HVLA - Upper Thoracic (T1-T4) Spinal Manipulation - Supine, Anterior-Posterior Flexion Technique скачать в хорошем качестве

HVLA - Upper Thoracic (T1-T4) Spinal Manipulation - Supine, Anterior-Posterior Flexion Technique

Upper Thoracic Extension T1-3 Setup Contact Point 1. Transverse processes of the target segment 2. Patient’s Elbows Applicator 1. Palm of the operator's right hand, held in a clenched position 2. Operator's lower sternum or upper abdomen Patient Position Supine with arms crossed over the chest Operator Stance To the right side of the patient, facing the plinth Palpation of Contact Point Palpate the spinous process of target segment with the tip of your index or middle finger; contact the contralateral transverse process with the thenar eminence and ipsilateral transverse process with the intermediate phalanges Fixation of Contact Points Positioning for thrust Take hold of the patient's left shoulder, and pull it towards you. Place the clenched palm of your right hand against the transverse processes of the segment. Roll the patient back to the supine position while pulling down with right arm to induce extension. Introduce side bending to the left until a sense of tension is palpable at the contact point. Apply firm pressure with your lower sternum or upper abdomen downwards towards the plinth. Maintaining this downwards leverage, introduce a force towards the patient's head in line with the patient's upper arms Levers Primary: Posterior to anterior Secondary: Extension as the patient is rotated over Tertiary: Slight side bending toward and/or rotation (optional) Additional: compression and exhalation of patient Adjustments for Pre-load and Thrust Immediately Pre-thrust Relax and adjust your balance Delivering the thrust The direction of thrust is downwards towards the couch and in a cephalad direction via your lower sternum or upper abdomen. Simultaneously, apply a thrust with your right hand against the transverse processes in an upwards and caudad direction. The hand contacting the transverse processes of T6 must actively participate in the generation of thrust forces Technique Modifications - Different shoulder girdle holds can be used Different applicators can be used Respiration can be used to make the technique more effective