SPINAL MANIPULATIVE THERAPY™ - FisioCampus · PT, OMT, Cert. SMT, Cert. DN, Dip. Osteopractic...

KENZEN FORMACIÓN – ESINFIS - Tel: 655813629 Via Augusta 2B Edificio Windsor Entlo 1ª Escalera B (BARCELONA)

[email protected] www.cursosfisiosysalud.com www.esinfis.com www.esinfis.com

476 CON VÍA AUGUSTA o bien VÍA AUGUSTA 2B. EDIFICIO

WINDSOR Entresuelo 1ª. Escalera B. También acceso por vía augusta frente al Hotel Abba Balmoral

CALENDARIO: SMT-1.- 27 y 28 de Febrero 2016 SMT-2.- 23 y 24 de Abril 2016 SMT-3.- 04 y 05 de Junio 2016 SMT-4.- 03 y 04 Septiembre 2016 Sábados y domingos De 9:00 a 13:00 y de 14:00 a 18:00

SPINAL MANIPULATIVE THERAPY™ SMT- TRATAMIENTO OSTEOPRÀCTICO (HVLA THRUST MANIPULATION)

SMT-1: High-Velocity Low-Amplitude Thrust Manipulation of the Cervical, Thoracic, Lumbar & SI Joints SMT-2: Cervicothoracic Dysfunction & Cervicogenic Headaches: Diagnosis & Management with HVLA Thrust

Manipulation & Exercise SMT-3: Lumbar and Sacroiliac Dysfunction: Diagnosis & Management with HVLA Thrust Manipulation & Exercise SMT-4: Certification in Spinal Manipulative Therapy (Cert. SMT): Comprehensive Review & Comprehensive Oral,

Practical & Written Examination

UN CURSO NOVEDOSO EN ESPAÑA DE GRAN ÉXITO EN EEUU

También disponible Dry Needling DN1 i 2

RECUPERA IMPORTE CURSO BONIFICANDOTELO DE LA

SEGURIDAD SOCIAL CON AYUDAS DE LA FUNDACIÓN TRIPARTITA

Dr. JAMES DUNNING. DPT, MSc Manip Ther, OCS, MTC, MCSP, MAACP (UK), FAAOMPT, MMACP (UK) Director, AAMT Fellowship in Orthopaedic Manual Physical Therapy. Fellow, American Academy of Orthopaedic Manual Physical Therapists (USA). Member, Manipulation Association of Chartered Physiotherapists (UK). Member, Acupuncture Association of Chartered Physiotherapists (UK)

Dr. FIRAS MOURAD. PT, OMT, Cert. SMT, Cert. DN, Dip. Osteopractic Faculty, AAMT Fellowship in Orthopaedic Manual Physical Therapy. Senior Instructor, Spinal Manipulation Institute & Dry Needling Institute. Certified in Spinal Manipulative Therapy & Certified in Dry Needling. Lecturer, Manual Therapy Master (IFOMPT), Università di Roma Tor Vergata, Italy. Lecturer, Sport Rehabilitation Master, Università di Pisa, Italy

Certificación en Terapia de manipulación espinal ™ CONSIGUE

TAMBIEN EL DIPLOMA DE OSTEOPRÁCTICO

DIRIGIDO A: KƐƚĞŽƉĂƚĂƐ��

DURACIÓN: 60 horas

LUGAR: KENZEN FORMACION. AV DIAGONAL 474-



INSTRUCTORS Dr. JAMES DUNNING

Dr. James Dunning is the President of Spinal Manipulation Institute and Dry Needling Institute of the American Academy of Manipulative Therapy. He is the owner of Alabama Physical Therapy & Acupuncture in Montgomery, Alabama. Dr. Dunning specializes in spinal manipulation, western and traditional Chinese acupuncture, and trigger point dry needling for a variety of neuromusculoskeletal conditions. Dr. Dunning graduated Magna Cum Laude and received a Bachelor of Science from Brigham Young University, a Master of Science in Physical Therapy from the University of the Pacific, California and a post-graduate Doctorate in Physical Therapy from the University of St. Augustine for Health Sciences, Florida. In addition, he received a post-graduate Master of Science in Advanced Manipulative Physiotherapy from the University of Birmingham, England, and has completed advanced training in osteopathic spinal manipulation and acupuncture through the London School of Osteopathy, British Medical Acupuncture Society, and Acupuncture Association of Chartered Physiotherapists (UK).

