1. WCPT Conference, Amsterdam
Spinal Manipulation – Evidence for
Physiotherapist Delivery of Effective
Procedures – a focussed symposia
Duncan Reid DHSc – Convenor (New Zealand)
Tim Flynn PhD (USA)
Wayne Hing PhD (NZ)
Chris McCarthy PhD (UK)
Peiter Westerhuis (Switzerland)
2. Dr Chris McCarthy PhD, MCSP, FMACP
CERVICAL SPINE - GENERAL HEALTH
ASSESSMENT
WCPT Conference, Amsterdam
20 – 23 June 2011
3. Cervical Spine Health &
Manipulation
Does OMPT cause CAD?
What are the risk factors for CAD?
What are the signs and symptoms?
What should be included in consent
discussions?
WCPT Conference, Amsterdam
20 – 23 June 2011
5. Contraindications Cautions
Multilevel radiculopathy Local Infection
Worsening neurological function Inflammatory disease
Upper motor neuron lesion Active Cancer
Unremitting, severe, non-mechanical History of cancer
pain Long term steroid use (<3/12)
Fracture Osteoporosis
Symptoms of a Cervical Artery Dissection Systemically unwell
Symptoms of Cervical Instability Hypermobility syndrome
Connective tissue disease
Risk Factors for Cervical Artery
Moore et al. 2005 CSP Guidelines for Whiplash Dysfunction
Risk factors for Cervical Instability
WCPT Conference, Amsterdam
20 – 23 June 2011
7. •Young (45 years) vertebrobasilar artery territory stroke patients were 5 times more
likely than controls to have visited a chiropractor within 1 week of the event date.
•No significant associations were found for those aged 45 years.
•The best available estimate of the incidence,, states that for every 100,000 persons
45 years of age who receive CMT, approximately 1.3 cases of vertebral artery
dissection or occlusion attributable to CMT would be observed within 1 week of
manipulative therapy. WCPT Conference, Amsterdam
20 – 23 June 2011
