A survey to examine attitudes and patterns of practice of physiotherapists who perform cervical spine manipulation

Can a professional development workshop with follow-up alter practitioner behaviour and outcomes for neck pain patients? A randomised controlled trial

“…questionnaire was developed in an iterative process based on previously published questionnaires (Grant & Niere, 2000;Hurley et al 2002), the expertise of the project team, feedback from previous workshops and pilot testing on a sample representative of the study population. The questionnaire had two sections and questions are presented within the tables of results (Table 2 and Table 3, Questionnaires were completed by all participants prior to the first weekend workshop and again four weeks after the final follow-up workshop.…”

Thoracic Spine Thrust Manipulation Improves Pain, Range of Motion, and Self-Reported Function in Patients With Mechanical Neck Pain: A Systematic Review

“…24,27,37 Moreover, the literature has recommended avoiding manual therapies at terminal ranges of motion 4 and cautioned against the use of cervical thrust manipulation due to the perceived risk of serious vascular complications, especially in specific subgroups of the population. 27,32,34 Alternatively, thoracic spine thrust manipulation may effectively address mechanical neck pain.…”

Screening for Vertebrobasilar Insufficiency in Patients With Neck Pain: Manual Therapy Decision-Making in the Presence of Uncertainty

“…Performing a screening examination in patients with neck pain is an important decision-making priority, 5,33,47,56,72 particularly given the frequency with which manual therapy interventions are utilized in these patients, 33,46 and a legitimate concern to minimize the risk of harm. Unfortunately, although VBI screening guidelines exist, 45,46 there is currently no clinical prediction rule that can accurately identify patients at risk for VBI and there is little evidence substantiating the accuracy of historical information, physical examination screening procedures, or diagnostic imaging to accurately identify patients at risk for VBI prior to manual therapy inter ventions.…”

“…17,46 Physical therapists who perform spinal manipulation in their clinical practice frequently use cervical manipulation and mobilization inter ventions in patients with neck pain and cervicogenic headaches. 33,46 Although the risk is very small, the extreme consequences associated with VBI require consideration in the treatment decisionmaking process for patients with neck pain.…”

“…5,33,47,56,72 For example, the Australian Physiotherapy Association published a clinical practice guideline in 1988, 3 which was updated in 2000. 45 The guidelines generally advocate that all patients with neck pain receive a subjective screening examination and perform active neck movements.…”