International Framework for Examination of the Cervical Region
Occasionally physical therapists are approached by the media to make comment on cervical manipulation and its associated risks. The following points may be of use in responding to such requests:
- Patient integrity is central to any response.
- Spinal manipulation is frequently a component of a package of care offered by physical therapists to individuals with spinal pain.
- Physical therapists should only comment on the practice of OMT within their profession and Member Organisation and refrain from commenting on the practice of other professions.
- Registration / certification / licensure to practice as a physical therapist requires rigorous professional entry competencies and professional standards to be met by the educational programme.
- A rigorous national and international process ensures the standards for OMT for each post-qualification educational programme in each country which is a MO of IFOMPT. The OMT academic curriculum includes the study of anatomy, biomechanics, physiology, pathology, function and physical examination and treatment.
- This OMT curriculum meets the international educational standards set by IFOMPT (a subgroup of the World Confederation for Physical Therapy, a member of the World Health Organisation) and provides a strong foundation for manual therapy, including spinal joint manipulation in physical therapy practice.
- Graduates of OMT are highly educated in the use of spinal manipulation with selected patients and for specific neuromusculoskeletal conditions to reduce pain, improve mobility and optimise function. Spinal manipulation is not appropriate for use in all clinical situations or with all patients.
- Physical therapists who practice OMT are committed to the delivery of evidence-based, safe, and effective health care and minimise the risks associated with spinal manipulation by:
- Conducting a thorough assessment prior to treatment to screen for patients who may be at risk. Patients are reassessed after all treatments.
- Using spinal manipulation only when it has been determined to be the best treatment choice. A decision to proceed with manipulation is based on all the clinical findings from the patient history and physical examination.
- Informing the patient about associated risks and obtaining the patient’s informed consent for the treatment through a shared decision making process.
- OMT management includes providing information to the patient on maintaining treatment effectiveness through appropriate exercises and other self-management, as well as how to identify and respond to the development of any adverse effects that may occur subsequent to treatment.
- OMT physical therapists are at the forefront of research on the safety and efficacy of manipulation. For example, IFOMPT is leading an international collaboration on ‘best practice’ for cervical spine assessment and treatment.
- Key reference recommendations[1][2][3][4][5].
- ↑ Bronfort G, Hass M, Evans RL, et al (2004). Efficacy of Spinal Manipulation and Mobilization for Low Back Pain and Neck Pain: A Systematic Review and Best Evidence Synthesis. Spine Journal 4(3):335–356.
- ↑ Rubinstien SM, Saskia M. Peerdeman SM, et al (2005). A systematic review of risk factors for cervical artery dissection. Stroke 36: 1575-80.
- ↑ Gross A, Goldsmith C, Hoving JL, et al (2007). Conservative management of mechanical neck disorders: a systematic review. Journal of Rheumatology 34(5):1083-1102.
- ↑ IFOMPT (2008). IFOMT Educational Standards Document. ↑ Kerry R, Taylor AJ, Mitchell JM, et al (2008). Cervical arterial dysfunction and manual therapy: A critical literature review to inform professional practice. Manual Therapy 13(4):278-288.
