The effect of HVLA manipulation on static and dynamic postural parameters – a case study of a patient with a blocked atlanto-occipital transition

Abstract

Objective. The study aimed to assess the effects of high velocity low amplitude (HVLA) manipulations on force distribution, pressures, and balance in individuals with atlanto-occipital blockage, focusing on post-treatment improvements. Research methods. Diagnostic tests (cervical spine compression, Spurling, de Kleyn) and pedobarography (using an EPS/R2 mat and BIOMECH STUDIO software) assessed functionality and postural parameters pre and post HVLA therapy. Results. Initial diagnosis showed significant disturbances in force distribution, balance, and gait. Post-HVLA therapy improvements included: 1. Balanced forefoot load during standing, with a decrease in heel load percentage. 2. Improved global body pressure distribution, with a notable decrease in left-side body pressure. 3. Enhanced anteroposterior and lateral body oscillation ranges, with a reduced ratio of extreme deflection distances to deflection surface and a decreased average speed of displacements. 4. Normalization of the right foot abduction angle, with no significant change in the left foot's visitation angle. 5. Slight improvements in foot vault index (AI) and average foot pressure during gait, with minimal changes in maximum foot pressure during gait. Conclusions. HVLA manipulation significantly improves static balance parameters but shows minimal improvement in gait parameters. This indicates a complex relationship between atlanto-occipital blockage and postural disorders, suggesting the need for further research to explore the association between postural defects and atlanto-occipital transition blockage, as well as the impact of these blockages on postural changes. Keywords atlanto-occipital blockage, HVLA manipulation, postural disorders, balance improvement, pedobarography