Sweeney Aoife, Doody Catherine
School of Physiotherapy and Performance Science, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
Man Ther. 2010 Feb;15(1):32-6. doi: 10.1016/j.math.2009.05.007. Epub 2009 Jul 25.
The purpose of this study was to determine the use of manipulation and mobilisation by the Chartered Physiotherapists (CMPT) in Manipulative Therapy Ireland and to describe adverse effects associated with the use of these techniques. A 44 item postal survey was sent to all 259 members of the CPMT (response rate 49%, n=127). All 127 respondents used non-High Velocity Thrust Techniques (HVTT) and 27% (n=34) used HVTT. Nine percent (n=12) used HVTT on the upper cervical spine. Twenty six percent (n=33) reported an adverse effect in the previous 2 years. The adverse effects were associated with the use of HVTT (4%, n=5), non-HVTT (20%, n=26) and cervical traction (2%, n=2). The most serious adverse effects were associated with non-HVTT and included 1 drop attack, 1 fainting episode and 1 Transient Ischemic Attack (TIA) 4 days post treatment. Fifty three percent (n=18) of HVTT users and 40% (n=44) of non-HVTT users reported carrying out a vertebrobasilar insufficiency (VBI) assessment. The study shows that VBI assessment may not detect every patient at risk of adverse effects. Large scale studies to investigate the risk of serious adverse reactions are needed. A system of reporting adverse effects on a routine basis could be considered.
本研究的目的是确定爱尔兰手法治疗特许物理治疗师（CMPT）对手法操作和松动术的使用情况，并描述与使用这些技术相关的不良反应。向CPMT的所有259名成员发送了一份包含44个条目的邮政调查问卷（回复率49%，n = 127）。所有127名受访者都使用了非高速推力技术（HVTT），27%（n = 34）使用了HVTT。9%（n = 12）在上颈椎使用了HVTT。26%（n = 33）报告在过去两年中有不良反应。不良反应与HVTT的使用（4%，n = 5）、非HVTT的使用（20%，n = 26）和颈椎牵引（2%，n = 2）有关。最严重的不良反应与非HVTT有关，包括1次猝倒发作、1次昏厥发作和治疗后4天的1次短暂性脑缺血发作（TIA）。53%（n = 18）的HVTT使用者和40%（n = 44）的非HVTT使用者报告进行了椎基底动脉供血不足（VBI）评估。该研究表明，VBI评估可能无法检测出每一位有不良反应风险的患者。需要进行大规模研究以调查严重不良反应的风险。可以考虑建立一个定期报告不良反应的系统。
