Index to Chiropractic Literature
Index to Chiropractic Literature
My ICL     Sign In
Tuesday, June 2, 2020
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature
Share:

ICL Home


For best results switch to Advanced Search.
Article Detail
Return to Search Results
ID 14736
  Title Is there a role for premanipulative testing before cervical manipulation?
URL http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10771502
Journal J Manipulative Physiol Ther. 2000 Mar-Apr;23(3):175-179
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes BACKGROUND: Spinal manipulative therapy is used millions of times every year to relieve symptoms from biomechanic dysfunction of the cervical spine. Concern about cerebrovascular accidents after cervical manipulative therapy is common but rarely reported. Premanipulative tests of the vertebral artery are presumed to identify patients at risk but controversy exists about their usefulness.

OBJECTIVE: The aim of this study was to examine vertebral artery blood flow in patients with a positive premanipulative test for contraindication to spinal manipulative therapy and to investigate if chiropractors would reconsider treating such patients if dynamic vascular Doppler examination was normal.

DESIGN AND SETTING: A prospective study at a university hospital vascular laboratory.

METHODS: Chiropractors in private practice from 3 Danish counties referred patients with a positive premanipulative test for an examination of vertebral artery blood flow. Premanipulative testing was performed by an experienced chiropractor. Flow velocities were measured in both vertebral arteries by color duplex sonography. In addition, chiropractors were asked if they would treat their patient despite a positive premanipulative test if the vascular ultrasound examination was normal.

RESULTS: A total of 20 consecutive patients with a positive premanipulative test were referred. Five were excluded because symptoms could not be reproduced during the vascular examination. In the remaining patients, no significant difference in peak flow velocity or time-averaged mean flow velocity with different head positions was found. Nineteen of 21 chiropractors would treat a patient with a positive premanipulative test if the vascular examination was normal. Eight of the patients with a positive manipulative test were treated without complications. Six are now symptom-free, and 2 have improved symptoms. The remaining 8 patients refused manipulation and continue to have the same symptoms.

CONCLUSION: It appears that a positive premanipulative test is not an absolute contraindication to manipulation of the cervical spine. If the test is able to identify patients at risk for cerebrovascular accidents, we suggest patients with a reproducible positive test should be referred for a duplex examination of the vertebral artery flow. If duplex flow is normal, the patient should be eligible for cervical manipulation despite the positive premanipulative test.

Click on the above link for the PubMed record for this article; full text by subscription.

   Text (Citation) Tagged (Export) Excel
 
Email To
Subject
 Message
Format
HTML Text     Excel



To use this feature you must register a personal account in My ICL. Registration is free! In My ICL you can save your ICL searches in My Searches, and you can save search results in My Collections. Be sure to use the Held Citations feature to collect citations from an entire search session. Read more search tips.

Sign Into Existing My ICL Account    |    Register A New My ICL Account
Search Tips
  • Enclose phrases in "quotation marks".  Examples: "low back pain", "evidence-based"
  • Retrieve all forms of a word with an asterisk*, also called a wildcard or truncation.  Example: chiropract* retrieves chiropractic, chiropractor, chiropractors
  • Register an account in My ICL to save search histories (My Searches) and collections of records (My Collections)
Advanced Search Tips