Several weeks ago, I placed a survey for all to provide their answer to whether or not a premanipulative hold is necessary prior to performing an OMT procedure to the cervical spine. Thanks for everyone who participated! Here are the results:
Interesting results in regards to 50% of the readers (half of the clinicians!) thought we should discontinue the pre-manipulative hold. That is quite a response for our very conservative practice patterns. How do these results compare to a similar study in 2004 in Manual Therapy??…see figure below:
This figure is taken off of an upcoming powerpoint slide for a lecture I’m teaching (reason for more bullet points). But, quite different results! My survey resulted in 50% of individuals endorsing discontinuing the pre-manipulative hold compared to only 12% in a prior survey.
-The comparison study surveyed Musculoskeletal physiotherapy members in Australia, had 419 responses and published in 2004.
-My survey only had 22 responses, was not limited to any country or additional training, and reported over 10 years later in 2013.
So, over the course of a decade, have we learned more about the pathophysiology of cervical artery dysfunction (CAD), more studies to show that we are less able to predict a dissection, and/or improved clinical reasoning through our subjective profiling??
You tell me! I believe it is all 3 of the above.
Did you think the results would be as shown??