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Flashcards in Intro to HVLA Deck (27):
1

muscle energy defined

form of OMT where patients muscles are actively used on request

2

what did AT still say about ME

need to restore muscle and ligaments before joint

3

who held a 5 day tutorial in 1970 described as ME

Fred Mitchell Sr.

4

muscle energy is what kind of technique

direct and active

5

benefits of ME

mobilize restricted joints and tissues
stretch tight muscles and fascia
decrease hypertonicity
lengthen fibers
improve circulation
balance neuromuscular relationships
strengthen weaker side of asymmetry
make patient feel better

6

advantage of ME over HVLA

gentle technique, safer, geriatric pt, osteoporosis or risks

7

contradictions of ME

open wounds
broken bones
uncoop patients
unresponsive patients
severe pain in muscle group utilized

8

indications of ME

somatic dysfunction
segmental or regional somatic dys
good for chronic pain, tight hamstrings etc
useful in torticollis

9

where is patient providing force

away from restriction/barrier

10

post isometric relaxation

neuromuscular bundle in refractory state immediately after contraction
aollows passive stretching to occur without reflex opposition

11

reciprocal inhibition

to lengthen shortened muscle
gentle contraction in agonist muscle and relex relaxation of antagonist

12

barrier is 3D, which planes

sagittal, transverse, and coronal
also translator motions: forward, and back
right and left, compression and distraction

13

ME technique specifics order

1) make diagnosis
2) position body part in restrictive barrier
3) patient provides force away from barrier, dr. provides counterforce (isometric contraction)
4) hold 3-5 seconds
5) pt and doctor relax
6) dr. engages new barrier
7) repeat until no new barrier, full ROM, or 3-5 X
8) reassess

14

when is Golgi tendon stretched

whenever muscles contract

15

purpose of Golgi tendon reflex

to prevent tissue disruption
responds to rapid change in length/tension

16

Osteopathic technique employing rapid, therapeutic force of brief duration that travels short distance within the anatomic ROM of a joint and engages restrictive barrier is

thrust technique

17

HVLA technique

direct
passive
move joint in direction of restrictive barrier
immediate restoration in ROM

18

historical perspective HVLA

1970s taught,
AT still: lightning bone setter

19

indications for HVLA

somatic dysfunction
restoration of motion, removal of restrictions

20

verterbral segment

vertebra above and below and disc in between the two

21

accumulation of force at restriction

one force applied to one vertebra other has opposing conterforce to resist inertia of body mass

22

thrust force

applied after the setup is locked against restrictive barrier
-if localization not accurately against restrictive barrier, thrust force will dissipate thrgouh other parts of body = increased risk for iatrogenic side effects

short quick thrust, not too forceful

23

when do you thrust? inhalation or exhalation

end of exhalation

24

neurophysiology of HVLA

sudden stretch activates Golgi to strongly inhibit muscle activity until they equalize
normalize imbalanced afferent input

25

HVLA precaustions/contraindications

-risk-benefit ratio
-neurological complications: vertebral/basilar artery, dens fracture, or dislocation, RA or DS, disc disruption
-joints can be sprained: consider hypermobile joints
-osseous or ligamentous damage
-pathologic fractures: osteoporosis, metastatic disease, arthritic spurs
-psychological contraindications: patient apprehension, patient does not want HVLA

26

JAOA article by Dr. Vick

evaluated injuries from manipulation was 1 and 1 million for all practitioners

27

position paper on OMT of cervical spine, AOA house of delegates

2005, speaks on overwhelming safety of cervical manipulation