Thoracic manipulative practice: risks and benefits

In recent years attention has be drawn to the risks, in" rel="nofollow">includin" rel="nofollow">ing adverse events of performin" rel="nofollow">ing orthopaedic manipulative techniques to the spin" rel="nofollow">ine in" rel="nofollow">in physiotherapy practice. As a result the International Federation of Orthopaedic Manipulative Physical Therapist has developed an evidence based framework and consensus document to assist clin" rel="nofollow">inicians in" rel="nofollow">in reasonin" rel="nofollow">ing through the relative risk for use in" rel="nofollow">in practice. Whilst this is focused to the cervical spin" rel="nofollow">ine, the reported risk of thoracic manipulative techniques remain" rel="nofollow">ins a relatively unexplored area. Recent research has reported a range of adverse events followin" rel="nofollow">ing thoracic thrust techniques, in" rel="nofollow">includin" rel="nofollow">ing mechanical/vascular in" rel="nofollow">injury to the spin" rel="nofollow">ine, pneumothorax, hamothorax and CSF leakage, albeit in" rel="nofollow">in a small numbers. Researchers suggest that that clin" rel="nofollow">inicians may not adequately screen for contrain" rel="nofollow">indications and precautions prior to undertakin" rel="nofollow">ing thoracic thrust techniques despite a reported higher in" rel="nofollow">incidence of side effects for patients receivin" rel="nofollow">ing thoracic thrust techniques compared to the cervical spin" rel="nofollow">ine. With a body of evidence now advocatin" rel="nofollow">ing the use of thoracic thrust techniques over the higher risk cervical manipulative techniques for presentations such as neck pain" rel="nofollow">in it is important to consider the safety of such techniques. This PhD will in" rel="nofollow">include as part of the research a critical review the current evidence of adverse events and side effects of usin" rel="nofollow">ing thoracic thrust techniques across all manipulative therapy professions. This will then in" rel="nofollow">inform a Delphi study to explore and derive a consensus of precautions and contrain" rel="nofollow">indications for the use of OMT in" rel="nofollow">in the thoracic spin" rel="nofollow">ine in" rel="nofollow">includin" rel="nofollow">ing thoracic thrust techniques, mobilisations and exercise. Dear writer , the research proposal must in" rel="nofollow">include : Aims/objective Hypothesis research question research approach and methodology proposed data analysis ethical issue