Dr. Dunning is a Manipulative Physiotherapist, Board Certified Orthopaedic Clinical Specialist, Certified Manual Therapist, Fellow of the American Academy of Orthopaedic Manual Physical Therapists, Member of the Manipulation Association of Chartered Physiotherapists (England), and Member of the Acupuncture Association of Chartered Physiotherapists (England). He has completed original experimental research investigating the effects of cervical manipulation on the electromyographic activity of the upper limb muscles.

Dr. Dunning presented on the neurophysiological effects of C5-6 high-velocity low-amplitude thrust manipulation on the biceps brachii muscle at the 2007 American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) Annual Conference in St. Louis. This original experimental research entitled "The effects of cervical manipulation on the resting electromyographic activity of the biceps brachii muscle" by Dunning & Rushton (2009) is published in the international journal Manual Therapy14 (2009) 508-513.

Dr. Dunning has a special interest in the use of acupuncture and spinal manipulation for the treatment of cervicogenic headaches, whiplash associated disorders of the cervicothoracic region, post-partum pelvic pain, sacroiliac joint dysfunctions, lumbar zygapophyseal joint dysfunctions, neurogenic cervicobrachial pain syndromes, craniofacial pain, and neuromyofascial pain syndromes.

In 2008, Dr. Dunning presented original experimental research on the effects of HVLA thrust manipulation on the electromyographic activity of upper limb muscles in Rotterdam, Netherlands at the 9th Congress of the International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT). Dr. Dunning was awarded the 2009 AAOMPT OPTP Research Grant for the study entitled, "Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multi-center randomized clinical trial"--Dunning et al (2012) was published in the January 2012 issue of the Journal of Orthopaedic & Sports Physical Therapy. Recently, Dr. Dunning presented the findings of his latest study entitled, "Bilateral and multiple cavitation sounds during upper cervical thrust manipulation" at the 2012 IFOMPT Conference in Quebec, Canada. Dunning et al (2013)was just published in the journal BMC Musculoskeletal Disorders and can be downloaded as a full text PDF. Most recently, Dr. Dunning taught spinal manipulation workshops and presented original experimental research at the 2013 Italian Manual Therapy Conference in Tuscany, Italy. Dr. Dunning's most recent article titled, "Dry needling: a literature review with implications for clinical practice guidelines" was published in 2013 in the journal Physical Therapy Reviews Dr. FIRAS MOURAD

Dr. Mourad specializes in spinal manipulation and dry needling for a variety of neuromusculoskeletal & sport injury conditions. Dr. Mourad received a Bachelor of Science in Physical Therapy from Brescia University (Italy), a Master degree in Manual Therapy (OMT-IFOMPT) from the University of Genova (Italy), and a post-graduate Certificate in Sport & Exercise Medicine from Ulster University (Belfast, UK). In addition, he completed a training program in musculoskeletal osteopathy through the Escuela de Osteopatia de Madrid (Spain).

Dr. Mourad is currently a PhD student at the Universidad Juan Carlos Rey in Madrid (Spain) supervised by Professor Cesar Fernandez De-Las-Peñas. Dr. Mourad’s research is focused on the neurophysiological effects of spinal manipulation and acupuncture in patients with migraine, tension type and/or cervicogenic headaches.

Dr. Mourad is a Lecturer in the Sport Rehabilitation Master degree at Pisa University (Italy) and in the Master degree (Fellowship) of Manual Therapy at the Tor Vergata University in Rome (Italy). He is a member of the Board of the Italian Manual Therapy Group (IFOMPT MO). Dr. Mourad is a co-author of the Dunning et al (2013) study titled, "Bilateral and multiple cavitation sounds during upper cervical thrust manipulation" published in the journal BMC Musculoskeletal Disorders and “Dry needling: a literature review with implications for clinical practice guidelines” published in 2014 in the journal Physical Therapy Reviews.



INTRODUCTION: Osteopractor - The New Medical Specialist

The Name Osteopractor denotes a very distinct specialization in medicine: Osteo- orginates from the Greek osteon (“bone”) and –practor originates from the Greek praktikos (“to practice, do, or perform”). Although the term osteopractor literally translates to “bone practitioner”, the most recent evidence-based practice guidelines for musculoskeletal disorders clearly supports a “multi-modal” approach; therefore, in addition to the joints (i.e. the bones), the direct treatment of myofascial trigger points, tendons, ligaments and fascia (all connected to the bones…) is certainly recognized within the osteopractic concept for optimal patient management. Likewise, a neurosurgeon doesn’t just operate on nerves during surgery, and osteopaths don’t just treat bone diseases.

