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(27,28) Additionally, scapular manipulation (labeled as a sham) was delivered as a HVLA thrust similar to the "active" treatment described in the upper to mid-thoracic spine.
Sotto questo profilo, non mancano alcune prove preliminari ed eterogenee di effetti indotti dalla manipolazione sul sistema immunitario ed endocrino: da un lato, si registrano una riduzione significativa post-manipolativa della proliferazione di citochine infiammatorie e un aumento di anticorpi (29); dall'altro lato, a HVLA toracica alta, si sono evidenziate variazioni significative di ossitocina e neurotensina nei minuti successivi nonche di concentrazione plasmatica di cortisolo dopo due ore (30); da ultimo, immediatamente dopo manipolazione cervicale praticata su pazienti asintomatici, si verifica un aumento della sostanza P a livello plasmatico del 70,55% oltre che una riduzione del Pressure Pain Threshold su C5 e C6 e sull'epicondilo laterale.
Conversely, he does not use SMT on patients who may have pain caused by nerve impingement, and he rarely uses HVLA to correct problems in the cervical spine--HVLA has been associated with a very low risk of vascular injury, stroke or death when used in the neck.
CVA: Cerebrovascular Accident, CSM: Cervical Spine Manipulation Screening guidelines have been implemented by the physiotherapy profession to help identify and screen for those at risk following a HVLA procedure (Rivett et al 2006).
Data reflects the number of unique patients receiving intervention per region (% receiving the respective intervention) HVLA SM Mobilization Soft Tissue CS 98 (21.2%) 94 (20.6%) 96 (21.1%) TS 121 (26.2%) 114 (25.0%) 118 (25.9%) LS 120 (26.0%) 118 (25.9%) 114 (25.1%) SI 81 (17.5%) 80 (17.5%) 81 (17.8%) Ext 42 (9.1%) 50 (11.0%) 46 (10.1%) Acupuncture Other Modalities CS 16 (33.3%) 44 (16.7%) TS 9 (18.8%) 57 (21.6%) LS 5 (10.4%) 67 (25.4%) SI 4 (8.3%) 62 (23.5%) Ext 14 (29.2%) 34 (12.9%) Legend: HVLA is high-velocity low-amplitude; SM is spinal manipulation; CS is cervical spine; TS is thoracic spine; LS is lumbar spine; SI is sacroiliac region, Ext is extremity.
Chiropractic care using HVLA thrusts to the subluxated segments were made.
(15) Manipulation, commonly referred to as "an adjustment" by chiropractors, is another form of manual therapy which involves a joint positioned at its restrictive barrier and then the practitioner applies a quick, short impulse (HVLA) thrust.
High velocity, low amplitude (HVLA) spinal manipulation was applied to the thoracic spine, with treatment area based upon restricted movements found in the examination.
Ninety percent of the respondents in this survey reported using the "Diversified" chiropractic technique system, an eclectic non-proprietary corpus of high-velocity, low-amplitude (HVLA) manipulative thrusts often accomplished by cavitation (22), and 74.4% of respondents indicated they 'primarily' use Diversified technique for patient care.
This made this study ineligible for review in our study since we limited our assessment to studies that only treated children using spinal manipulative therapy (SMT) [described as high-velocity, low amplitude (HVLA) thrusting procedures].
Inclusion criteria were as follows: subjects were age 18 or less; studies must involve more than two subject; treatments must have been administered by a chiropractor; treatment administered was manual, high-velocity low-amplitude (HVLA) thrusting spinal manipulations, most commonly associated with Diversified technique within the chiropractic profession; papers were written in English; were published between January 1980 and March 2011; prospective or retrospective studies including randomized controlled trials, controlled clinical/quasi-experimental trials, prospective cohort studies or retrospective case series; studies using some type of outcome measure for determining the effect of chiropractic care; published in peer-reviewed journal; and only studies involving human subjects.
Therefore, the primary objective of this paper is to review the use of high-velocity low-amplitude (HVLA) SMT for CR, reflecting on chiropractic treatment practices.
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