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MACP and Cervical Artery Dysfunction Review (Click here)

Cervical Artery Dysfunction and the risks of moving the cervical spine.
A critical review of the evidence base was commissioned in 2004 by the Manipulation Association of Chartered Physiotherapists (MACP) in response to demands from the MACP membership. The demands suggested an uncertainty among the members regarding the nature of arterial insufficiency related to the cervical spine (commonly referred to as vertebrobasilar insufficiency (VBI)), the risks of manual therapy with respect to such arterial complications, and the MACP's position on pre-cervical spine treatment screening. The review was undertaken by an international group of clinicians and academics and was published on the MACP website in 2005, being made freely available to all.

The document was a consultation document and comment was invited from all relevant stakeholders. The 2005 review has now been amended in response to the feedback received and in light of more recent evidence. The updated review provides an evidence-based information source to further facilitate clinicians understanding of the effect of manual therapy on the cervical spine with regards to cervical blood flow. The document is designed to assist clinicians in their clinical reasoning during their assessment of neck pain and headache in relation to potential neurovascular dysfunction. It is an investigation of a wide range of vascular conditions of the cervico-cranial region and their relationship to manual therapy and movement of the neck.

The document is NOT a clinical guideline, but DOES provide evidence-based information which may assist in differential diagnosis and pre-treatment screening. The MACP recommends the clinician approaches these clinical issues using the same evidence based clinical decision making processes that are widely advocated in today's health care environment. There are considerable resources on the World Wide Web to guide clinical decision making, examples of which can be found via the links below.

Dr Chris McCarthy
Honorary Chair of the MACP
2007

http://www.intute.ac.uk/healthandlifesciences/

http://www.csp.org.uk/director/effectivepractice.cfm

http://www.haemodynamics.com/downloads.php