Hurley L, Yardley K, Gross A R, Hendry L, McLaughlin L
Department of Physiotherapy, University of Toronto, Ontario, Canada.
Man Ther. 2002 Feb;7(1):10-8. doi: 10.1054/math.2001.0430.
As part of the process of developing a Clinical Practice Guideline (CPG) on cervical spine manipulation (CSM), a working group sent out an 82-item postal survey to 150 randomly selected Ontario physiotherapists (PTs) who perform spinal manipulation, to collect information on the socio-demographics, practices, opinions of risk, and attitudes towards CPGs of these PTs (n = 118; response rate = 79%). Of the 118 respondents who performed spinal manipulation, 41 performed CSM. Respondents strongly agreed with three out of six indications listed in the survey for applying CSM: segmental fixation, stiff but stable joint, internal derangement (over 70%). Respondents also strongly agreed (over 88%) that all screening tests listed in the survey should be performed prior to applying CSM: tests for irritability, stability, vascular and neurological systems. Respondents rated patient education, other manual therapy, and exercise as the most common adjuncts to CSM (over 88%). Respondents reported seeing mild complications or side effects only rarely following the application of CSM. Fourteen percent of respondents reported having a written CSM policy or CPG on CSM in their work setting. Feedback from this survey will be used in developing a CSM CPG. A future survey will evaluate changes in clinical practice and in attitudes toward CPGs some time after the dissemination of the CSM CPG.
作为制定颈椎推拿临床实践指南（CPG）过程的一部分，一个工作小组向安大略省150名随机挑选的从事脊柱推拿的物理治疗师（PT）发放了一份包含82个项目的邮政调查问卷，以收集这些PT的社会人口统计学信息、实践情况、风险看法以及对CPG的态度（n = 118；回复率 = 79%）。在118名从事脊柱推拿的受访者中，41人进行颈椎推拿。受访者强烈同意调查问卷中列出的六项颈椎推拿适应证中的三项：节段性固定、僵硬但稳定的关节、内在紊乱（超过70%）。受访者还强烈同意（超过88%）在进行颈椎推拿之前应进行调查问卷中列出的所有筛查测试：激惹性测试、稳定性测试、血管和神经系统测试。受访者将患者教育、其他手法治疗和运动评为颈椎推拿最常见的辅助手段（超过88%）。受访者报告称，在进行颈椎推拿后仅很少见到轻微并发症或副作用。14%的受访者报告在其工作场所拥有关于颈椎推拿的书面政策或CPG。本次调查的反馈将用于制定颈椎推拿CPG。未来的一项调查将在颈椎推拿CPG发布一段时间后评估临床实践的变化以及对CPG态度的变化。
