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OPP Lect 27
OPP lect 27 HVLA & Articular Techniques
Question | Answer |
---|---|
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. |