The Effect High Velocity Low Amplitude Hip Mobilization on Strength in Subjects With Lower Extremity Pathology
The Effect High Velocity Low Amplitude Hip Mobilization on Strength in Subjects With Lower Extremity Pathology
Introduction: Lower extremity weakness associated with musculoskeletal pathology can cause
 activity limitations. Physical therapy intervention in the form of exercise is commonly
 directed at improving muscular performance, however, neuromuscular adaptations may limit the
 effectiveness of traditional strengthening exercises. Manual therapy techniques have been
 used as a disinhibitory intervention to increase muscle activation and strength before
 participating in strengthening exercises or performing functional tasks While there is recent
 evidence to support joint mobilization as a valuable manual therapy disinhibitory
 intervention Currently, there is no evidence to substantiate anecdotal experience that a
 HVLAT hip distraction mobilization improves muscle performance in subjects with lower
 extremity pathology and lower extremity weakness. The purpose of this study was to determine
 if a HVLAT hip distraction mobilization would result in an immediate change of maximal force
 output of the quadriceps, gluteus maximus and gluteus medius.

 Methods: Forty individuals with a lower extremity pathology volunteered for this study.
 Inclusion criteria were having a unilateral musculoskeletal pathology, being greater than 18
 years of age, 10% decrease in muscle strength in symptomatic side compared to healthy side,
 and absence of medical precautions that would prevent a maximal effort strength test and
 exclusion criteria included individuals with a history lower extremity recent muscle or
 tendon ruptures (within the past 6 months) and postoperative knee, hip and ankle surgery.
 Demographic data, including diagnosis from referring physician were collected. All subjects
 completed the Lower extremity function scale (LEFS). A single evaluator blinded to the
 involved extremity was responsible for quadriceps, gluteus medius and maximus strength
 analysis pre and post mobilization of both symptomatic and non-symptomatic sides. The subject
 underwent the HVLAT hip distraction mobilization of the symptomatic side, and an immediate
 re-assessment of strength of both symptomatic and non-symptomatic sides followed the
 mobilization.
Inclusion Criteria:

 -  Individuals with a lower extremity pathology volunteered for this study

 -  Being greater than 18 years of age

 -  10% decrease in muscle strength in symptomatic side compared to healthy side

 -  Absence of medical precautions that would prevent a maximal effort strength test.

 Exclusion Criteria:

 -  Included individuals with a history lower extremity arthroplasty.

 -  Recent muscle or tendon ruptures (within the past 6 months)

 -  Unhealed fractures

 -  Neurological diseases

 -  Malignant cancer

 -  Osteoporosis

 -  Active infections processes

 -  Early postoperative knee, hip and ankle surgery with range of motion and weight
 bearing restrictions.