Manual Therapy and Cervical Arterial Dysfunction: Difference between revisions

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*Outline of the material to be covered and the depth it will be covered in
*Outline of the material to be covered and the depth it will be covered in


This Physiopedia page offers a recent, evidence-informed perspective on the issue of adverse neuro-vascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge established thought and practice and to recognise areas where practice should develop. By considering the themes presented in this page, the physiotherapist can broaden his or her approach to neurovascular assessment in line with recent evidence and thought. The presented material is based on clinically relevant questions. The nature of vertebasilar insufficiency and the utility of pre-treatment testing are examined in light of recent evidence. In addition, material is presented on internal carotid artery pathology, and the significanc of considering atherosclerosis in clinical reasoning. These later two areas are not commonly recognised within manual therapy literature; however, their importance to differential diagnosis of head and neck pain, as well as estimating treatment related risk, is of vital importance.   
This Physiopedia page offers a recent, evidence-informed perspective on the issue of adverse neuro-vascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge established thought and practice and to recognise areas where practice should develop.&nbsp;By considering the themes presented in this page, the physiotherapist can broaden his or her approach to neurovascular assessment in line with recent evidence and thought.&nbsp;The presented material is based on clinically relevant questions.&nbsp;The nature of vertebasilar insufficiency and the utility of pre-treatment testing are examined in light of recent evidence.&nbsp;In addition, material is presented on internal carotid artery pathology, and the significanc of considering atherosclerosis in clinical reasoning.&nbsp;These later two areas are not commonly recognised within manual therapy literature; however, their importance to differential diagnosis of head and neck pain, as well as estimating treatment related risk, is of vital importance (reference).&nbsp;(reference) proposed that the term cervical arterial dysfunction is more appropriate than classically used nomenclature because this term refers more accurately and completely to the range of pathologies at different anatomical sites that manual therapists treating patients with head and neck pain are likely to encounter (reference).<span>&nbsp;This page accepts this.</span>&nbsp; &nbsp;<br>  
 
We propose that the term cervical arterial dysfunction is more appropriate than classically used nomenclature. This term refers more accurately and completely to the range of pathologies at different anatomical sites that manual therapists treating patients with head and neck pain are likely to encounter.<br>  


*Recent key publications in the area
*Recent key publications in the area

Revision as of 00:18, 10 March 2014

Title[edit | edit source]

Manual Therapy and Cervical Arterial Dysfunction

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  • Outline of the material to be covered and the depth it will be covered in

This Physiopedia page offers a recent, evidence-informed perspective on the issue of adverse neuro-vascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge established thought and practice and to recognise areas where practice should develop. By considering the themes presented in this page, the physiotherapist can broaden his or her approach to neurovascular assessment in line with recent evidence and thought. The presented material is based on clinically relevant questions. The nature of vertebasilar insufficiency and the utility of pre-treatment testing are examined in light of recent evidence. In addition, material is presented on internal carotid artery pathology, and the significanc of considering atherosclerosis in clinical reasoning. These later two areas are not commonly recognised within manual therapy literature; however, their importance to differential diagnosis of head and neck pain, as well as estimating treatment related risk, is of vital importance (reference). (reference) proposed that the term cervical arterial dysfunction is more appropriate than classically used nomenclature because this term refers more accurately and completely to the range of pathologies at different anatomical sites that manual therapists treating patients with head and neck pain are likely to encounter (reference). This page accepts this.   

  • Recent key publications in the area

Kerry R, Taylor AJ, Mitchell J, McCarthy C, Brew J. Manual Therapy and Cervical Arterial Dysfunction, Directions for the Fuuture: A Clinical Perspective. The Journal of Manual & Manipulative Therapy 2008;16(suppl 1):39-48.  

Of interest, the above journal also presents a brief review of the medico-legal status pertaining to this area. Although this is English law-related, the themes derived from this section should be of interest to all manual therapists.

Kerry R, Taylor AJ. Cervical Arterial Dysfunction Assessment and Manual Therapy. Manual Therapy 2006;11:243-253.

Kerry R, Taylor AJ. Cervical Arterial Dusfunction: Knowledge and Reasoning for Manual Physical Therapists. Journal of Orthopaedic & Sports Physical Therapy 2009;39(suppl 5):378-387. 

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