Intro to HVLA Flashcards
When was HVLA first discovered?
2700 bce is earliest Chinese recording
Who wrote a book on joints in which body weight or a wooden lever could be used to impart spinal pressure or thrust?
Hippocrates (460-385 bce)
What did Hippocrates note that his treatment should be followed with?
exercise
What was A.T. Still known as?
lightning bone setter
-typically describing rapid joint repositioning by Central American healers
Who started the Palmer school or Chiropractic and used HVLA within their practice?
Dr. D.D. Palmer
Who were early students of Dr. Still further developed different approaches of thrust techniques?
Dr. Hulett
Dr. Hazzare
Dr. McConnell
What kind of treatment is HVLA?
direct
Definition of HVLA
osteopathic technique employing a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of a joint and that engages the restrictive barrier to elicit release of restriction (thrust technique)
How is the forced described in HVLA?
- not overpowering
- minimum required
- the more precise the localization of positioning, the less force is needed
Define range of motion quantity
determined by the amount of movement available from a neutral position; used to reference maximum distance available for thrusting techniques
Define end feel
quantity and quality of motion of a joint when it is brought passively near and up to physiologic or restrictive barrier or motion
What does firm and distinct normally refer to?
arthrodial dysfunction
What does rubbery usually refer to?
muscle, fascia, reflex
What are the indications for HVLA?
- dysfunction localizes to a joint
- most likely effective when there is a distinctive barrier with a firm or hard end feel
- may be successful when other techniques have either failed or provided only partial release
Steps of neurophysiology of a SD
1) loca segment irritation
2) focal edema and swelling
3) tightening of myofascial and capsular components of the joint
4) reflex hypertonicity of regional muscles (facilitation)
5) TART changes palpable
6) diagnosis of somatic dysfunction
Mechanism of Treatment: Neurophys of HVLA
1) thrust through the restrictive barrier
2) restoration of motion at articulation
3) restoration of normal proprioceptive input
4) reflex relaxation of muscles
5) improvement of TART findings
How does HVLA differ in barrier positioning compared to others?
HVLA localizes firmly against the RB
Most other treatments localize to feather edge of RB
What is the goal of HVLA?
OMT’s goal is restore motion and tissue balance
What are the steps for HVLA?
1) correctly diagnose SD
2) provide some soft tissue preparation
3) Localize forces to a segment or joint; engage the RB in all 3 planes of motion
4) release enhancing maneuver (patient exhalation)
5) accumulation of forces
6) corrective thrus
7) return to neutral
8) reassess for effectiveness and SD persistence
Why is preparation done before HVLA?
- reduces risk of soft tissue injury
- increases patient confidence in physician
Why is relaxation critical for HVLA?
- frees up cortex to receive kinesthetic input from hands and fingers (physician)
- relaxed physician muscles are better prepared for rapid contraction
- patient muscle relaxation prevents tensing that can interfere with correction
- reduces risk of muscle or tendon injury
Where are the forces localized?
facet joints between the two vertebrate
How do forces move?
from top down
How are forces applied?
from the bottom