The problem comes into play where the word "Osteopractor" is just too similar to "Osteopath" - according to the American Academy of Osteopathy. Therein lies a battle that is finishing hopefully in the next few months.

Dr. James Dunning has gone to great pains and personal expense to secure the name "Osteopractor" to designate this specialization for physicians and physical therapists that complete the training provided by the American Academy of Manipulative Therapy. The Spinal Manipulation Institute and the Dry Needling Institute fall under the AAMT. There is now a Fellowship being offered by the AAMT that would allow for the practitioner to earn the credential FAAOMPT - considered the premium fellow credential amongst manual physical therapists.

Dr Dunning's Dry Needling Courses and Spinal Manipulation courses are always sold out and overbooked. The rapid growth of the AAMT is a testament to the work that he is doing to provide the best training in evidence-based treatment and diagnosis of neuromusculoskeletal problems that can be addressed with Spinal Manipulation, Dry Needling, and Extremity Manipulation.

The DIPLOMA in OSTEOPRACTIC™ is a 12 to 18 months post-graduate training program and is only awarded to licensed physical therapists, medical doctors, or osteopaths that have successfully:

1. CERTIFIED in DRY NEEDLING (Cert. DN) by completing the DN-1 and DN-2 dry needling courses, and 2. CERTIFIED in SPINAL MANIPULATIVE THERAPY (Cert. SMT) by completing SMT-1 to 4 of the OSTEOPRACTIC™ HVLA Thrust Manipulation Series, and 3. Completed the EXTREMITY MANIPULATIVE THERAPY (EMT-1) course in OSTEOPRACTIC™ HVLA thrust manipulation of the upper and lower extremities. 4. Completed the INSTRUMENT-ASSISTED SOFT-TISSUE MOBILIZATION (IASTM-1) for Spinal & Extremity Conditions: an Evidence-Based Approach course. 5. Completed the DIFFERENTIAL DIAGNOSIS & MULTI-MODAL MANAGEMENT (DD-1) of Upper & Lower Extremity Spine Related Pain Syndromes course.

INTRODUCCIÓN: Osteopráctico – Nueva especialidad Médica

El Nombre de Osteopráctico es una especialización muy distinta en la medicina: La palabra Osteon proviene del Griego y significa ("hueso") y -practor se refiere a la práctica, hacer, o realizar. Aunque el término Osteopráctico se traduce literalmente como "practicante hueso", las guías de práctica basada en la evidencia más recientes para los trastornos musculoesqueléticos apoya claramente un enfoque "multi-modal"; Por lo tanto, es, sin duda reconocido dentro del concepto Osteopráctico para el manejo óptimo del paciente, el tratamiento directo de las articulaciones, los puntos gatillo miofasciales, tendones, ligamentos y fascia (todos conectados a los huesos ...). Del mismo modo, un neurocirujano no sólo opera en los nervios durante la cirugía, y los osteópatas apenas tratar las enfermedades óseas.

El problema viene en juego donde la palabra "Osteopractor" es demasiado similar a "osteópata" - según la Academia Americana de Osteopatía. Ahí radica una batalla que se espera termine en los próximos meses.

Dr. James Dunning ha hecho a un gran esfuerzo y gasto personal para asegurar el nombre de "Osteopractor" para designar esta especialización para los médicos y fisioterapeutas que completan la formación impartida por la Academy of Manipulative Therapy. El Instituto de Spinal Manipulation Institute and the Dry Needling está amparado por la AAMT. En la actualidad, los Cursos en Punción seca (DN) y de Manipulación de la Columna (trust – SMTP) del Dr. Dunning están teniendo un éxito aclaparador en EEUU. El rápido crecimiento de la AAMT es un testimonio de la labor que está haciendo para proporcionar la mejor formación en el tratamiento basado en la evidencia y el diagnóstico de los problemas musculoesqueléticos que se pueden abordar con Spinal Manipulation, Dry Needling, and Extremity Manipulation. El Diploma de OSTEOPRACTIC™ es un programa de formación de postgrado de 12 a 18 meses y sólo se concede a los fisioterapeutas que completan con éxito todos los niveles:

