Hey Brendon,
Thanks for commenting! I will play devil's advocate here and say, if the test doesn't have any validity or able to screen (rule-out) a condition,...is it even worth it?
Meaning, if it was negative, then an unfortunate event occurred post-manipulation or even mob/stretch/etc; from a medico-legal standpoint, can you have support?
Hv
Brendon Blake PT - 11 years ago
Very interesting question! I've pondered this a lot. My current thinking is, why not do the test. It doesn't take long, it's time to settle the patient down and ask about their day. What if it's a 1/1000 chance you catch something, that hasn't shown up in research yet. There has been more and more discussion about the surprising anomalous location of the vertebral artery, does this matter? There are still enough unknowns, that I don't mind taking the extra few seconds, just for peace of mind.
Hey Jon,
Yes, good comment. Roger has put out 2 pieces of literature I believe showing several case reports where BP readings led to clinical decision making.
Honestly, I put BP readings ahead of pre-manip hold for my clinical decision making.
Hv
Jon - 11 years ago
Went I saw Roger Kerry and Alan Taylor talk about CAD they stated how important BP readings were and suggested these should be the first part to ANY cervical spine examination, before ROM etc etc
Hey Brendon,
Thanks for commenting! I will play devil's advocate here and say, if the test doesn't have any validity or able to screen (rule-out) a condition,...is it even worth it?
Meaning, if it was negative, then an unfortunate event occurred post-manipulation or even mob/stretch/etc; from a medico-legal standpoint, can you have support?
Hv
Very interesting question! I've pondered this a lot. My current thinking is, why not do the test. It doesn't take long, it's time to settle the patient down and ask about their day. What if it's a 1/1000 chance you catch something, that hasn't shown up in research yet. There has been more and more discussion about the surprising anomalous location of the vertebral artery, does this matter? There are still enough unknowns, that I don't mind taking the extra few seconds, just for peace of mind.
Hey Jon,
Yes, good comment. Roger has put out 2 pieces of literature I believe showing several case reports where BP readings led to clinical decision making.
Honestly, I put BP readings ahead of pre-manip hold for my clinical decision making.
Hv
Went I saw Roger Kerry and Alan Taylor talk about CAD they stated how important BP readings were and suggested these should be the first part to ANY cervical spine examination, before ROM etc etc