Introduction: ME and HVLA Flashcards Preview

OS II Exam #1 > Introduction: ME and HVLA > Flashcards

Flashcards in Introduction: ME and HVLA Deck (17):
1

muscle energy basics

direct technique
active technique
using pt. mm energy as activating force
dr counteracts pts force
isometric = no movement in active phase
mm remain the same length
achieve relaxation after contraction of mm

2

muscle energy

direct technique
active technique

3

goals of mm energy

Mobilize restricted joints and tissues
Stretch tight muscles and fascia
Decrease hypertonicity
Lengthen fibers
Improve local circulation
Balance neuromuscular relationships
Strengthen weaker side of asymmetry
Make Patient feel better

4

advantages of mm energy

“Safer” than HVLA
gentle technique
Geriatirc pt
Osteoporosis or risks
other conditions which may not allow the use of thrust techniques

5

contraindications of mm energy

Open wounds
Broken bones
Uncooperative patients
Unresponsive patients
Severe pain in muscle group utilized

6

indications of mm energy

Somatic Dysfunction
Use alone or to prepare patient for HVLA or other modality
after ME, may find HVLA not needed
Segmental or regional somatic dys
Useful in torticollis
also good for chronic pain conditions, tight hamstrings, tension HA…..

7

techniques of mm energy

diagnos
engage restrictive barrier and pt. provides a force against it
dr provides equal counterforce to achieve isometric contraction
hold for 3-5 seconds
pt and dr relaxes together
engage new barrier
repeat until no further restrictions
reassess

8

golgi tendon reflex

afferent neuron (1b) carry information to spinal cord
synapse w/ inhibitory interneurons
synapse with alpha motor neuron in anterior gray horn
send inhibitory message to mm to cause reflex relaxation of mm

9

post isometric relaxation

neuromuscular bundle is in a refractory state immediately after contraction, allowing passive
stretching to occur without reflex opposition
muscle contraction stretches Golgi tendon organ ultimately causing reflex relaxation

10

HVLA basics

This is a direct technique
Passive technique
Moving the joint in the direction of the restrictive barrier
Applying a precise thrust
Immediate restoration in range of motion
Consider relaxing surrounding soft tissues first

11

HVLA basics

This is a direct technique
Passive technique
Moving the joint in the direction of the restrictive barrier
Applying a precise thrust
Immediate restoration in range of motion
Consider relaxing surrounding soft tissues first

12

indications for HVLA

Primary = Somatic Dysfunction
Must understand somatic dysfunction and barrier concepts
Secondary benefits – restoration of motion, removal of restrictions…
Improve motion and biomechanical function
Pain reduction
Decrease inappropriate somato-visceral reflexes

13

thrust force

applied after the setup is locked against the restrictive barrier
short quick thrust
DO NOT back off the barrier just before the thrust
DO NOT carry the thrust over a great distance
DO NOT be over tentative and apply a low velocity force

14

neruophysiology of HVLA

asymmetric tension in tissues around a joint leads to pressure and thus asymmetric afferent inputs
thrusting gaps the joint causing a sudden stretch
sudden stretch activates the golgi tendon organ

15

HVLA precautions/contraindications

risk-benefit ration
neurological complications
joints can be sprained
osseous or ligamentous damage
pathologic fractures
psychological contraindications

16

guidelines of safety for HVLA

be aware of possible complications
accurate diagnosis
listen w/ hands and fingers
if barrier does not feel right don't thrust
emphasize specificity w. engagement of barrier
ask permission to treat
if response does not meet expectations re-evaluate
SD is the indication not pain
be aware that SD can co-exist w/ other conditions

17

HVLA technique

Diagnosis
Localize segment
Position to restrictive barrier
Release-enhancing maneuver (Patient breathing)
Mobilizing force – thrust
Reassess - TART