The effect of cervical rotation on blood flow in the contralateral vertebral artery

Zaina, C; Grant, Ruth; Johnson, Catherine; Dansie, Brenton; Taylor, James; Spyropolous, P.

doi:10.1016/s1356-689x(02)00155-8

Cited by 47 publications

(49 citation statements)

References 17 publications

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“…Other studies, however, have found no change in blood fl ow [29][30][31][32] . Some authors have used the results of studies demonstrating a reduction in blood fl ow to support the validity of screening tests; i.e., one tests to assess blood fl ow changes, these studies demonstrate that rotation changes blood fl ow; therefore, the test is valid.…”

Section: Is Functional Pre-treatment Screening Useful?mentioning

confidence: 99%

Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective

Kerry¹,

Taylor²,

Mitchell³

et al. 2008

Journal of Manual & Manipulative Therapy

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Section: Is Functional Pre-treatment Screening Useful?mentioning

confidence: 99%

Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective

Kerry¹,

Taylor²,

Mitchell³

et al. 2008

Journal of Manual & Manipulative Therapy

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“…However, Licht et al 34 did not fi nd changes in fl ow velocity when studying 11 subjects undergoing vertebral artery testing. Zaina et al 35 also did not fi nd changes in volume fl ow rate of the vertebral arteries in 20 subjects in various degrees of cervical rotation.…”

Section: Neurovascular Findingsmentioning

confidence: 89%

“…The VAT has traditionally been recommended as a pre-manipulation test to screen for vertebral artery pathology that could lead to higher incidence of adverse effects following HVLA thrust manipulation. However, as noted above, the clinical usefulness of this test has recently been questioned and its construct and predictive validity has been debated in the literature [33][34][35] . Thiel and Rix 49 asserted that careful history taking and physical examination could identify those patients at risk for vertebral artery pathology, and that provocative testing was very unlikely to provide additional useful information.…”

Section: Weekmentioning

confidence: 99%

Orthopaedic Manual Physical Therapy Including Thrust Manipulation and Exercise in the Management of a Patient with Cervicogenic Headache: A Case Report

Duijn¹,

Duijn²,

Nitsch³

2007

Journal of Manual & Manipulative Therapy

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It has been reported that in Western society as many as 16% of individuals experience cervicogenic headache, which can lead to signifi cant amounts of pain and perceived disability. Cervicogenic headache is characterized by unilateral occipital-temporal pain that is increased by neck movement; it is accompanied by cervical hypomobility, postural changes, and/or increased cervical muscle tone. This case report describes the physical therapy differential diagnosis, management, and outcomes of a patient with cervicogenic headache. The patient was a 40-year-old woman referred by her physiatrist with complaints of cervical pain and ipsilateral temporal headache. The patient presented with increased muscle tone, multiple-level joint hypomobility in the cervical and thoracic spine, muscle weakness, and postural changes. Self-report outcome measures included the Visual Analog Scale for headache pain intensity and the Neck Disability Index. Management consisted of various thrust and non-thrust manipulations, soft tissue mobilizations, postural re-education, and exercise to address postural defi cits and cervical and thoracic hypomobility and diminished strength. At discharge, the patient demonstrated clinically meaningful improvements with regard to pain, disability, and headache. This case report indicates that a multimodal physical therapy treatment program may be effective in the management of a patient diagnosed with cervicogenic headache.Key Words: Cervicogenic Headache, Manipulation, Thrust, Exercise, Physical Therapy Orthopaedic Manual Physical Therapy Including Thrust Manipulation and Exercise in the Management of a Patient withCervicogenic Headache: A Case Report C ervicogenic headaches are commonly encountered in physical therapy (PT) practice. Cervicogenic headache is a headache type validated recently by the International Headache Society (IHS) that is hypothesized to originate due to nociception in the cervical area. In a Scandinavian population study, its prevalence was established at approximately 16%1 . Table 1 outlines the diagnostic criteria for cervical headaches as described by the IHS 2 . Horn and Smith 3 reviewed the literature on approaches to management of cervicogenic headache using orthopedic manual physical therapy (OMPT) principles. They recommended careful examination to identify all impairments, to provide a differential diagnosis, and to plan appropriate intervention. Recommended interventions included joint mobilization, soft tissue mobilization, retraining of specifi c postural muscle groups, and patient education. The authors recommended that emphasis should be placed on home and self-management skills and on increasing patient understanding of the predisposing factors with regard to cervicogenic headache. Jull 4 also described the importance of an accurate differential diagnosis ascertaining the cervical musculoskeletal origin of the headache to assure success with management of a cervical headache patient. She described the history and symptomatic features of cervical headach...

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“…However, the validity of the provocative positional tests to predict a patient's risk of stroke from neck manipulation remains controversial, largely because of contradictory findings arising from various ultrasound flow studies of the craniocervical arteries (Zaina, Grant et al 2003, Mitchell 2009, Sultan, Hartshorne et al 2009, Bowler, Shamley et al 2011). …”

Section: Introductionmentioning

confidence: 99%

“…Attempts to quantify blood flow changes in the VAs on neck rotation, with the premise that large changes in flow might indicate greater biomechanical stress on the artery, have yielded conflicting findings. Some studies showing reduced flow on contralateral rotation, some with ipsilateral and others no change in either direction, sometimes despite positive VBI tests (Thiel, Wallace et al 1994, Haynes 1996, Rivett, Sharples et al 1999, Haynes and Milne 2001 Sakaguchi, Kitagawa et al 2003, Zaina, Grant et al 2003, Mitchell, Keene et al 2004, Sultan, Hartshorne et al 2009, Bowler, Shamley et al 2011, Quesnele, Triano et al 2014. Of the few studies that have examined blood flow in the ICAs, similarly conflicting findings have emerged (Sultan, Hartshorne et al 2009, Bowler, Shamley et al 2011.…”

Section: Introductionmentioning

confidence: 99%

The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow: A sub analysis of an MRI study

et al. 2015

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The effect of cervical rotation on blood flow in the contralateral vertebral artery

Cited by 47 publications

References 17 publications

Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective

Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective

Orthopaedic Manual Physical Therapy Including Thrust Manipulation and Exercise in the Management of a Patient with Cervicogenic Headache: A Case Report

The effect of end-range cervical rotation on vertebral and internal carotid arterial blood flow and cerebral inflow: A sub analysis of an MRI study

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