1. CERTIFIED in DRY NEEDLING (Cert. DN) by completing the DN-1 and DN-2 dry needling courses, and 2. CERTIFIED in SPINAL MANIPULATIVE THERAPY (Cert. SMT) by completing SMT-1 to 4 of the OSTEOPRACTIC™ HVLA Thrust Manipulation Series, and 3. Completed the EXTREMITY MANIPULATIVE THERAPY (EMT-1) course in OSTEOPRACTIC™ HVLA thrust manipulation of the upper and lower extremities. 4. Completed the INSTRUMENT-ASSISTED SOFT-TISSUE MOBILIZATION (IASTM-1) for Spinal & Extremity Conditions: an Evidence-Based Approach course. 5. Completed the DIFFERENTIAL DIAGNOSIS & MULTI-MODAL MANAGEMENT (DD-1) of Upper & Lower Extremity Spine Related Pain Syndromes course.

Hoy en dia solamente podemos encontrar en España los niveles de DN1, DN2 y SMTP1 en la escuela de KENZEN FORMACIÓN en Barcelona



An OSTEOPRACTOR is a physical therapist or medical doctor that has completed an evidence-based post-graduate training

program in the use of high-velocity low-amplitude thrust manipulation and dry needling for the diagnosis and treatment

of neuromusculoskeletal conditions of the spine and extremities.

Un OSTEOPRACTICO es un fisioterapeuta que ha completado un programa de formación de postgrado basada en la evidencia en el uso de alta velocidad de baja amplitud manipulación de empuje

y punción seca para el diagnóstico y tratamiento de patología musculoesqueléticas de la columna vertebral y las extremidades.

INTRODUCTION: Osteopractor - The New Medical Specialist

The term osteopractor has nothing to do with the chiropractic or osteopathic professions; that is, the osteopractor concept is firmly focused on the management of neuromusculoskeletal disorders in an evidence-based fashion, not the treatment of other organ istanbul travesti systems as the profession of chiropractic has traditionally engaged. More specifically, the osteopractic concept does not subscribe to the theory of the “Vertebral Subluxation Complex” as the primary cause of “dis-ease”. In short, osteopractic physical therapists do not diagnose or treat all 10-organ systems as chiropractic physicians are trained and licensed to do, and they do not utilize medicine or surgery as osteopathic physicians are trained and licensed to do. Lastly, spinal manipulation and dry needling are shared procedures between many healthcare professions; however, the philosophy, the clinical reasoning, and the conditions treated with these procedures dramatically differs between professions.

We teach the scientific principles AND the specific hands-on-skills necessary to achieve safe and effective thrust manipulation of the cervical, thoracic, lumbar, sacroiliac, and rib articulations. Furthermore, we teach how to safely deliver very specific and highly effective thrust manipulations to the upper cervical atlanto-axial (C1-2) and occipito-atlantal (C0-1) joints and the "difficult to get" first and second rib articulations.

Spinal Manipulation Institute teaches course attendees how to gain mastery over those difficult to manipulate junctional zones including the craniocervical, cervicothoracic, thoracolumbar and lumbosacral regions. We teach the specific psychomotor skills necessary to become a specialist in spinal manipulative therapy.

INTRODUCCIÓN: Osteopráctico – Nueva especialidad Médica

El término Osteopráctico no tiene nada que ver con las profesiones quiropráctica u osteopatía; es decir, el concepto Osteopráctico está firmemente centrada en la gestión de los trastornos musculoesqueléticos de una forma basada en la evidencia, no como lo abordan en la profesión de quiropráxia. Más concretamente, el concepto Osteopráctico no se suscribe a la teoría del "complejo de subluxación vertebral" como la causa principal del malestar. En resumen, los fisioterapeutas Osteoprácticos no diagnostican o tratan a través de lps 10-de órganos como hacen los quiroprácticos. Por último, spinal manipulation and dry needling son procedimientos utilizados en muchas profesiones sanitarias; Sin embargo, la filosofía, el razonamiento clínico, y las condiciones de tratamiento con estos procedimientos difiere drásticamente.

