The amelioration of atlanto-axial rotation asymmetry using high velocity low amplitude manipulation: is the direction of thrust important?
Source: Journal of Osteopathic Medicine 4(1):8-14.
Abstract: Background: High velocity low amplitude (HVLA) manipulation has been proposed as a potential treatment of range of motion disorders. Objective: The paper aims to examine the effectiveness of the HVLA manipulation in various directions on passive atlanto-axial (AA) asymmetry. Methods: Forty individuals with 8% or more unilateral passive AA asymmetry with mean age of 28 years participated in the study, each as part of one of three groups. In the first group (n=14), a single HVLA manipulation was given in the direction of the restricted range. The second group (n=14) was given a single manipulation in a direction opposite to the restricted range. The third group (n=12) was given bilateral manipulation. A successful HVLA manipulation was defined as being accompanied by audible cavitations; however this did not occur in four study participants. Passive measures of end-ranges were performed pre and post manipulation. Results: The HVLA manipulation produced a statistically significant and immediate improvement of AA rotation asymmetry for all the three groups. Conclusion: HVLA manipulation of the atlanto-axial articulation produces a significant immediate amelioration of passive atlanto-axial rotation asymmetry, irrespective of the direction in which the manipulation is applied. (CIRRIE Abstract)
Institution: Osteopathic Medicine, School of Health Sciences, Victoria University, PO Box 14428 MCMC, Melbourne 8001, Australia.