Quiz 4

Question 1

The cochrane collaboration review determined the the most beneficial intervention for patients with mechanical neck pain with or without headache should be?

Answer 1

A combination of manipulation/ mobilization and exercise

Question 2

Combination of manipulation and exercise resulted in a/

Answer 2

Significant cost savings of up to 68%

Question 3

6 predictors that a patient will have a positive outcome with cervical manipulation according to Tseng: Initial scores on NDI? Having _ _ pattern, not performing sedentary work for more than _ _ _ _, feeling better while _ _ _, did not feel worse while _ _ _, and the diagnosis of _ _ _ .

Answer 3

Initial NDI score of less than 11.5
Having bilateral involvement pattern
Not performing sedentary work for more than 5 hours per day
Feeling better while moving the neck
Did not feel worse while extending the neck
Diagnosis of spondylosis without radiculopathy.

Question 4

Presence of _ or _ of the 6 predictors increased the probability of success with manipulation from _% to _%

Answer 4

Presence of 4 or more of the 6 predictors

Increased probability of success from 60%-89%

Question 5

What are the 6 factors that Cleland et al report as predictors of short-term positive outcomes with thoracic manipulations: Symptom duration of? No symptoms _ to the . Subject reports that looking up? Score of _ _ _ on the Fear-avoidance beliefs Questionairre- Physical activity. Diminished upper _ _ _ (-_). Cervical extension of?

Answer 5

Symptom duration of less than 30 days
No symptoms distal to the shoulder
Subject reports that looking up does not aggravate symptoms
Score of less than 12 not the Fear-avoidance Questionairre
Diminished upper thoracic spine kyphosis (T3-T5)
Cervical extension of less than 30 degrees

Question 6

Ylinen et al assessed the effectiveness of a stretching regimen 5X per week vs. manual therapy 2X/ week and found that patients with neck pain often presented with impairments of flexibility/ tightness of which key muscles? (4)

Answer 6

PLUS

Pec major and minor
Levator Scapula
Upper trapezius
Scalenes (PAM)

Question 7

What did the authors of the study conclude was the best treatment for impaired flexibility/ tightness of the muscles of the lower cervical and upper thoracic spine?

Answer 7

Targeted Stretching exercises

Question 8

According to a study by Jull et al what combination of interventions was the most effective in reducing headache frequency in patients who met the diagnostic criteria?

Answer 8

Most effective treatment was mobilization/ manipulation and exercise combination

Question 9

In Jull et al study they recommended using manipulation/ mobilization in combination with exercise regimen that used _ _ _ exercises to train muscle control of the cervico-scapular region. First stage aimed to target the _ _ _ muscles, then subsequently _ exercises using a low level of _ _ were used to to train the co-contraction of the neck flexors and extensors. Level of evidence?

Answer 9

Used low level endurance exercises to train muscles:

• first stage aimed to target the deep neck flexor muscles
• subsequently isometric exercises using a low level of rotatory resistance were used to train the co-contraction of . . . .

Level of evidence: I

Question 10

What was the overall recommendation for use of coordination, strengthening, and endurance exercises?

Answer 10

Clinicians should consider the use of coordination, strengthening and endurance exercises to reduce neck pain and headache

Question 11

Specific repeated movements or procedures to promote centralization are _ _ _ in reducing disability when compared to other forms of interventions. What is the grade of evidence associated with centralization procedures and exercises?

Answer 11

Repeated movements or procedures to promote centralization are NOT MORE BENEFICIAL in reducing disability.

Grade of Evidence: C

Question 12

Upper Quarter and nerve mobilization procedures: clinicians _ _ the _ of upper quarter and nerve mobilization procedures to reduce pain and disability in patients with _ and _ pain.

Answer 12

Clinicians SHOULD CONSIDER THE USE OF upper quarter and nerve mobilization procedures to reduce pain and disability in patients with NECK AND ARM PAIN

Question 13

What is the grade of evidence associated with upper quarter and nerve mobilization procedures?

Answer 13

Grade of Evidence: B

Question 14

Use of traction recommendations: Clinicians should consider the use of _ _ _ _, combined with other interventions such as _ _ and _ _, for reducing pain and disability in patients with neck and neck-related arm pain.

Answer 14

The use of MECHANICAL INTERMITTENT CERVICAL TRACTION, combined with other interventions such as MANUAL THERAPY AND STRENGTHENING EXERCISES, for reducing pain and disability

Question 15

What is the grade of evidence associated with the use of traction?

Answer 15

Grade: B

Question 16

Which interventions received an evidence grade of A when it comes to decreasing pain and disability? (3)

Answer 16

PCC

Patient education and counseling
Coordination, strengthening, and endurance exercises
Cervical manipulation and mobilization

Question 17

Which interventions received an evidence grade of B for reducing pain and disability? (2)

Answer 17

UTah

Upper quarter and nerve mobilization procedures
Traction

Question 18

Which interventions have an evidence level of C? (3)

Answer 18

C ST

Centralization procedures and exercises
Stretching exercises
Thoracic manipulation and mobilization