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

Przemysław Malich, Aleksandra Bitenc-Jasieńko, Agata Pasternak, Adrian Westfal, Helena Gronwald, Karina Kijak, Krzysztof Gronwald, Krzysztof Konior, Danuta Lietz-Kijak

Przemysław Malich, Aleksandra Bitenc-Jasieńko, Agata Pasternak, Adrian Westfal, Helena Gronwald, Karina Kijak, Krzysztof Gronwald, Krzysztof Konior, Danuta Lietz-Kijak – The effect of HVLA manipulation on static and dynamic postural parameters – a case study of a patient with a blocked atlanto-occipital transition –  Fizjoterapia Polska 2024; 24(1); 215-225

DOI: https://doi.org/10.56984/8ZG2EF8t5I

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
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Changes in body balance due to exposure to trauma – multi-center studies

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Anna Walińska, Kinga Gonta, Elżbieta Szkiler, Milena Kraft, Alina Kirpichnikova, Karolina Trąbska, Anna Parus, Tomasz Kupc, Malwina Waleryn-Sagun, Anna Szadkowska, Rafał Mosur, Kamila Mosur, Damian Szyguła, Nicola Książek, Małgorzata Barszczewska, Patrycja Janta, Aneta Mandrosa, Joanna Jarosławska, Klaudia Smolińska, Marta Szewczyk, Agnieszka Byszewska, Anna Morzyńska, Marzena Tuszkowska, Barbara Wrocławska-Tuszkowska, Marek Gapiński, Tomasz Kowalik, Karolina Adamska, Katarzyna Pawliwiec, Jan Głodowski, Konrad Kijak, Małgorzata Kowacka, Danuta Lietz-Kijak

Aleksandra Bitenc-Jasiejko, Krzysztof Konior, Danuta Lietz-Kijak et al – Changes in body balance due to exposure to trauma – multi-center studies. Fizjoterapia Polska 2023; 23(5); 313-326

DOI: https://doi.org/10.56984/8ZG20Bb3T

Abstract
Aim. The purpose of the study was to assess the impact of a traumatic event experienced by the subject on postural balance and biomechanical parameters of gait.
Research methodology. The study involved 31 people (n = 100%), including 22 women (nk% = 70.97%), 9 men (nm% = 29.03), aged 29-60. People with diseases and dysfunctions affecting body balance and gait pattern were excluded from the study.
Balance and gait tests were performed using pedobarography (pedobarograph mod. EPS R2, Biomech Studio v2 software). The balance test was performed while standing, for 20 seconds, with sampling every 1 ms (millisecond) – the number of samples during one test is 20,000. The balance and gait assessment tests were performed twice. Test I included testing in neutral conditions, Test II included testing in conditions in which the subject was exposed
to a traumatic event he or she had experienced in the past (so-called exposure to “experienced trauma”).
Results. The obtained results of studies on the impact of exposure to experienced trauma on body balance while standing showed significant differences in body fluctuations in the most important parameters of stabilometric assessment.
The obtained results of research on the impact of exposure to trauma on the subject’s gait showed no significant differences between the test in neutral conditions and the test during exposure.
Conclusions. (1) Exposure to the trauma experienced by the subject significantly affects the body’s balance in a standing position. (2) The research showed no influence of exposure to the experienced trauma on the subject’s gait in the area of the time of contact of the feet with the ground and on the values of maximum and average pressure; The area of the plane where the feet are placed on the ground changes significantly before and after exposure to the trauma experienced by the subject. (3) In research on the impact of trauma on body posture, detailed results of studies on the range of COP fluctuations in each plane should be taken into account – the study showed that the analysis of only average results may significantly indicate an incorrect result in the assessment of body balance.

Keywords
stress, trauma, PTSD, body balance, gait, stabilometry, pedobarography

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