HVLA

Question 1

HVLA

Answer 1

passive direct technique that uses thrust to mobilize a joint through the restrictive barrier

Involves:
Joint misalignment
mechanoreceptor feedback
muscle spindles
Golgi tendon reflex responses

Question 2

Steps to HVLA

Answer 2

1. correct dx
2. set up - reversing dx, take to restrictive barrier (exception cervical HVLA with side bending emphasis!)
   - localize!
3. pt relaxation - deep breath and exhale to relaxation
4. Thrust - maintain localization until thrust

Question 3

Indications for HVLA

Answer 3

tx of motion loss in SD

Not indicated for joint restriction d/t pathologic changes: contractures, advanced degenerative dz

Question 4

Absolute contraindications of HLVA

Answer 4

osteoporosis
osteomyelitis including Pott's disease
Fractures in area of thrust
Bone metastasis
Severe RA
Downs

Question 5

Relative contraindications of HVLA

Answer 5

acute whiplash
pregnancy
post surgical conditions
Herniated nucleus propulsus
anticoagulation tx or hemophiliacs
vertebral artery ischemia - + Wallenberg test

Question 6

Complications of HVLA

Answer 6

minor: soreness or sx exacerbation

Major:
MC: vertebral artery injury - cervical rotation w/ extended neck

Low back MC: cauda equina syndrome (very rare)