Lumbar Rotation Mobilization With Ligamentous Tension Locking High-Velocity Thrust
Di động Xoay Thắt lưng kèm đẩy mạnh
Indications:
To improve unilateral opening of a segment,
To provide symptomatic relief, or
To restore a segment to a neutral position.
Ligamentous tension locking increases the specificity of this procedure.
Technique:
Patient Position:
The patient is in a right side- lying position facing you with both hips and knees flexed. The patient is close enough to you to allow 1/3 of the thighs to be placed over the edge of the table. The patient set-up is as follows:
You place the patient’s knee of the upper leg in contact with your ASIS.
Supporting the patient’s upper leg with your caudal hand, move from left to right while palpating with your cephalad hand for motion to arrive at the lumbar interspinous space of the segment being mobilized.
Once motion is felt to arrive at the desired segment, the patient’s foot of the upper leg is placed behind the knee of the lower leg for stabilization.
Your caudal hand is now moved to the Interspinous Space to monitor motion as your cephalad hand grasps the patient’s lower arm and gently pulls toward the ceiling thus producing rotation down to the desired segment.
Clinician Position & Hand Placement:
You are in a straddle stance position facing the patient.
Your caudal hand is placed at the patient’s posterior buttock and your cephalad hand weaves through the patient’s upper arm in order to allow your cephalad hand to produce a skin lock with the caudal hand as your cephalad hand fingers are placed at the upper side of the spinous process of the superior vertebra of the segment being mobilized and the fingers of your caudal hand block the underside of the spinous process of the inferior vertebra of the segment being mobilized.
An alternate hand contact uses the caudal forearm at the gluteals.
Force Application:
With all hand contacts in place, the patient is rotated toward you to place the trunk in a position that is perpendicular to the table. Slack is taken up until the ligamentous tension lock is engaged.
Force is then applied by either your cephalad arm contact through the patient’s trunk while the caudal arm blocks at the pelvis or vice versa.
The patient takes a deep breath and as they slowly exhale, slack is taken up and a high-velocity low amplitude thrust is delivered at end range.
Alternately, using the gluteal contact, force is delivered superiorly and anteriorly in order to close the involved segment.
Lumbar rotation mobilization with ligamentous tension locking HVT.
