Vertebral Artery Test: Difference between revisions
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== Purpose<br> == | == Purpose<br> == | ||
The vertebral artery test is used in physiotherapy to test the vertebral artery blood flow, searching for symptoms of vertebral artery disease<ref name="1">Jeanette Mitchell; Doppler insonation of vertebral artery blood flow changes associated with cervical spine rotation: Implications for manual therapists; Physiotherapy Theory and Practice; 2007; 23(6):303-313</ref><ref name="2">R. Grant; Vertebral Artery Testing – the Australian Association protocol after 6 years; Manual Therapy; 1996; 1; 149-153</ref><ref name="3">Jeanette A. Mitchell; Changes in vertebral artery flow following normal rotation of the cervical spine; Journal of Manipulative and Physiological Therapeutics; 347-351, 2002</ref>. Vertebral artery disease is also known as vertebrobasilar ischaemia (VBI)<ref name="1" /><ref name="2" /><ref name="5">Jeanette A. Mitchell; Is cervical spine rotation, as used in the standard vertebrobasilar insufficiency test, associated with a measureable change in intracranial vertebral artery blood flow?; Manual Therapy; 2004; 9 ; 220–227</ref>. <br> | The vertebral artery test is used in physiotherapy to test the vertebral artery blood flow, searching for symptoms of vertebral artery disease<ref name="1">Jeanette Mitchell; Doppler insonation of vertebral artery blood flow changes associated with cervical spine rotation: Implications for manual therapists; Physiotherapy Theory and Practice; 2007; 23(6):303-313</ref><ref name="2">R. Grant; Vertebral Artery Testing – the Australian Association protocol after 6 years; Manual Therapy; 1996; 1; 149-153</ref><ref name="3">Jeanette A. Mitchell; Changes in vertebral artery flow following normal rotation of the cervical spine; Journal of Manipulative and Physiological Therapeutics; 347-351, 2002</ref>. Vertebral artery disease is also known as vertebrobasilar ischaemia (VBI)<ref name="1" /><ref name="2" /><ref name="5">Jeanette A. Mitchell; Is cervical spine rotation, as used in the standard vertebrobasilar insufficiency test, associated with a measureable change in intracranial vertebral artery blood flow?; Manual Therapy; 2004; 9 ; 220–227</ref>. <br> | ||
== Clinicallly Relevant Anatomy == | |||
== Technique<br> == | == Technique<br> == | ||
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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.
Clinicallly Relevant Anatomy[edit | edit source]
Technique
[edit | edit source]
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> 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 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> tag; name cannot be a simple integer. Use a descriptive title.
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
