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Physiother Can. 2013 Spring;65(2):167-75. doi: 10.3138/ptc.2012-11.

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

Author information

  • 1Department of Clinical Epidemiology and Biostatistics.
  • 2School of Rehabilitation Sciences ; Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre.
  • 3Centre for Evidence Based Medicine; McMaster University, Hamilton.
  • 4School of Physical Therapy.
  • 5School of Physical Therapy ; Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Ont.

Abstract

in English, French

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.

KEYWORDS:

beliefs; palpation; spinal manipulation; utilization

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