The Evidence on Cervicothoracic SMT

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Author:
dmshaw9
ID:
261999
Filename:
The Evidence on Cervicothoracic SMT
Updated:
2014-02-14 10:53:51
Tags:
Evidence Cervicothoracic SMT
Folders:
MS2
Description:
MS2
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  1. Cervical Manipulation for Mechanical Neck Pain
    (Success if 4+ present)

    • Initial NDI score <11.50 points
    • Bilateral pattern of involvement
    • Not performing sedentary work > 5 hrs/day
    • Feels better while moving the neck
    • Does not feel worse while extending the neck
    • Diagnosis of spondylosis w/o radiculopathy
  2. Cervicothoracic Manipulation for Shoulder Pain
    (Indicated if 3 or more present)

    • Pain free active shoulder flex < 127 degrees
    • Shoulder IR < 53 degrees
    • (-) Neer impingement test
    • Not taking any medication for the shoulder pain
    • Duration of symptoms < 90 days
  3. Cervical Radiculopathy
    (Diagnostic if 3 or more present)

    • Cervical rotation toward the involved side < 60 degrees
    • (+) ULTTA
    • (+) Cervical Distraction Test
    • (+) Spurling's A Test
  4. Short-Term Outcomes w/ Cervical Radiculopathy
    (Successful outcome likely if 3 or more present)

    • Age < 54
    • Dominant arm not affected
    • Looking down does not worsen symptoms
    • Received multimodal treatment for > 50% of visits
  5. Strong Evidence
    • Examination/Outcome Measures: NDI (Neck Disability Index) and PSFS (Patient-Specific Functional Scale)
    • Cervical Mobilization/Manipulation
    • Coordination, Strengthening, & Endurance Exercise
    • Patient Education and Counseling
  6. Moderate Evidence
    Risk Factors: (all lead to development of chronic neck pain)

    • Age > 40
    • Coexisting LBP
    • Hx of neck pain
    • Cycling as a regular activity
    • Loss of strength in the hands
    • Worrisome attitude
    • Poor QOL
    • Less vitality
  7. Weak Evidence
    Thoracic Mobilization/Manipulation (for primary complaints of neck pain)
  8. Theoretical/Foundational Evidence
    Pathoanatomic Features: assess for impaired function of muscle, connective, ad nerve tissues associated w/ the identified pathological tissues when a patient presents w/ neck pain

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