Hayes HVLA DSA/Lab (for written exam)

Question 1

HVLA is a _____ and _____ technique.

It is a _____ mobilization with _____ technique.

Answer 1

• HVLA is a Passive and Direct technique.
• It is a specific, localized mobilization with impulse technique.

Question 2

HVLA definition

Answer 2

HVLA definition:

• an osteopathic technique employing a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of motion of a joint
• and that engages the restrictive barrier in one or more planes of motion to elicit release of restriction.

Question 3

You _____ (do/do not) have to hear a “pop” or articulatory sound

to have done the technique correctly.

Answer 3

• You do not have to hear a “pop” or articulatory sound to have done the technique correctly.

Question 4

When doing HVLA you are at the _____ level.

Answer 4

When doing HVLA

• you are at the articular level.
  
  • Restoration of restricted articular motion.
  • Release of entrapped synovial folds
  • Disruption of peri-articular or articular micro adhesions
  • Resetting of aberrant nociceptive and/or mechano-receptor activity
  • Vacuum theory/cavitation

Question 5

Indications of HVLA

Answer 5

Indications of HVLA

• Acute, subacute, and chronic biomechanical somatic dysfunctions of articular origin
  
  • not related to fractures, visceral or inflammatory disease.

Question 6

Relative Contraindications of HVLA

Answer 6

Relative Contraindications of HVLA

• Mild-to-moderate strain or sprain in the area to be treated
• Mild osteopenia or osteoporosis in the area that will be receiving compression, torsion, or another such force from the positioning and/or thrust
• Osteoarthritic joints with moderate motion loss
• Rheumatoid disease (other than in the spine)
• Minimal disc bulge and/or herniation with radicular symptoms
• Atypical joint or facet and other conditions with associated congenital anomalies
• Some hypermobile states

Question 7

Absolute Contraindications of HVLA

Answer 7

Absolute Contraindications of HVLA

• Joint instability
• Severe osteoporosis
• Metastasis in the area that will be receiving compression, torsion, or other such force from the positioning and/or thrust
• Osteoarthritic joint with ankylosis
• Severe discogenic spondylosis with ankylosis
• Osteomyelitis in the area that will be receiving compression, torsion, or other such force from the positioning and/or thrust
• Infection of the tissues in the area that will be receiving compression from the positioning and/or thrust
• Joint replacement in the area that will be receiving compression, torsion, or other such force and/or thrust
• Severe herniated disc** with **radiculopathy
• Congenital anomalies such as Klippel-Feil syndrome, blocked vertebra, Chiari malformation
• Conditions such as Down syndrome (especially cervical spine)
• Rheumatoid arthritis of the cervical (especially at C1-C2) region
• Achondroplastic dwarfism (cervical spine)
• Vertebrobasilar insufficiency

Question 8

HVLA Technique Treatment Sequence

Answer 8

HVLA Technique Treatment Sequence

• Diagnose the somatic dysfunction correctly
• Localize the segment to be treated.
• Control the area so the patient is comfortable and relaxed.
• Position to the restrictive barrier
• Use distracting maneuvers if necessary
  
  • e.g., patient’s breathing, isometric contraction, jaw clenching, and then relaxing.
• When the patient is relaxed and not guarded
  
  • add a rapid acceleration (mobilizing force) thrust within the articulatory plane(s) of the joint
    
    • with total joint movement kept to the absolute minimum.
• Reassess the somatic dysfunction