Regarding High-Velocity/Low-Amplitude (HVLA) adjusting techniques in chiropractic: Controlled pre-loaded impulse of low amplitude; Part 5 of a series.

Abstract: A discussion is presented which questions the relevance and interpretation of the term High Velocity Low Amplitude (HVLA) is used as a descriptive for seemingly most spinal manipulative techniques. It is suggested that among the range of manual manipulative techniques a distinct majority may be regarded as being of varying degrees of both velocity and amplitude although relatively few may be considered as strictly HVLA. It seems that the HVLA term has been loosely adopted and presumed as a descriptive of manipulation without due research or serious consideration as to its accuracy and has often been misunderstood and adopted inappropriately.

Contrary to earlier assumptions, it is suggested that the chiropractic vertebral adjustment does not take an articulation beyond its normal range of movement. There are occasions when an HVLA technique could be employed as the technique of choice. These still do not necessarily take a joint beyond its physiological limit.

Classification of manipulative techniques is submitted in order to more accurately identify the physical characteristics involved in the different forms of manipulation, including chiropractic adjustments. However, due to the capricious nature in identifying the subtleties of the technique, any classification remains quite subjective and renders limited definitive value to the HVLA term. In essence, the accuracy and appropriateness of the so-called High Velocity Low Amplitude or HVLA technique in manual spinal manipulation is questioned.

Indexing terms: Manipulation, Vertebral adjustment, Technique, Chiropractic.

Cite: Rome P. Waterhouse JD. The specific chiropractic adjustment is conducted within an articulation’s physiological range of motion: Part 4 of a series. Asia-Pacific Chiropr J. 2021;1.3. URL 


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