DO (True or False) 3 — Questions and Answers
Question 1: Osteoporosis is an absolute contraindication to High-Velocity Low-Amplitude (HVLA) technique in all cases.
- True
- False — osteoporosis is a relative contraindication that requires clinical judgment (Correct answer)
- True, but only for spinal HVLA
- HVLA is safe in all patients with osteoporosis
Correct answer: False — osteoporosis is a relative contraindication that requires clinical judgment
Osteoporosis is generally a relative contraindication to HVLA; severe osteoporosis may become absolute, but the determination must be individualized.
Question 2: Muscle Energy Technique (MET) requires the patient to actively contract specific muscles against a physician-applied counterforce.
- True (Correct answer)
- False — MET is a passive technique requiring no patient effort
- True, but only for lumbar somatic dysfunction
- MET uses the physician's muscle contraction, not the patient's
Correct answer: True
MET is a direct, active technique in which the patient voluntarily contracts specific muscles on request against a precisely controlled counterforce applied by the physician.
Question 3: In Counterstrain technique, the position of comfort must be maintained for exactly 90 seconds before slow return to neutral.
- True (Correct answer)
- False — the hold time is 30 seconds
- True, but only for anterior tender points
- The hold time in Counterstrain is 45 seconds
Correct answer: True
Counterstrain requires holding the position of maximal comfort for 90 seconds to allow the shortened muscle spindles to reset.
Question 4: Facilitated Positional Release (FPR) adds a compression or torsion vector to the indirect position of ease.
- True (Correct answer)
- False — FPR uses a distraction force only
- True, but only when treating thoracic spine
- FPR is identical to Counterstrain with no additional facilitating force
Correct answer: True
FPR adds a facilitating force (compression or torsion) to the position of ease, significantly shortening treatment time compared to Counterstrain.
Question 5: Balanced Ligamentous Tension (BLT) is an indirect technique because the physician moves the joint away from the restrictive barrier.
- True (Correct answer)
- False — BLT moves toward the barrier and is therefore direct
- True, but only for cranial BLT applications
- BLT is classified as neither direct nor indirect
Correct answer: True
BLT is indirect because the physician positions the joint away from the restrictive barrier toward the point of balanced ligamentous tension, allowing inherent body forces to restore motion.
Question 6: Thoracic lymphatic pump technique enhances lymphatic flow by applying rhythmic compression forces to the thoracic cage.
- True (Correct answer)
- False — thoracic pump compresses only the thoracic inlet, not the cage
- True, but it only increases venous, not lymphatic flow
- Lymphatic pump techniques are restricted to abdominal application only
Correct answer: True
Thoracic lymphatic pump uses rhythmic compression of the thoracic cage to create pressure gradients that drive lymphatic and immune fluid flow.
Question 7: Soft tissue technique in osteopathic medicine is classified as a direct, passive technique.
- True (Correct answer)
- False — soft tissue technique is indirect
- True, but it also requires active patient participation
- Soft tissue is classified separately from direct and indirect techniques
Correct answer: True
Soft tissue technique is direct and passive, with the physician applying kneading, stretching, and inhibitory pressure while the patient remains relaxed.
DO (True or False) 3
Osteoporosis is an absolute contraindication to High-Velocity Low-Amplitude (HVLA) technique in all cases.