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Palpatory and Ultrasound Assessment of Cervical Dysfunctions and the Effect of Cervical High-Velocity, Low-Amplitude (HVLA) Technique

Journal: The AAO Journal Date: 2017/12, 27(3):, type of study: clinical trial

Free full text   (https://meridian.allenpress.com/aaoj/)

Keywords:

cervical dysfunction [2]
cervical spine [210]
high velocity low amplitude [39]
osteopathic manipulative treatment [2973]
OMT [2951]
ultrasound [28]
palpation [170]
clinical trial [612]

Abstract:

Background Ultrasound is commonly used to assess musculoskeletal abnorhmalities. 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 ultra-sound in measuring the improvement of rotational symmetry of lumbar somatic dysfunction (SD) after the use of HVLA.ObjectivesThe purpose of this study was to evaluate the use of ultrasonogra-phy 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. MethodTwo 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 per-formed at the level of the segment with the key SD after HVLA reassessment or CVH completion. Palpatory and Ultrasound Assessment of Cervical Dysfunctions and the Effect of Cervical High-Velocity, Low-Amplitude (HVLA) Technique. 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)


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