En esta formación de posgrado enseñamos los principios científicos y las habilidades manuales necesarias para lograr la manipulación de empuje (thrust), de forma segura y eficaz, de las articulaciones cervicales, torácicas, lumbares, sacroilíacas y las costillas. Además, enseñamos forma segura, específica, y altamente eficaz las manipulaciones de empuje (thrust) en las articulaciones atlanto-axial superior cervical (C1-2) y occipito-atlantal (C0-1) y las complejas primera y segunda articulaciones costales.

Spinal Manipulation Institute enseña a los asistentes al curso cómo ganar dominio sobre aquellas difíciles zonas de unión a manipular, incluidas las regiones cráneo-cervicales, cervico-torácica, toracolumbar y lumbosacra. Enseñamos las habilidades psicomotoras específicas necesarias para convertirse en un especialista en spinal manipulative therapy.



COURSE DESCRIPTION SMTP-1: This two-day seminar includes 70% hands-on practical training and 30% didactic lecture instruction. The content of the seminar highlights the biomechanical principles and practical hands-on skills required to perform high-velocity low-amplitude (HVLA) thrust manipulation techniques in a competent and safe manner for all of the spinal regions. Clinical case studies are presented for discussion of diagnosis and management based upon clinical reasoning and the best available empirical evidence. Course tuition includes 110 page booklet with detailed description and pictures of all HVLA thrust techniques, current evidence underpinning the use of spinal manipulation in cervicogenic headaches, acute and chronic low back pain, sacroiliac joint dysfunction, and idiopathic neck pain.

COURSE OBJECTIVES: At the completion of this course, participants will be able to: 1. Describe the indications, precautions and contra-indications (relative and absolute) of high-velocity low-amplitude thrust manipulation. Demonstrate pre-manipulative screening tests for cervical artery dysfunction (Vertebro-Basilar-Insufficiency) and upper cervical instability and understand their limitations. 2. Improve the use of body and posture in application of high-velocity low-amplitude thrust, making them an integral part of technique delivery. 3. Start combining leverages using multiple components in order to focus forces and build “mechanical barriers” at target motion segments. 4. Develop the psychomotor skills necessary to appreciate the pre-manipulative barrier (end-feel) utilized in minimal leverage or momentum induced manipulative technique by concentrating on combining multiple leverages in order to minimize the overall amplitude and force required to achieve cavitation. 5. Facilitate sound clinical reasoning processes behind the choice (or not) of high-velocity low-amplitude techniques and an appreciation of the current evidence base behind their application. 6. Demystify the delivery of high-velocity low-amplitude thrust manipulation and develop an appreciation of its merits and limitations in every day clinical practice. 7. Utilize clinical reasoning skills in the selection of high-velocity low-amplitude thrust manipulation techniques for a variety of neuromusculoskeletal dysfunctions. 8. Demonstrate safe, competent and proficient performance of HVLA thrust manipulation techniques, including pre-thrust positioning and actual thrust application of mid and lower cervical, thoracic, rib, lumbar and sacro-iliac regions. 9. Describe and demonstrate HVLA thrust manipulation for the junctional zones: upper cervical, cervicothoracic, thoracolumbar and lumbosacral regions 10. Learn how to effectively diagnose and treat upper, mid, and lower cervical joint dysfunction, sacro-iliac joint dysfunction, lumbar spine facet syndromes, second and third rib syndromes, and cervicothoracic joint dysfunction.

DESCRIPCIÓN DEL CURSO SMTP-1: Este seminario de dos días incluye 70% práctica 30% teórica Del contenido del seminario se destacan los principios biomecánicos y prácticas manuales para realizar las técnicas de manipulación de empuje (thurst) de alta velocidad y baja amplitud (HVLA) de una manera competente y de forma segura para todas las regiones de la columna vertebral. Con la ayuda de casos clínicos aprenderemos a hacer diagnósticos y planes de tratamiento, siempre basados en el razonamiento clínico y la mejor evidencia empírica disponible. El curso incluye una amplia documentación con más de 110 páginas en las que se detallan las técnicas (thrust) de empuje HVLA con fotografías y explicaciones, así como la evidencia actual que sustenta el uso de la “spinal manipulation” en dolor de cabeza cervicogénicos, lumbalgia aguda y crónica, disfunción de la articulación sacroilíaca, y dolor de cuello idiopático.

