is the final force applied?

Relaxation/exhalation phase


What is the main indication of HVLA?

Motion loss in somatic dysfunction


What are the absolute contraindications?

1) Osteoporosis
2) Osteomyelitis (including Pott's)
3) Fractures in area of thrust
4) Bone mets
5) Severe RA
6) Down's


Why are RA pts at risk?

RA weakens the transverse ligament of the dens, so cervical manipulation may cause AA subluxation


Why are Down's pts at risk?

Laxity in transverse ligament of dens may results in AA subluxation with cervical manipulation


What are the relative contraindications?

1) Acute whiplash
2) Pregnancy
3) Post-op conditions
4) Herniated nucleus pulposus
5) Pt's on anticoagulaion or hemophiliacs
6) Vertebral artery ischemia (positive Wallenberg's test)


What is the most common MINOR complication?

Soreness or symptom exacerbation


What is the most common MAJOR complication overall?

Vertebral artery injury--usually due to cervical rotatory forces with neck in extended position


What is the most common MAJOR complication in the low back?

Cauda equina syndrome (very rare)