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Should we abandon positional testing for vertebrobasilar insufficiency?
Musculoskelet Sci Pract
April 2020
School of Health and Rehabilitation Sciences, University of Queensland, Australia.
Positional testing for vertebrobasilar insufficiency (VBI) is used by physiotherapists as part of pre-manipulative screening protocols. Recently, the validity of the tests have been questioned because a negative test does not infer safety with cervical manipulative therapy but the reasoning surrounding this opinion may be questioned. While the positional tests were developed to test vertebral artery flow contralateral to the direction of head movement and the subsequent effect on cerebral blood supply, as inferred by symptom reproduction, ultrasound studies have shown that vertebral artery flow is inherently variable.
View Article and Find Full Text PDFAustralian musculoskeletal physiotherapist's perceptions, attitudes and opinions towards pre-manipulative screening of the cervical spine prior to manual therapy: Report from the focus groups.
Musculoskelet Sci Pract
February 2019
Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia.
Background: The Australian Physiotherapy Association 2006 VBI Guidelines are used by many of the member organisations of IFOMPT. These Guidelines are due for revision incorporating recent research findings, international guides, and member's recommendations.
Purpose: To identify and consider Australian musculoskeletal physiotherapists' recommendations to inform revision of the 2006 VBI Guidelines.
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.
Man Ther
June 2015
Discipline of Physiotherapy, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, NSW, Australia.
Introduction: Cervical spine manual therapy has been associated with a small risk of serious adverse neurovascular events, particularly to the vertebral arteries. Sustained end-range rotation is recommended clinically as a pre-manipulative screening tool; however ultrasound studies have yielded conflicting results about the effect of rotation on blood flow in the vertebral arteries. There has been little research on internal carotid arterial flow or utilising the reference standard of angiography.
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