Spinal High-Velocity Low-Amplitude Thrust - Coursework Example

Spinal High-Velo Low-Amplitude Thrust By Spinal manipulation and mobilization has been used formany years to treat neuromusculokeletal disorders.This is in reference to low back pains that are prevalent in the elderly population. This has led to increased research into the field of high velocity low amplitude thrust.Spinal High velocity low amplitude falls under osteopathic manipulative treatment and the goal of this type of treatment is to ensure restoration in the balance and motion to various areas of the spine that have been injured. With appropriate balance, healing elements and fluids can return to an injured part of the spine and by products of the injury that might be toxic are drained away (Chaitow, 2008).By using the thrust technique, the doctor has to apply high velocity and low amplitude pressure soas to be able to restore the motion of specific joints. This method enables the specific join to regain its usual motion range and resets the neural reflexes. After application of this procedure on patients there is a reduction or total removal of physical signs that symbolize changes in the somatic dysfunction tissue, tenderness, motion restriction and asymmetry. By using the High Velocity- Low Amplitude method a doctor makes use of their hands to try and identify joints whose movements are asymmetrical to the other joints. On location of this point, the doctor engages the barrier to motion in the specific joint and then uses a short but quick thrust so as to overcome the barrier. In most cases, apopping sound will be an indicator that motion has been restored to the particular joint (Souter, 2012). This type of manipulative treatment usually involves a rapid thrust over a certain short distance through a pathologic barrier. It is important to note that the movement of the joint is within its usual motion range and is not more than the anatomic barrier or motion range. When the patient is placed in the correct position by the physician, very little pressure is required and the high velocity- low amplitude can be specifically to the spine’s targeted segments. The main goal of this type of treatment is to restore the movement of the joints or to provide a desirable gap between two surfaces that are articulating. There are many techniques that can be applied in this industry to deal with this kind of problems. The high velocity low technology has a close resemblance and contradicting opinions. There is a major difference between this form of therapy and the practice of chiropracy. In the practice of chiropracy, the chiropractors will strive to manipulate the affected joint so that it will stretch beyond its anatomic range of motion. On the other hand osteopathic doctors will consider the range of motion of the particular joint and they will have to exercise to the joint within this particular limitation of the abnormal pathological curve. The positioning of the patients is important during the application of high velocity low amplitude thrust manipulation on the spinal cord (Bergmann, 2011). There is wide spread criticism from patients who undergo lumbar spine manipulations that it is uncomfortable and this is because of the strain that they feel in their rib cage and spine during this exercise. This therefore means that adequate knowledge must be put in the positioning of the patients to ensure that there is a reduction in the rotation leverage amount and exertion of pressure on the rib cage and the torso. This can be aided by some knowledge of spinal coupling and biomechanics. On the treatment couch, there are two positions that the patient can be placed in and this can either be a flexed posture or a neutral posture (Donnelly, 2000). Once the problem affecting the patient has been identified then the most appropriate position is chosen depending on the comfort in gives to the patient. This method of ensuring comfort to the patient has been proven to reduce the chances of soreness that might occur to the patients after this type of treatment. At some instances, it is not possible to place the patient in a position that is suitable for pre thrust treatment.Therefore the only option left in such a case is the use of the sitting position. There are various principles that will apply such positioning and spinal coupling. It will involve the use of primary rotation movements and a minimal quantity of secondary side bending in the opposite direction in what is referred to as the upslope technique.The application of the thrust technique must be done in such a manner that there are low chances of developing stress after the treatment process and this can be done in the following ways (Rakel, 2012). The neck and the head should be supported appropriately to ensure minimal movement; the direction of the thrust should not be due to rotation but along the joint plane of the apophyseal. The apophyseal joint can be identified by using small trial thrusts and this ensures that the customer is comfortable. There are various theories that have been associated with this form of spinal manipulation and these are discussed below Biomechanical Biomechanics is a branch of science whose focus is on the internal and external forces that act along the biologic Al systems and the effects produced by these forces. In regards to manipulations, this refers to the forces that are exerted by the chiropractors on their patients as they take them through high speed, low amplitude