"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, June 13, 2012

Should Physical Therapists Stop Manipulating the Cervical Spine?

The Chartered Society of Physiotherapy (Great Britain) posted this announcement on June 8, 2012: Stop spinal manipulation for neck pain, warn researchers.

Neil O’Connell, lecturer at Brunel University’s Centre for Research and Rehabilitation, advises physical therapists to warn their patients against cervical spinal manipulation whether from physical therapists, chiropractors or osteopaths.

Mr O'Connell argues that there is consistent evidence of an association between spinal manipulation and tears to the lining of the vertebral artery in the neck, which can cause stroke.

Countering Mr. O'Connell's argument is David Cassidy, a Canadian professor of epidemiology at the University of Toronto.

Professor Cassidy argues there is...
  • "...high quality evidence showed that manipulation could clearly benefit patients with neck pain
  • that there was no causal link between manipulation and stroke
  • and that the treatment should remain as an option for therapists."
Mr. OConnell's full text position paper is here.

Professor Cassidy's full text position paper is here.

Mr. OConnell's British Medical Journal article is here. (subscription required)

Professor Cassidy's British Medical Journal article is here. (subscription required)

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.