OBJETIVOS: 1. Describir las indicaciones, precauciones y contraindicaciones (relativa y absoluta) de alta velocidad de baja amplitud manipulación de empuje (thrust). Aprender las pruebas de detección previa a la manipulación para la disfunción de la arteria cervical y la inestabilidad cervical superior, así como comprender sus limitaciones. 2. Mejorar el uso del cuerpo y la postura en la solicitud de alta velocidad de baja amplitud empuje 3. Combinación de palancas que utilizan varios componentes con el fin de centrar las fuerzas y construir "barreras mecánicas" en los segmentos de movimiento de destino que deseamos abordar. 4. Desarrollar las habilidades psicomotoras necesarias para apreciar la barrera pre-manipuladora utilizando un apalancamiento mínimo o induciendo un impulso, concentrándonos en la combinación de varias palancas para minimizar la amplitud global y la fuerza necesaria para lograr la cavitación. 5. Facilitar procesos de razonamiento clínico de cada elección (o no) de las técnicas y la evidencia disponible detrás de cada una de ellas. 6. Comprender las ventajas y limitaciones de la técnica. 7. Aprenderemos a utilizar habilidades de razonamiento clínico en la selección de cada técnica HVLA para la amplia variedad de trastornos musculoesquelético que nos podemos encontrar. 8. Demostraremos la seguridad y competencia dela HVLA en el posicionamiento pre-empuje y empuje aplicación real de medio y bajo cervical, torácica, torácica, lumbar y sacro-ilíacas regiones. 9. Describiremos y demostraremos la técnica HVLA en las zonas de unión: cervical superior, cervicotorácica, toracolumbar y regiones lumbosacra 10. Aprenderemos a cómo diagnosticar y tratar con eficacia las disfunciones cervicales superiores, media e inferiores, la disfunción de la articulación sacroilíaca, lumbar síndromes faceta de la espina dorsal, síndromes segunda y tercera costilla, y disfunción de la articulación cervicotorácica.



COURSE DESCRIPTION SMTP-2: SMT-2 is a two-day (15 contact hours) course with an emphasis on upper cervical, mid-cervical and upper thoracic spine dysfunction, as it relates to cervicogenic headaches, whiplash associated disorders, and idiopathic neck pain diagnosis and management. Advanced HVLA thrust manipulation techniques for the occipito-atlantal (C0/1), atlanto-axial (C1/2), C2/3 articulations (in supine and sitting positions) along with a focus on 1st, 2nd and 3rd rib articulation HVLA thrust manipulation procedures (costotransverse and costovertebral articulations). A special emphasis will also be given to a variety of HVLA thrust manipulation procedures used to treat the cervicothoracic junction (C7-T3) including side-lying, prone, sitting and supine variations of such. An evidence-based approach to the diagnosis and management of deep cervical flexor dysfunction will be undertaken; in addition, the best way to train the deep neck flexors will be instructed. Furthermore, the inter-relationship between arthrogenic muscle inhibition of the craniocervical flexors and the immediate changes in motor control post HVLAT manipulation of specifically the upper cervical spine (C0/1 and C1/2) articulations will be explored. A comprehensive literature review of the neurophysiological effects of HVLAT manipulation will be presented and will include evidence to support alterations post-HVLAT manipulation in feed-forward activation times, isometric muscle strength, resting EMG activity of segmentally associated muscles, and passive range of motion. An exploration of pain physiology as it applies specifically to post manipulation hypoalgesic effects will be presented, and an overview of the sympathoexcitatory effects seen in the upper limbs following spinal manipulation will be explored. Current research (RCTs and systematic reviews) to support the effectiveness of HVLAT and exercise in the treatment of cervicogenic headaches, idiopathic neck pain and whiplash associated disorders will be presented. This course is 70% hands-on and 30% didactic instruction.

