HVLA: High Velocity Low Amplitude Technique

40 Q&A flashcards covering HVLA concepts from lecture notes.

What does HVLA stand for?

High Velocity Low Amplitude technique.

What is the basic force profile of HVLA?

A rapid, brief force traveling a short distance within the joint's range of motion.

HVLA engages which barrier to elicit release?

The restrictive barrier.

What audible/palpable event is often associated with HVLA?

A release or 'pop' due to cavitation.

HVLA is classified as which type of osteopathic technique?

An articulatory technique (ART).

During HVLA, is the patient active or passive, and who performs the work?

The patient is passive; the physician performs the thrust.

Into which barrier is the thrust directed in HVLA?

Into the restrictive barrier.

What two barriers are described in HVLA practice?

Physiologic barrier and anatomic barrier.

What is the proposed mechanism of action for HVLA?

A sudden stretch/change in joint afferent activity leading to neural changes and reduced muscle hypertonicity.

Which neural components are implicated in HVLA's mechanism?

Type Ia afferents and brain somatosensory integration (N20 and N30).

How might HVLA help chronic pain according to the mechanism?

By normalizing somatosensory integration and helping the brain 'unlearn' dysfunctional pain patterns.

List some reported outcomes after HVLA.

Increased joint mobility, reduced muscle spasms, increased ROM, decreased pain, improved strength, and improved autonomic balance.

What theory explains the HVLA 'pop' as cavitation?

Tribonucleation: rapid separation causes a phase change from liquid to gas.

What does the HVLA 'pop' typically represent?

Cavitation of the joint.

What are the primary indications for HVLA?

Articular somatic dysfunction and joint motion restriction with a firm articular barrier.

Name an HVLA application that targets tissue adhesions.

Disruption of connective tissue adhesions.

HVLA can treat chronic dysfunction that is resistant to what?

Other treatment modalities.

True or false: HVLA can modify reflexes.

True.

How can HVLA be used in irreversible situations?

As a maintenance treatment.

How may HVLA help restore alignment?

Restoration of bony alignment.

Name additional effects beyond alignment that HVLA may address.

Addressing meniscoid entrapment; pain modulation; reprogramming of the CNS; reflex relaxation of affected muscles.

List three conditions with strong EBm support for HVLA.

Low back pain; neck pain; epicondylalgia.

List some conditions with smaller EBm support for HVLA.

Temporomandibular joint disorders; shoulder pain; headaches.

What are absolute contraindications to HVLA?

• Upper cervical instability

• Rheumatoid arthritis

• Down syndrome

• Achondroplasia/Chiari malformation

• Fracture/dislocation/spinal or joint instability

• Inflammatory joint disease joint infection,bony malignancy

• Patient refusal.

Which chromosomal condition is an absolute contraindication?

Down syndrome.

What condition related to blood flow is a contraindication?

Vertebrobasilar insufficiency.

Which cervical condition involves fusion and is listed as a contraindication?

Klippel-Feil syndrome.

Name a spinal inflammatory disease that contraindicates HVLA.

Inflammatory joint disease.

What is a contraindication related to infection?

Joint infection.

What is the absolute contraindication involving cancer?

Bony malignancy.

Why is patient refusal listed among contraindications?

Because informed consent is required; refusal means HVLA should not be performed.

Which conditions are associated with atlantoaxial instability risk?

Achondroplasia; Down syndrome; Morquio syndrome; Neurofibromatosis; Osteogenesis imperfecta; Rheumatoid arthritis.

Which ligament is often lax in atlantoaxial instability?

Transverse ligament.

Name a relative precaution affecting the cervical region.

Acute herniated nucleus pulposus.

Name another relative precaution: acute radiculopathy.

Acute radiculopathy.

Name another relative precaution: acute whiplash/severe muscle spasm/strain.

Acute whiplash or severe muscle spasm/strain.

Name a bone-condition precaution: osteoporosis/osteopenia.

Osteopenia or osteoporosis.

Name a condition involving vertebral movement as a precaution.

Spondylolisthesis.