Beliefs and Practice Patterns in Spinal Manipulation and Spinal Motion Palpation Reported by Canadian Manipulative Physiotherapists

Author:

Carlesso Lisa C.1,Macdermid Joy C.23,Santaguida P. Lina4,Thabane Lehana1,Giulekas Kevin5,Larocque Leo5,Millard James5,Williams Caitlin5,Miller Jack5,Chesworth Bert M.56

Affiliation:

1. Department of Clinical Epidemiology and Biostatistics

2. School of Rehabilitation Sciences

3. Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre

4. Centre for Evidence Based Medicine; McMaster University, Hamilton

5. School of Physical Therapy

6. Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ont.

Abstract

Purpose: This practice survey describes how Fellows of the Canadian Academy of Manipulative Physiotherapy (FCAMPT) use spinal manipulation and mobilization and how they perceive their competence in performing spinal assessment; it also quantifies relationships between clinical experience and use of spinal manipulation. Methods: A cross-sectional survey was designed based on input from experts and the literature was administered to a random sample of the FCAMPT mailing list. Descriptive (including frequencies) and inferential statistical analyses (including linear regression) were performed. Results: The response rate was 82% (278/338 eligible FCAMPTs). Most (99%) used spinal manipulation. Two-thirds (62%) used clinical presentation as a factor when deciding to mobilize or manipulate. The least frequently manipulated spinal region was the cervical spine (2% of patients); 60% felt that cervical manipulation generated more adverse events. Increased experience was associated with increased use of upper cervical manipulation among male respondents (14% more often for every 10 years after certification; β, 95% CI=1.37, 0.89–1.85, p<0.001) but not among female respondents. Confidence in palpation accuracy decreased in lower regions of the spine. Conclusion: The use of spinal manipulation/mobilization is prevalent among FCAMPTs, but is less commonly used in the neck because of a perceived association with adverse events.

Publisher

University of Toronto Press Inc. (UTPress)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

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