manipulation of their spine and the resultant physiological responses that are produces by such treatments (Maitland, 2001). These external forces have been found to vary greatly due to the clinicians performing the operations and the exact location of the spine that is being treated. Manipulation of the spine produces responses on the reflex at locations that are far from the area that is being treated and causes movements of the vertebral bodies in Para- physiological zones while also being associated with facet joint cavitation (Maizes& Low Dog, 2012). During spinal manipulation of the neck, strains and stresses on the spinal artery were much smaller than those that were produced during diagnostic procedures and motion testing.Research on the biomechanical theory has proven that there is very little evidence that can show that manipulation procedures can cause stress and strains on soft and hard tissues to the patients. It is however critical that care be taken and all HVLA treatments are handled with care to minimize every possible risk. Muscular reflex Manipulations usually involve the muscles and in some cases the muscles are stretched extensively. It is therefore believed that Spinal High-Velocity Low-Amplitude Thrust hasa negative effect on the muscular reflexes if it is conducted over long periods of time.A study was conducted to determine the relationship between muscular reflexes and spinal manipulation procedures (Petty & Petty, 2012). Spinal manipulation has been found to be able to treat back pain. However, the effect of this action on the muscles was not known. As such, a study was conducted and after the manipulation procedures the muscular reflexes were noted. It was found that all forms of manipulation whether there was thrust involved or not led to increases in muscular activity. This shows that the long term use of manipulation procedures can led to inhibitory effects on an individual’s motor system although this is only on a short term basis. Neurophysiological This refers to the nervous system. Spinal manipulation involves a major component of the human body and as such it directly affects the nervous system.Studies have been conducted to show the effects of manipulation on short latency stretch reflex amplitudes and motor evoked potentials of the muscles in the erector spinal of the various patients who has chronic cases of low back pain (Byfield, 2012) There were no changes in the long run but it was established that in cases where there was an audible sound after spinal manipulation these patients recorded a reduction in short latency stretch reflex. This shows that a single manipulation procedure cannot alter the excitability of the stretch reflex, however, it is clearly indicated that the reflex of the stretch muscle is attenuated when manipulation of the spine causes audible sounds on the joints. As such, manipulation may have a negative effect on the gainof the muscle spindles plus other segments on the reflex pathways. Psychological It is believed that spinal manipulation has a psychological effect on the patients. It is therefore important to have in depth understanding of these effects in regards to the various types of manual therapies that are used to treat spinal pain so that in the long term it can help in developing more efficient treatment strategies specifically for this group of patients. In conclusion, there are very many theories that have been brought forward to try and explain Spinal High-Velocity Low-Amplitude Thrust (Triano, 1998). Most of them have been backed by evidence that has been collected after several years of research. It is therefore true that spinal manipulation is one of the ways to treat back pains; however, it has some secondary effects such that the muscles may be over stretched or they might develop neurophysiological effects. This therefore means that this form of treatment should be treated with a lot of care to ensure that it does not have negative effects on the wellbeing of the patients. Bibliography BERGMANN, T. (2011).Chiropractic technique principles and procedures. St. Louis, Mo, Elsevier/Mosby BROTZMAN, S. B., MANSKE, R. C., & DAUGHERTY, K. (2011).Clinical orthopaedic rehabilitation: an evidence-based approach. Philadelphia, PA, Elsevier Mosby. BYFIELD, D. (2012). Technique skills in chiropractic. Edinburgh, Churchill Livingstone/Elsevier CHAITOW, L. (2008). Naturopathic physical medicine: theory and practice for manual therapists and naturopaths. Edinburgh, Churchill Livingstone/Elsevier. Donnelly, J. 2000. Realism and international relations. Cambridge [England: Cambridge University Press. FERNÁNDEZ-DE-LAS-PEÑAS, C., ARENDT-NIELSEN, L., & GERWIN, R. (2010).Tension-type and cervicogenic headache: pathophysiology, diagnosis, and management. Sudbury, Mass, Jones and Bartlett Publishers. MAITLAND, J. (2001). Spinal manipulation made simple: a manual of soft tissue techniques. Berkeley, North Atlantic Books. MAIZES, V., & LOW DOG, T. (2010).Integrative womens health. Oxford, Oxford University Press PETTY, N. J., & PETTY, N. J. (2012).Principles of neuromusculoskeletal treatment and management: a guide for therapists. Edinburgh, Churchill Livingstone Elsevier. RAKEL, D. (2012). Integrative medicine. Philadelphia, PA, Elsevier Saunders. SOUTER, A.(2012). Back pain. Oxford, Oxford University Press. TRIANO, J. J. (1998). Biomechanical analysis of motions and loads during spinal manipulation.Thesis (Ph. D.)--University of Michigan, 1998. Read More