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Stroke and Manipulation - Chiropractic Doctor


Stroke and Manipulation 105
Clinical Aspects of Cervical Artery Strokes

1.0

$20.00 USD

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  • Cite the strength of evidence about whether chiropractic neck manipulation causes cervical artery dissection (CAD) based on a systematic review, meta-analysis, and evaluation of the body of evidence as a whole
  • Summarize our current state of knowledge on cervical artery dissection and how it impacts the practice of cervical spinal manipulation
  • Outline the state of knowledge regarding bedside diagnosis and management of an acute vestibular syndrome, with the suspicion for stroke 
  • Describe the demographics, past health care utilization, and comorbidities of vertebrobasilar artery stroke patients in Ontario, Canada who consulted a chiropractor within one year prior to their stroke
  • Analyze the nature of internal carotid artery biomechanics and associated risk of injury during cervical spinal manipulation

Shawn Thistle, DC

Downloadable Course in PDF
Journal Article Review
Text

Stroke and Manipulation 104

Cervical Spinal Manipulative Therapy (CSMT) and Vertebrobasilar Ischemia (VBI)


8.0

$160.00 USD

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  • Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
  • Review and describe cerebrovascular anatomy and hemodynamics.
  • Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia.
  • Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
  • Identify radiographic signs of a vertebral artery dissection.
  • List and discuss the uses, pros and cons of current examination tools as they apply to vertebral artery dissection.
  • Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis.
  • Define and contrast currently suggested procedures and develop a vertebrobasilar ischemia plan of action.
  • Explore various perspectives and reveal bias in both public media and biomedical journals.
  • Identify and define new theoretical concepts and prophylactic therapies.
  • Give multiple examples of anti-chiropractic bias in the biomedical literature
  • List and describe the most common red flags for a patient “at risk” for suffering Vertebrobasilar Ischemia following cervical manipulation.
  • Recite list of scientific studies relating to laboratory testing of plasma Homocystine levels and its relationship to Vertebrobasilar Ischemia from vertebral artery dissection.
  • List examples of bias against chiropractic cited in both the popular media as well as in biomedical journals.
  • Critically review landmark articles regarding the issue of cervical manipulation and vertebrobasilar distribution ischemia.
  • List studies suggesting that a high plasma homocystine level may be associated with vertebrobasilar dissection.
  • Cite studies suggesting that increasing folic acid intake can reduce plasma Homocystine levels.
  • Identify laboratory tests that may be useful in helping calculate an individual’s risk of suffering vertebrobasilar stroke following cervical manipulation.

Joseph Ferezy, DC, DACAN, FIACN

AudioVisual Course

Stroke and Manipulation 103
Risk, Association, Screening and Blood Flow

1.0

$20.00 USD

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  • Compare the risk of injury (via Medicare data) between two cohorts of patients treated by chiropractic spinal manipulation versus treatment by a primary care physician
  • Investigate the association between chiropractic manipulative treatment and vertebrobasilar artery stroke
  • Assess the level and quality of evidence regarding the potential association between cervical manipulation and cervical artery dissection/stroke
  • Evaluate the diagnostic accuracy of premanipulative vertebrobasilar tests in terms of sensitivity, specificity, predictive values and likelihood ratios in adults
  • Observe vertebral artery blood-flow after cervical manipulation and various head positions

Shawn Thistle, DC

Downloadable Course in PDF
Journal Article Review
Text

Stroke and Manipulation 102

SMT in the Medicare Population - Risks, Facts, and Figures


1.0

$20.00 USD

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  • Compare the associations of chiropractic care and stroke with primary care physician (PCP) care and stroke in the Medicare population
  • Quantify risk of stroke after chiropractic spinal manipulation, as compared to evaluation by a primary care physician, for Medicare beneficiaries aged 66 to 99 years with neck pain
  • Determine the hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under cervical rotatory manipulation: a finite element analysis
  • Review compensation claims for chiropractic in Denmark and Norway 2004-2012
  • Examine the risk of traumatic injury associated with chiropractic SMT in the Medicare population

Dean Smith, DC, PhD

AudioVisual Course

Stroke and Manipulation 101

Stroke and Spinal Manipulation: Anatomy, Epidemiology, Pathogenesis of Dissections and Triggers, Neurological Syndromes, Clinical Management


2.0

$40.00 USD

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  • Illustrate the pathogenesis of CADs ­dissection mechanisms
  • Identify putative causes and triggers of CAD
  • Estimate the purported incidence of cerebrovascular syndromes following cervical manipulation
  • Distinguish between the neurological syndromes
  • Identify stroke risk factors in general
  • Assess the value of pre-manipulation testing: to screen or not to screen?
  • Outline the warning signs/symptoms of CAD
  • Indicate what to include in the patient history and examination
  • Describe what to do if you suspect CAD
  • Point out how to communicate risk to patients as well as implementing strategies to prevent CAD
  • Assess the current literature on the relationship between stroke and manipulation
  • Describe the anatomy of the blood supply to the brain
  • Summarize the clinical biomechanics of vertebral arteries
  • Outline the epidemiology and classification of cervicocerebral (vertebral and internal carotid) arterial dissections (CAD) or strokes
  • Recognize the diseases affecting cervicocerebral arteries

Dean Smith, DC, PhD

AudioVisual Course