Intro to HVLA Lecture

Question 1

Review the first few slides on the history if you want, idk if they will test on it

Answer 1

slides 2-5

Question 2

HVLA is an Osteopathic technique employing a _____, therapeutic force of brief duration that travels a ______ ______ within the anatomic range of a joint and that engages the restrictive barrier to elicit release of restriction

Answer 2

rapid

short distance

Question 3

Describe the force that is involved in HVLA

Answer 3

Not extreme or overpowering

minimum amount of force that is required to release one localized segment

more precise of the localization, the less force is needed

Question 4

Describe a type 1 neutral positioning of the spine

Answer 4

Thoracic and lumbar motion of rotation and sidebending happen in opposite directions.

Question 5

Describe a type 2 extended or flexed positioning of the spine

Answer 5

Motion of rotation and sidebending happen in matching directions.

Question 6

What are the indications for HVLA?

Answer 6

Dysfunction that localizes to a joint

distinctive barrier with a hard end feel

Question 7

What is the mechanism of treatment for HVLA and what specifically does it treat

Answer 7

HVLA treats the tightening of myofascial and capsular components of the joint

1. Thrust through the restrictive barrier
2. restore the motion at articulation
   3restore proprioceptive input
3. reflexive relaxation of the muscles
4. improvement of TART

Question 8

What are possible reasons for the “noise” that is heard with HVLA

Answer 8

1. Conversion of nitrogen from liquid to gas
2. eventuation of gas in the synovial fluid with the breaking of surface tension
3. snapping or releasing of ligamentous adhesions
4. ballooning of the capsule

Question 9

OMT’s goal is to restore _____ and ______ balance

Answer 9

motion and tissue

Question 10

How do you localize the forces to a segment or a joint?

Answer 10

Engage the RB in all 3 planes of motion

“stacking”

Question 11

Review the ‘how to” slides on HVLA, making flashcards for these is silly

Answer 11

K thanks bye

Question 12

If localization is lost during an HVLA treatment, what should you do?

Answer 12

Reassess and restack

Question 13

The _______ of force is typically towards the culmination of all vectors used for localization.

Answer 13

direction

Question 14

What are the basic steps in performing an HVLA treatment?

Answer 14

1. Correctly Diagnose SD
2. Tissue preparation (ST, MFR, ME).
3. Localize forces to the segment in all 3 planes.
4. Release enhancing maneuver?
5. Accumulate force at the barrier
6. Mobilizing force-corrective thrust
7. Return to neutral
8. Reassess for effectiveness and SD persistence

Question 15

In regards to OMT, what is important to consider with treating the elderly?

Answer 15

they respond more slowly, so they need more “recovery” time and fewer total treatments

Question 16

Most cases, discourage thrusting the same segment more than _____ ___ _______ because the tissue need time to recover and frequent treatment can lead to hyper mobility

Answer 16

once a week

Question 17

List some possible alternatives to consider suggesting if the same SD continues to occur

Answer 17

posture

leg length

scoliosis

strength imbalances

scar tissue

joint instability

etc

Question 18

What are the benefits of HVLA>

Answer 18

Time efficient

well tolerated

immediate relief with increased ROM

Question 19

What are the indications for HVLA?

Answer 19

• Somatic dysfunction.
• Articular somatic dysfunction.
• Joint motion restriction with a firm articular barrier.
– When regional dysfunction is judged to be a joint motion restriction, not a primarily soft tissue restriction.

Question 20

What is important to consider with HVLA treatment?

Answer 20

THOROUGH HX!

cervical spine: avoid hyperextension and excessive rotation

Question 21

What are two of the biggest absolute contraindications of HVLA due to alar ligament instability?

Answer 21

Rheumatoid arthritis and down syndrome

Question 22

Review all of the indications, contraindications in case they decide to get tricky on the exam

Answer 22

you can do this