High-Velocity, Low-Amplitude Management of Posterior Rib Somatic Dysfunction

Abstract Background Ultrasound is commonly used to assess musculoskeletal abnormalities. High-velocity, low-amplitude (HVLA) is an osteopathic manipulative treatment technique commonly used by osteopathic physicians. The Shaw et al study has shown the reliability of ultrasound in measuring the improvement of rotational symmetry of lumbar somatic dysfunction (SD) after the use of HVLA. Objectives The purpose of this study was to evaluate the use of ultrasonography as a reference tool to quantitatively assess the rotational symmetry of cervical SD after the use of HVLA. Design The study was separated into 2 phases: 1) cervical diagnosis and pretreatment imaging and 2) HVLA or cranial vault hold (CVH) and post-treatment imaging. Method Two physicians independently diagnosed each participant (N = 51) with an SD between levels C2–C7; the key SD (the segment with the most posteriorly rotated articular pillar (AP)) was chosen. Ultrasound imaging was performed immediately after diagnosis. Next, the participants were randomly distributed into a treatment group, in which the participants were treated with HVLA, and a control group, in which a CVH was performed on the participant. Members of the HVLA group were then reassessed to confirm the key SD had resolved. Ultrasound imaging was immediately performed at the level of the segment with the key SD after HVLA reassessment or CVH completion. Results Physician reassessment confirmed SD resolution in 25 of 25 HVLA participants and 0 of 26 control participants. There was no significant change in ultrasound-measured AP rotation for the HVLA group (M=.05680 cm, P=.179) or control group (M=.02384 cm, P=.160). Conclusions Despite a palpatory resolution of the cervical SD, ultrasound was not able to determine a statistically significant change in AP rotation in either the HVLA or the control group.

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Effect of high velocity–low amplitude treatment on superoxide dismutase and glutathione peroxidase activities in erythrocytes from men with neck pain

Clinical Chiropractic ◽

10.1016/j.clch.2011.09.027 ◽

2011 ◽

Vol 14 (4) ◽

pp. 162-163

Author(s):

Carolina Kolberg ◽

Andréa Horst ◽

Maira Moraes ◽

Angela Kolberg ◽

Wania Aparecida Partata

Keyword(s):

Superoxide Dismutase ◽

Glutathione Peroxidase ◽

Neck Pain ◽

High Velocity ◽

Low Amplitude

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EFFECTIVENESS OF LUMBAR MANIPULATION (HIGH VELOCITY LOW AMPLITUDE) FOR THE TREATMENT OF LOW BACK PAIN IN COMPARISON TO BACK STRETCHING EXERCISES

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.1.1/004 ◽

2012 ◽

Vol 1 (1) ◽

pp. 23-27

Author(s):

Syed Abid Mehdi Kazmi ◽

Nabiha Mujahid Faruq ◽

Sumaira Imran Farooqui ◽

Jharna Devi

Keyword(s):

Low Back Pain ◽

Back Pain ◽

High Velocity ◽

Low Back ◽

Before And After ◽

History Of ◽

Group A ◽

Group B ◽

Low Amplitude ◽

Stretching Exercises

OBJECTIVES To assess the effectiveness of lumbar manipulation (high velocity low amplitude) for the treatment of low back pain in comparison to back stretching exercises. Randomized Control Trial (Experimental Study) The study was conducted on 200 patients at the Physiotherapy Department of Ziauddin Hospital among patients with history of low back pain of acute, sub acute or chronic origin. In this study, patients were divided into two groups, group A and group B equally. Group A of 100 patients received Lumbar Manipulation (High Velocity Low Amplitude) and at the same time Group B of 100 patients were treated by back stretching exercises. A pre tested and structured questionnaire was used to collect data. Data was entered and analyzed by using SPSS. Pain was measured on Visual Analogue Scale before and after the given treatment. The study showed significant results for both the interventions in the treatment of low back pain but Lumbar Manipulation has been more effective in different types of low back pain while stretching exercises are less effective. On the basis of this study, we are very confident that lumbar manipulation is more effective for the treatment of low back pain compared to back stretching

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The temporal effects of a single session of high-velocity, low-amplitude thrust manipulation on subjects with spinal pain

Physical Therapy Reviews ◽

10.1179/174328810x12647087218712 ◽

2010 ◽

Vol 15 (1) ◽

pp. 29-35 ◽

Cited By ~ 11

Author(s):

Rogelio A. Coronado ◽

Joel E. Bialosky ◽

Chad E. Cook

Keyword(s):

High Velocity ◽

Spinal Pain ◽

Single Session ◽

Temporal Effects ◽

Low Amplitude

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Differences in force-time parameters and electromyographic characteristics of two high-velocity, low-amplitude spinal manipulations following one another in quick succession

Chiropractic & Manual Therapies ◽

10.1186/s12998-020-00355-0 ◽

2020 ◽

Vol 28 (1) ◽

Author(s):

Lindsay M. Gorrell ◽

Philip J. Conway ◽

Walter Herzog

Keyword(s):

High Velocity ◽

Spinal Manipulative Therapy ◽

Peak Force ◽

Manipulative Therapy ◽

Force Application ◽

Thoracic Spinal ◽

Time Parameters ◽

Force Time ◽

Upper Thoracic ◽

Low Amplitude

Abstract Background Spinal manipulative therapy is an effective treatment for neck pain. However, the mechanisms underlying its clinical efficacy are not fully understood. Previous studies have not systematically compared force-time parameters and electromyographic responses associated with spinal manipulation. In this study, force-time parameters and electromyographic characteristics associated with multiple manual high-velocity, low-amplitude cervical and upper thoracic spinal manipulations were investigated. The purpose of this analysis was to compare the force-time parameters and electromyographic characteristics between two spinal manipulations delivered following one another in quick succession if the first thrust was not associated with an audible cavitation. Methods Nine asymptomatic and eighteen symptomatic participants received six Diversified-style spinal manipulations to the cervical and upper thoracic spines during data collected February 2018 to September 2019. Peak force, rate of force application and thrust duration were measured using a pressure pad. Bipolar surface electrodes were used to measure the electromyographic responses and reflex delay times in sixteen neck, back and limb outlet muscles bilaterally. Differences in force-time parameters and electromyographic data were analyzed between the first and second thrust. Results Fifty-two spinal manipulations were included in this analysis. Peak force was greater (p < 0.001) and rate of force application faster (p < 0.001) in the second thrust. Furthermore, peak electromyographic responses were higher following the second thrust in asymptomatic (p < 0.001) and symptomatic (p < 0.001) subjects. Also, electromyographic delays were shorter in the symptomatic compared to the asymptomatic participants for the second thrust (p = 0.039). There were no adverse patient events. Conclusion When a second manipulation was delivered because there was not audible cavitation during the first thrust, the second thrust was associated with greater treatment forces and faster thrust rates. Peak electromyographic responses were greater following the second thrust.

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