Pre-manipulative testing and the use of the velocimeter

Thomas, Lucy C., Rivett, Darren A. and Bolton, Philip S. (2008) Pre-manipulative testing and the use of the velocimeter. Manual Therapy, 13 1: 29-36. doi:10.1016/j.math.2006.11.003

Author Thomas, Lucy C.
Rivett, Darren A.
Bolton, Philip S.
Title Pre-manipulative testing and the use of the velocimeter
Journal name Manual Therapy   Check publisher's open access policy
ISSN 1356-689X
Publication date 2008-01-01
Year available 2008
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.math.2006.11.003
Open Access Status Not yet assessed
Volume 13
Issue 1
Start page 29
End page 36
Total pages 8
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 3600 Health Professions
Abstract Manipulation of the cervical spine remains a common intervention for neck pain and dysfunction, despite the well-documented associated risk of vertebrobasilar stroke. The currently advocated pre-manipulative risk assessment protocols include the use of provocative positional tests to challenge the integrity of the vascular supply to the brain. This paper critically evaluates the validity of these pre-manipulative provocative tests in the light of ultrasonographic blood flow studies of the vertebral arteries. It also critically evaluates the evidence concerning the clinical utility of a portable continuous wave Doppler device (or velocimeter) to examine vertebral artery blood flow prior to neck manipulation. There is clear evidence that the provocative tests may produce both false positive and false negative findings. Initial research regarding the clinical use of a velocimeter suggests this device may provide a more objective assessment of vertebral artery blood flow than the provocative tests. However, the sensitivity, specificity and reliability of the use of the velocimeter in identifying abnormal vascular flow in the vertebral arteries, and therefore its clinical utility, has not yet been fully established.
Keyword Cervical manipulation
Cervical vertebrae
Doppler ultrasonography
Vertebral artery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Health and Rehabilitation Sciences Publications
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Created: Wed, 26 Feb 2014, 20:19:58 EST by Ms Kate Rowe on behalf of School of Health & Rehabilitation Sciences