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OS II (Spring 2020) > Intro to HVLA > Flashcards

Intro to HVLA Flashcards

1
Q

When was the first documented HVLA treatment?

A

2700 bce (earliest Chinese recordings)

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2
Q

What physician, besides AT Still, promoted HVLA?

A

Dr. Palmer (opened Palmer School of Chiropractic Medicine in 1892)

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3
Q

Who furthered HVLA techniques?

A

Dr. Hulett
Dr. Hazzare
Dr. McConnell

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4
Q

What is the definition of HVLA?

A

thrusting technique

employs a rapid, therapeutic force of brief duration that travels a short distance w/ in anatomic range of a joint & engages the restrictive barrier to elicit release

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5
Q

What force do you use in HVLA?

A

minimum amount of force required for release of 1 localized segment

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6
Q

What is most important in HVLA?

A

more precise localization of positioning, less force is needed

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7
Q

When can tears during muscle stretching occur?

A

before anatomic barrier is met

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8
Q

Quantity in ROM

A

determined by amount of movement available from neutral position

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9
Q

What do you look for in HVLA?

A

end feel in ROM that is firm & distinct

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10
Q

What does rubbery end feel indicate?

A

typically from muscle, fascia, or reflex

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11
Q

What is HVLA?

A

a joint release technique

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12
Q

Indications for HVLA

A

dysfunction localized to a joint

distinctive barrier w/ firm or hard end feel

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13
Q

Mechanism of treatment w/ HVLA

A

thrust thru restrictive barrier

restoration of motion @ articulation

restoration of normal proprioceptive input

reflex relaxation of muscles

improve TART findings

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14
Q

What is the barrier positioning in HLVA?

A

localize firmly against restrictive barrier

moves thru restrictive barrier into elastic barrier to restore motion

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15
Q

Is noise in HVLA necessary for success?

A

NO!

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16
Q

What is the goal of OMT?

A

restore or augment tissue function

17
Q

Steps for HVLA

A

diagnose SD

provide soft tissue prep

localize force to segment or joint

release enhancing maneuver

accumulation of forces

corrective thrust

return to neutral

reassess

18
Q

What is the purpose of soft tissue preparation?

A

reduces risk of soft tissue injury

increases pt confidence in physician

19
Q

Why should physician be relaxed during HVLA?

A

free up cortex to receive kinesthetic input from hands & fingers (can think about what you are feeling more)

relaxed muscles better for rapid contraction

20
Q

Why should pt be relaxed during HVLA?

A

muscle relax prevents tensing that can interfere w/ correction

reduces risk of muscle or tendon injury

21
Q

What is localization of HVLA?

A

engagement & stacking of barriers

22
Q

Where can you treat in all 3 planes of motion?

A

the spine

23
Q

Where is the HVLA force localized on vertebrae?

A

forces localized to facet joints between 2 vertebrae (L3 SD on L4)

24
Q

What occurs during accumulation of forces?

A

move firmly against barrier on pt exhalation

25
Q

When should you not continue to thrust?

A

if localization to barrier in 1 of the planes is lost

26
Q

What is the direction of your thrust?

A

towards the culmination of all planes of motion

27
Q

What are the general rules regarding OMT dosage?

A

more acute or sick, less the dose

older pts respond more slowly

usually do not thrust the same segment more than once a week

decrease treatment as pt improvement duration increases

28
Q

Benefits of HVLA

A

time efficient

well tolerated

pt usually experiences immediate relief, decreased pain & increased ROM

29
Q

Indications for HVLA

A

SD
articular SD
joint motion restriction

30
Q

When is HVLA super helpful?

A

adhesive capsulitis

chronic dysfunction

modify reflexes

hypomobile joints

restore alignment

reduce meniscus entrapment

pain modulation

31
Q

What is significant about OMT safety & efficacy?

A

OMT is one of safest procedures in medicine

32
Q

How to minimize injury w/ HVLA?

A

take thorough history
careful PE
use minimal amt of force

33
Q

What is a major precaution for cervical spine?

A

avoid hyperextension & excessive rotation

34
Q

“Absolute” contraindications for HVLA

A 
local cancer
ligament disruption
RA
Down Syndrome
Osteomyelitis
Spinal cord Dx
35
Q

What is the most important absolute contraindication for OMT/HVLA?

A

pt refusal

36
Q

What are relative contraindications for HVLA?

A 
acute herniated nucleus pulposus
acute radiculopathy
acute injury
osteoporosis
spondylolisthesis
metabolic bone disease
hypermobile syndromes
37
Q

What are some precautions for HVLA?

A

apprehension by pt

mild to moderate strain or sprain in area being treated

38
Q

When would you avoid compression?

A

mild osteopenia or osteoporosis

OS II (Spring 2020) (6 decks)

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