Dr. Firas Mourad

Workshop Title: 

Reconceptualizing Cervical Thrust Manipulation: Important Aspects For Safety and Effectiveness

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Workshop Objectives:

Cervical thrust manipulation (CTM) is considered an adjuvant intervention to education and exercise therapy within a multimodal care pathway. Nevertheless, CTM recommendation as a first-line intervention is conflicting among clinical practice guidelines. All the above, lead to strongly debate regarding hands-on treatment, raising the suggestion of abandoning CTM. The World Health Organization consider CTM to be a safe and effective, with few, mild, transient adverse events. Anecdotal evidence reported cervical artery dissection and vertebrobasilar artery stroke following CTM. However, although strong evidence suggests that CTM may not be the direct cause of serious adverse events, anxiety regarding safety has been still reported as one of the major barriers to its use. Therefore, it is paramount that clinicians who utilize CTM are well informed of their safety and how to enact CTM within clinical practice guidelines’ recommendations and their daily practice. Historically, spinal manipulation was considered to operate through biomechanical and neurophysiological mechanisms, but their interaction was frequently not considered. In addition, results from randomized controlled trials must be interpreted according to limitations and heterogeneity of the available studies and the lack of knowledge of spinal manipulation mechanisms.

During the workshop participant will learn the updated knowledge surrounding CTM for its technical delivery, the mechanisms behind its effectiveness, its indications, and safety. Therefore, this session will focus on contemporary knowledge regarding CTM, in order to prompt clinicians to be able to make sense of the heterogeneity of evidence, and reconceptualize CTM in their daily practice.