quiz 6 - 8,9,57 Flashcards
8
what is evidenced based health care
system of practices that optimizes patient care by combining clinical expertise with the best available external scientific basis
8
what is the best way of determining the evidence for the efficacy of treatment for a given condition
performing a high quality systematic review of all available published randomized clinical trials on topic
8
is there any scientific evidence for the efficacy of spinal manipulation for the treatment of LBP
some evidence on the short term efficacy, especially in the treatment of acute but also chronic LBP. insufficient data availible to draw firm conclusions regarding the efficacy for lumbar radiculopathy caused by confirmed disc herniation
8
s there any scientific evidence for the efficacy of spinal manipulation for the treatment of neck pain
emerging evidence from the existing randomized trials suggests that manipulation and mobilization have effects that are similar to commonly used treatment such as PT and exercise but appear superior to usually medical care. there is a need for more high quality trials and synthesis of existing trials in new, updated, systemic review
8
most important areas that need to be addressed regarding the effectiveness of chiro spinal manipulations
need to determine the best types of manipulation for different types of musculoskeletal conditions in various types of patients, as well as the optimal dose and frequency of manipulation
9
effectiveness of manipulations on non-musculoskeletal conditions
spinal joint dysfunction lead to dysfunction in vasomotor, sudomotor and secretory motor control
9
how many randomized controlled clinical trials have been conducted of spinal manipulation in the treatment of tension-headaches? migraines? cervicogenic headaches?
tension headache- 3
migrains - 3
cervicogenic - 4
9
how would you characterize the results of the scientific evidence for the effectiveness of spinal manipulation on asthma?
4 randomized trials 4 case series 2 case reports no difference between sham adjustments and the real thing did improve quality of life
9
characterize the result of three randomized trials of chiro care for infantile colic
2 showed beneficial of chiro care
1 showed it was unable to demonstrate a difference
9
what is the state of the evidence base for the treatment by spinal manipulation of non-musculoskeletal conditions which are not predominated by pain
state of evidence is poor
frew randomized trials, case series, or case reports
additional research needs to be done
57
estimated rate of post - SMT CVA?
1/400,000 per 5.8 manipulations
57
common vascular lesion associated with SMT
dissection of the vertebral artery at the level of upper cervicals
57
know factors associated with dissection of cervical cerebral blood vessels?
vertebral artery anomalies fibromuscular dysplasia medical cystic necrosis CT abnormalities genetic disorders of collagen inherited factors upper respiratory tract infection precursor lesioins trauma
57
clinical presentation of a patient suffering from a vertebral artery dissection
severe pain 1 side of head/neck dizziness drop attacks diplopia dysarthria dysphagia ataxia of gait nausea numbness on 1 side of face/body nystagmus hemianesthesia hemiparesis/monoparesis dysphasia confusion visual field disturbance
57
neurological conditions that should be watched carefully when treating a patient with lumbar or cervical disc syndromes?
progressive radiculopathy
myelopathy
cauda equina
