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22
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Graduate
11/30/2013

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Term
Walker 2008 SPINE
Definition
The Effectiveness of Manual Physical Therapy and Exercise for Mechanical Neck Pain
Term
Walker Objective
Definition
To assess the effectiveness of manual physical therapy and exercise (MTE) for mechanical neck pain
with or without unilateral upper extremity (UE) symptoms, as compared to a minimal intervention (MIN) approach
Term
Walker Background
Definition
Mounting evidence supports the use of manual therapy and exercise for me-
chanical neck pain, but no studies have directly assessed its effectiveness for UE symptoms
Term
Walker Results
Definition
The MTE group demonstrated significantly larger reductions in short- and long-term neck disability
index scores
Term
Walker Conclusion
Definition
An impairment-based MTE program re-
sulted in clinically and statistically significant short- and
long-term improvements in pain, disability, and patientperceived recovery in patients with mechanical neck pain when compared to a program comprising advice, a mobility exercise, and sub-therapeutic ultrasound
Term
Walker MIN group (control)
Definition
Patients in the MTE group received manual physical therapy
interventions specifically targeted to impairments identified during the physical examination. Each treatment session consisted of 1 to 3 manual interventions such as thrust and nonthrust joint mobilization, muscle energy, or stretching techniques commonly used in clinical practice.
Therapists were not limited in the
selection of treatment techniques or the region to be treated. All
patients in the MTE group were provided with a standard home
exercise program of cervical retraction, deep neck flexor strength-
ening,and cervical rotation ROM exercises. Physical therapists could prescribe additional exercises to target specific impairments or reinforce the manual interventions.
Term
Walker MTE group (treatment)
Definition
Patients in the MIN group received a basic treatment plan consistent with general practitioner care. Patients were provided with a basic regimen of postural advice, encouragement to maintain neck motion and daily activities, cervical rotation ROM ex-
ercise, and instructions for continued prescription medication use.
Minimalist physical therapy treatments consisted of subtherapeu-
tic pulsed (10%) ultrasound at 0.1 W/cm 2 for 10 minutes applied
to the cervical spine and cervical rotation ROM exercises. Placebo
ultrasound was included in this intervention approach to balance
therapist-patient interaction times between groups and to maintain patient expectations for physical therapy treatment and subsequent improvement. Patients were blinded to the use of sub-therapeutic ultrasound dosages.
Term
Cook 2010 Journal of Manual and Manipulative Therapy
Definition
Clustered clinical findings for diagnosis of cervical spine myelopathy
Term
Cook 10 findings tested
Definition
Age >45 years
Spurling’s test
Distraction test
Hoffmann’s test
Clonus
Babinski test
Gait deviation
Hyper-reflexia biceps
Inverted supinator sign
Hyper-reflexia quadriceps
Hyper-reflexia Achilles
Pain score
Pain constancy
Term
Cook: Spurlings
Definition
It involves turning the patient's head to the affected side and applying downward pressure to the top of the patient's head. If radicular pain is elicited, this is called a positive Spurling's sign
Term
Cook:Hoffmans
Definition
The test involves tapping the nail or flicking the terminal phalanx of the middle or ring finger. A positive response is seen with flexion of the terminal phalanx of the thumb.
Term
Cook:inverted supinator
Definition
How to perform: Using reflex hammer, strike the brachioradialis tendon near radial styloid process at distal end of radius
Positive test: Finger flexion
Term
Cook:Gait
Definition
incidence of abnormally wide
based gait, ataxia, or spastic gait.
Term
Cook: meaningful findings clustered
Definition
gait deviation
Hoffmann’s test
inverted supinator sign
Babinski test
age >45 years
Term
Cook: clusters Sensitivity/Specificity
Definition
1/5 (+) 31%SP, 4/5 (+)100% SP
1/5 (+) 94%SN, 4/5 (+) 9% SN
Term
Cook: conclusion
Definition
Combinations of three of five or four of five tests enabled adjustments of post-test probability of the
condition to 94–99%. These clusters may be useful in identifying patients with this complex diagnosis in
similar patient populations.
Term
Whitcroft: 2010 SPINE
Definition
Comparison of Methods of Measuring Active Cervical Range of Motion
Term
Whitcroft:Objective
Definition
to compare the reliability and accuracy of visual estimation, tape measurement, and the universal
goniometer (UG) with that of the CROM goniometer in measuring active CROM in healthy volunteers. The sec-
ondary objective was to identify the single neck movement that best represents overall range of motion.
Term
Whitcroft:Background
Definition
Neck movement is affected by pathology in the spine and shoulder. A reliable and accurate measurement of neck movement is required to quantify injury, recovery, and disability.
Term
Whitcroft:Methods
Definition
Active cervical flexion, extension, right and left lateral flexion and rotation were measured in 100 healthy volunteers
Term
Whitcroft: Results
Definition
Compared with the CROM goniometer, the
UG aligned on fixed landmarks was the most accurate method, followed by the UG on anatomic landmarks. The
reliability of the UG was between substantial and perfect. Visual estimation was reproducible but measured range of movement inaccurately. Tape measurement was inaccurate. Extension best reflected overall range
Term
Whitcroft:Conclusion
Definition
The UG aligned on a fixed landmark is
most reliable method of measuring neck movement clinically. Where range must be quickly assessed, extension should be measured
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