Lumbar HVLA Lecture and LAB Flashcards
Oldest HVLA
2700 BCE in Chinese recordings
Indications for HVLA
Greatest regional dysfunction is at the joint.
Uncommonly, HVLA is used for fascial restrictions.
More likely effective when there is a distinctive barrier with a firm or hard end feel.
HVLA positioning into what part of the barrier?
Firmly against the Restrictive barrier
Source of noise?
Conversion of nitrogen in joint fluid from liquid to gas by negative pressure
Words we don’t use to describe OMT
Subluxed (Generally) “Out of place (?)” “Out of joint” Dislocated Slipped disc Adjust Put back into place (?)
Steps for HVLA
Correctly Diagnose SD Provide some soft tissue preparation MET, MFR, Kneading, etc. Localize forces to a segment or joint Engage the RB in all 3 planes of motion = “stacking.” Release enhancing maneuver Patient exhalation is typical Accumulation of forces Corrective thrust Return to neutral Reassess for effectiveness and SD persistence
Why do MER or ST before HVLA?
Reduces risk of soft tissue injury
Increases patient confidence in physician
Engagement of barrier from top down?
“Through the dysfunction”
e.g. T12 Tx includes upper body movement including T12
Engagement of barrier from bottom up?
up “To the dysfunction”
E.g. T12 Tx includes movement only up to and at L1
Each level of the unit is used as an opposing counterforce (T12 on L1)
What is a corrective thrust?
The direction of force is typically towards the culmination of all vectors used for localization.
Is popping the goal of HVLA?
NO
How often should HVLA be done?
Older patients respond more slowly.
Most cases, discourage thrusting the same segment more than once a week
Decrease treatment as patient improvement duration increases.
What kind of barrier indicates HVLA should be done?
Modality of choice for SDs with distinct firm barrier.
Indications of HVLA?
Somatic dysfunction.
Articular somatic dysfunction.
Joint motion restriction with a firm articular barrier.
Benefits of HVLA?
Greater reflex relaxation of associated muscles.
