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Carlesso, CL., Macdermid, CJ., Santaguida, LP., Thabane, L., Giulekas, K., Larocque, L., Millard, J., Williams, C., Miller, J., Chesworth, MB. (2013) 'Beliefs and practice patterns in spinal manipulation and spinal motion palpation reported by canadian manipulative physiotherapists', Physiother Can.2013 Spring;65(2):167-75.

Physiother Can.2013 Spring;65(2):167-75.

Beliefs and practice patterns in spinal manipulation and spinal motion palpation reported by canadian manipulative physiotherapists

L C Carlesso, J C Macdermid, P L Santaguida, L Thabane, K Giulekas, L Larocque, J Millard, C Williams, J Miller, B M Chesworth

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.

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