Vertebral Artery Test: Difference between revisions
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== Evidence == | == Evidence == | ||
The test is commonly used for over the past 30 years<ref name="2" />. The reduction of the lumen has been reported by many authors, but a lot of these studies weren’t sufficient enough because of lack of good samples of normal people and VBI patients over a wide range of age. Therefore, those results may be controversial<ref name="1" /><ref name="6">Symons BP, Leonard T, Herzog W; Internal forces sustainedby the vertebral artery during spinal manipulative therapy; Manual Therapy; 2002</ref>.<br>There are a lot of inconsistencies in the studies also. The review of Mitchell et al. says that in 7 of the 20 studies, there was not found any loss of blood flow in the VA<ref name="1" />. Because of the inconsistency in the literature, there will be false positive/negative blood flow results in cervical spine rotation. Therefore, the | The test is commonly used for over the past 30 years<ref name="2" />. The reduction of the lumen has been reported by many authors, but a lot of these studies weren’t sufficient enough because of lack of good samples of normal people and VBI patients over a wide range of age. Therefore, those results may be controversial<ref name="1" /><ref name="6">Symons BP, Leonard T, Herzog W; Internal forces sustainedby the vertebral artery during spinal manipulative therapy; Manual Therapy; 2002</ref>.<br>There are a lot of inconsistencies in the studies also. The review of Mitchell et al. says that in 7 of the 20 studies, there was not found any loss of blood flow in the VA<ref name="1" />. Because of the inconsistency in the literature, there will be false positive/negative blood flow results in cervical spine rotation.<ref name="1" /><br> | ||
‘Côté et al.’ sais that the positive predictive value of this test(the proportion of subjects with a positive test who are correctly diagnosed) is 0%, and the negative predictive value of this test ranged from 63%-97%. The test was found not valid enough to detect a reduced blood flow in the VA. Therefore, the value of this test as a clinnical screening procedure is questionable.<ref name="1" /><ref name="7">Côté P et al.; The validity of the extension-rotation test as a clinical screening procedure before neck manipulation: a secondary analysis; J Manipulative Physiol Ther;. 1996 Mar-Apr;19(3):159-64</ref>.<br> | |||
== Resources == | == Resources == |
Revision as of 12:45, 22 November 2011
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Search Strategy[edit | edit source]
Search engines:
• PubMed
• Web of Knowledge
• http://scholar.google.be/
Key Words
• Vertebral Artery Test
• Extension Rotation Test
• Vertebral artery flow
• Vertrebrobasilar ischiaemia
Purpose
[edit | edit source]
The vertebral artery test is used in physiotherapy to test the vertebral artery blood flow, searching for symptoms of vertebral artery diseaseCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title. Vertebral artery disease is also known as vertebrobasilar ischaemia (VBI)Cite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title.
Technique
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To test the blood flow in the vertebral artery (VA), one should put the patient on his back and perform an passive extension, followed by a passive rotation of the neckCite error: Invalid <ref>
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tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title. The rotation should be performed in both directionsCite error: Invalid <ref>
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The manoeuvre causes a reduction of the lumen of the intracranial VA of the contralateral sideCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title. results in dizziness, nausea, syncope, dysarthria, dysphagia, and disturbances of the hearing or vision, paresis or paralysis of patients with VBICite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title.
To have a demonstration of the technique, click here
Evidence[edit | edit source]
The test is commonly used for over the past 30 yearsCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title. The reduction of the lumen has been reported by many authors, but a lot of these studies weren’t sufficient enough because of lack of good samples of normal people and VBI patients over a wide range of age. Therefore, those results may be controversialCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title.
There are a lot of inconsistencies in the studies also. The review of Mitchell et al. says that in 7 of the 20 studies, there was not found any loss of blood flow in the VACite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title. Because of the inconsistency in the literature, there will be false positive/negative blood flow results in cervical spine rotation.Cite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title
‘Côté et al.’ sais that the positive predictive value of this test(the proportion of subjects with a positive test who are correctly diagnosed) is 0%, and the negative predictive value of this test ranged from 63%-97%. The test was found not valid enough to detect a reduced blood flow in the VA. Therefore, the value of this test as a clinnical screening procedure is questionable.Cite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref>
tag; name cannot be a simple integer. Use a descriptive title.
Resources[edit | edit source]
add any relevant resources here