Manual therapy and cervical arterial dysfunction, directions for the future: a clinical perspective.

The Journal of Manual & Manipulative Therapy
R KerryJohn Brew

Abstract

This paper offers a contemporary, evidence-based perspective on the issue of adverse neurovascular events related to cervical spine manual therapy. The purpose of this perspective is to challenge traditional thought and practice and to recognize areas where practice and research should develop. By considering the themes presented in this paper, the clinician can broaden his or her approach to neurovascular assessment in line with contemporary evidence and thought. We present information based on clinically relevant questions. The nature of vertebrobasilar insufficiency and the utility of pre-treatment testing are examined in light of contemporary evidence. In addition, we report on internal carotid artery pathology, and the significance of appreciating atherosclerosis in clinical decision-making. These later two areas are not commonly recognized within manual therapy literature, and we suggest that their importance to differential diagnosis of head and neck pain, as well as estimating treatment related risk, is paramount. 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 anatomica...Continue Reading

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Citations

Jul 16, 2010·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·C ColosimoA Berardelli
Nov 21, 2018·The Journal of Manual & Manipulative Therapy·Nicola R HeneghanAlison Rushton
Dec 2, 2011·The Journal of Manual & Manipulative Therapy·Rob SillevisKristina Beekhuizen
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Aug 27, 2015·The Journal of Manual & Manipulative Therapy·Emilio J Puentedura, William H O'Grady
Sep 16, 2017·The Journal of Manual & Manipulative Therapy·Max K JordonSarah Scriven
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Dec 8, 2020·Journal of Physical Therapy Science·Brent HarperHarrison Vaughan

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