Cervical Spine TBC 4

Question 1

Mobility deficits: These are superior to minimal intervention

Answer 1

• manual therapy
• exercise

Question 2

Mobility deficits: Thrust manipulation and non-thrust manipulation are (more/less/equally) effective

Answer 2

equally - no difference between the two (Leaver 2010)

Question 3

Mobility deficits: High quality evidence for exercise combined with

Answer 3

manual therapy

Question 4

2006

Mobility deficits: Patients who benefit from cervical manipulation

6 predictors for pts who experienced immediate improvement in either pain, satisfaction, or perception of condition

Answer 4

1. initial scores on NDI < 11.5
2. B involvement pattern
3. ≤ 5 hours sedentary work per day
4. feeling better when moving the neck
5. did not feel worse when extending theneck
6. dx of spondylosis without radiculopathy

Question 5

2006

Mobility deficits: 6 predictors for improvement with manipulation

NDI score

Answer 5

< 11.5

Question 6

2006

Mobility deficits: 6 predictors for improvement with manipulation

The presence of (#) or more of the 6 predictors increases the probability of success with manipulation from 60% to (%)

Answer 6

4 or more

89%

Question 7

2012

Mobility deficits: Patients who benefit from cervical manipulation (4 criteria)

Answer 7

1. sx duration < 38 days
2. positive expectation that manipulation will help
3. cervical rotation asymmetry ≥ 10˚
4. pain with PA spring testing of middle cervical spine

Question 8

Mobility deficits: CPR for thoracic manipulation

Answer 8

• sx duration < 30 days
• no sx’s distal to shoulder
• looking up doesn’t worsen symptoms
• cervical ext < 30˚
• diminished upper thoracic kyphosis (T3-5)
• FABQPA < 12

Question 9

Mobility deficits: CPR for thoracic manipulation

3+ present increases the probability of success from

Answer 9

54% to 86%

Question 10

Mobility deficits: Thoracic manipulation

The published CPG for neck pain recommends that thoracic spine manipulation can be used for pts with primary c/o neck pain. In addition, it can reduce pain and disability in pts with

Answer 10

neck pain

neck related arm pain

Question 11

Neck pain with headaches: 3 main types

Answer 11

• migraine
• tension
• cervicogenic

Question 12

Neck pain with headaches: PT is MOST effective for this type

Answer 12

cervicogenic

Question 13

Neck pain with headaches: (bilateral/unilateral) HA associated with neck/occipital area symptoms that are aggravated by neck movements or positions

Answer 13

unilateral

Question 14

Neck pain with headaches: HA produced with provocation of (contralateral/ipsilateral) posterior cervical myofascia and joints

Answer 14

ipsilateral

Question 15

Neck pain with headaches: restricted (ROM/mobility)

Answer 15

• cervical ROM
• C0-2 segmental mobility

Question 16

Neck pain with headaches: Special testing

Answer 16

• (+) cervical flexion rotation test
• impaired DNF control during CCFT

Question 17

Neck pain with headaches: management evidence indicates these should be used

Answer 17

• cervical manipulation
• thoracic manipulation
• stretching exercises
• coordination, strengthening, endurance exercise