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Knowledge and use of craniovertebral instability testing by Australian physiotherapists
1School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, 2308, Australia. Peter.Osmotherly@newcastle.edu.au
Manual Therapy
|February 5, 2011
Summary
Australian physiotherapists lack consensus on defining and screening for craniovertebral instability (CVI) before manual therapy. This confusion impacts clinical practice and guideline development for cervical spine manipulation.
Area of Science:
- Physiotherapy
- Manual Therapy
- Spinal Biomechanics
Background:
- Formalized guidelines for pre-manipulative screening of the cervical spine are increasingly adopted internationally.
- Craniovertebral instability (CVI) testing remains a controversial aspect of pre-manipulative screening protocols.
Purpose of the Study:
- To investigate the current practices, knowledge, and attitudes of Australian physiotherapists concerning pre-manipulative testing for CVI.
- To identify discrepancies in understanding and application of CVI screening among Australian physiotherapists.
Main Methods:
- A formally validated questionnaire was distributed to members of Musculoskeletal Physiotherapy Australia.
- Survey data were analyzed, with sub-group analysis based on postgraduate musculoskeletal qualifications.
Main Results:
- Respondents exhibited varied definitions of CVI, with significant disagreement on its nature and presentation.
- Over half of respondents rarely or never used specific stress tests for CVI screening.
- While 87% supported including CVI information in guidelines, recommendations for specific screening tests lacked broad support, especially from those with postgraduate qualifications.
Conclusions:
- There is a notable lack of consensus regarding the definition and clinical presentation of CVI among Australian physiotherapists.
- Inconsistent clinical testing for CVI reflects an underlying confusion and insufficient knowledge.
- Current willingness and knowledge are inadequate for recommending robust guidelines for CVI screening in pre-manipulative practice.
