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OPP Lect 27

OPP lect 27 HVLA & Articular Techniques

What is a Direct manipulative Technique? Give 4 examples Treatment where the restrictive barrier is engaged and a final activating force is applied to correct somatic dysfunction: 1.DMF. 2.ME. 3.Articulatory. 4.Thrust.
When would you want to use Lumbar HVLA/LVHA? 1.Back pain. 2.Pelvic pain. 3.Scoliosis.
Relative contraindications for Lumbar HVLA/LVHA 1.Acute Sprain or fracture. 2.Cancer/infection. 3.DVT. 4.Vascular instability (on BL thinners, or have a bleeding disorder).
When will you have radiculopathy/Neuropathy? What test would you use to test for it in the lumbar spine? If the neurologic exam is ABNORMAL neurological exam (then get Xray or workup). **Straight Leg Raise.
What is the somatic dysfunction: fullness only at L3 on the R, gets better in flexion. L3 FRSR
Thrust (HVLA) Technique using a rapid force of brief duration that travels a short distance within the anatomic ROM of joint. **it engages the restrictive barrier in one or more planes of motion to elicit release of restriction.
What are some relative contraindications for HVLA/LVHA that you should treat with caution 1.Joint inflammation. 2.Undiagnosed neuropathy. 3.Hypermobility. 4.Osteoarthritis. 5.Osteoporosis. 6.Elderly. 7.Patient guarding.
4 Steps of THRUST 1.Diagnose joint restriction. 2.Move the joint to the direct barrier of all planes (localization). 3.Apply a short quick thrust through the direct barrier. 4.Retest.
With thrusts, what will DECREASE muscle gaurding and prevent injury? Faster thrusts prevent muscle gaurding. Applying them only to a short distance prevents injury.
Lumbar lateral Recumbent HVLA 1.Rotated side down on the table. 2.Flex knee & turn trunk until motion at segment. 3.Hold shoulder and rotate pelvis until motion at segment. 4.Short quick rotational thrust at end of exhalation.
What type of back pain is manipulation effective on? 1.Acute. 2.Subacute. 3.Chronic.
What creates the "Pop" sound in Thrust? ARTICULATORY RELEASE: joint immobility creates a partial vacuum containing CO2 and gas within the joint fluid. When the joint is seperated the vapor cavity collapses. **doesn't indicate effectiveness, rather its the return of ROM**
Is repeated joint popping degenerative? NO, can get an overuse soarness from TOO much popping.
Articulatory Technique (LVHA) Low velocity/moderate to high amplitude where the joint is carried through its full ROM. **Activating force is a repetitive springing motion OR repetitive concentric movement of joint through restrictive barrier.
5 steps of LVHA 1.Diagnose restricted joint motion. 2.Slow movement of joint into position of laxity. 3.Slow movement of joint into its restriction for all planes. 4.3-5 repetitions as one smooth movement. 5.Retest motion. **Dont forget to do more than 1 time.
Supine Lumbar Articulatory **this is a combined thrust so you only do it once instead of 3-5 times. 1.Stand on side away from rotation. 2.Hold affected side ASIS. 3.Slowly lift patient into flexion & rotation. 4.Repeat for other side.
Describe the mechanisms of action for HVLA/LVHA 1.Restoration of joint mobility. 2.Reduced muscle tension (immediate muscle relaxation in neurological myotome). 3.Reduced nocioception (local & distal reduction of pain).
What is the main difference b/w ME, HVLA, LVHA? Method of ACTIVATION: 1.ME: Isometric contraction. 2.HVLA: short/quick thrust. 3.LVHA: Long/slow movement 3-5 times.
Created by: WeeG