DESCRIPCIÓN DEL CURSO SMTP-2: SMT-2 es un curso de dos días (15 horas presenciales) que hace énfasis en el diagnóstico y tratamiento de la zona cervical superior, en la disfunción de la zona media cervical y zona superior torácica de la columna, lo que se refiere a dolores de cabeza cervicogénicos, síndrome del latigazo cervical, y al dolor de cuello idiopático Las técnicas avanzadas HVLA thrust manipulation abordan la zona occipito-atlantal (C0/1), atlanto-axial (C1/2), articulaciones C2/3 (en posición supina y sentada), enfocando articulación de la primera, segunda y tercera costilla. También se da especial énfasis a una variedad de procediemitnos HVLA utilizados para tratar la unión cervicotorácica (C7-T3) incluidos en decúbito lateral, en pronación, sentado y variaciones supina de los mismos. Se llevará a cabo un enfoque basado en la evidencia para el diagnóstico y tratamiento de la disfunción del flexor profundo cervical; también te enseñaremos la mejor manera de entrenar los flexores profundos del cuello. Además, se explorará la interrelación entre la inhibición muscular artrogenica de los flexores craneocervicales y los cambios inmediatos en el control motor después de HVLAT, específicamente de las articulaciones de lacolumna cervical superior (C0/1 C1/2). Se presentará una exhaustiva revisión de la literatura de los efectos neurofisiológicos de la manipulación HVLAT que incluirá evidencias que apoyan las alteraciones post-HVLAT en tiempos de activación, en la fuerza muscular isométrica, apoyado por la actividad EMG de los músculos asociados y por el rango de movimiento pasivo. Se presentará también los efectos hipoanalgésicos en las post HVLA aplicado especificamente en fisiologías dolorosas, y una visión general de los efectos simpatoexcitatorios vistos en los miembros superiores depues de la manipulación. Se presentarán investigaciones actuales (RCT’s y revisiones sistemáticas) para apoyar la eficacia de HVLAT y en el tratamiento de dolores de cabeza, dolor de cabeza idiopatico cervicogénicos y síndrome del latigazo cervical. Este curso es de 70% práctica y 30% instrucción didáctica.



COURSE DESCRIPTION SMTP-3: SMT-3 is a two-day (15 contact hours) course with an emphasis on the diagnosis and management of thoracolumbar junction syndrome, mid-lumbar facet joint syndrome, lumbosacral junction (L5/S1) syndrome, sacroiliac dysfunction (innominate and sacral), symphysis pubis dysfunction and secondary piriformis and quadratus lumborum syndromes. Advanced high-velocity low-amplitude thrust (HVLAT) manipulation procedures for the pelvic girdle will be instructed including: sacroiliac joint (innominate on sacrum) in prone, sidelying, and supine positions, as well as HVLAT manipulation of the symphysis pubis articulation. A special emphasis will be given to direct HVLAT manipulation procedures to the sacrum itself (in prone and sidelying positions) to correct sacrum on innominate dysfunctions. Attention will also be given to three different variations of the classic lumbar roll manipulative procedure including: transverse process (mamillary process) "push" and body drop, spinous process "pull" and body drop, and the classic osteopathic "sulcus" thrust manipulation to the lumbar facet joints. Four techniques to address thoracolumbar junction (T10-L2) facet dysfunction will also be instructed: two variations in supine, one in prone, and one in side-lying. All techniques instructed will be "direct" techniques taking the form of high-velocity low-amplitude thrust manipulation (HVLAT), no muscle energy or other "indirect" techniques will be instructed. The traditional clinical diagnosis of lumbar spine instability will be explored, and this along with traditional lumbar stabilization training will be challenged using an evidence-based approach. Further, an evidence-based approach to the strength and endurance training of the lumbar multifidus muscles will be taken; that is, the most effective exercises, as shown by empirical evidence, for training of these deep lumbar transversospinals will be instructed and this will be supported and underpinned by recent MRI, CT, and ultrasound studies. Current evidence (RCTs and systematic reviews) will be discussed to support the effectiveness of HVLAT manipulation and exercise in the treatment of acute and chronic LBP, post-partum pelvic pain, and sacroiliac joint dysfunction. This course is 70% hands-on and 30% didactic instruction. SMT-3 may be taken after SMT-1 has been completed; that is, completion of SMT-2 is not required before SMT-3 may be taken.

DESCRIPCIÓN DEL CURSO SMTP-3: SMT-3 es un curso de 2 días (15 horas presenciales) y se centra en el diagnóstico y tratamiento del síndrome de la articulación toracolumbar, el síndrome de la articulación media lumbar, articulación lumbosacra (L5/S1), disfunción sacroilíaca (innominada y sacra), disfunción del pubis y piriforme secundaria y síndrome quadratus lumborum. Las técnicas avanzadas HVLA thrust manipulation abordan los procedimientos para cintura pélvica, incluyendo la articulación sacroilíaca en pronación, en decúbit, en decúbito lateral y en posición supina. También como la HVLAT actúa en la articulación sínfisis del pubis. Se dará un énfasis especial en los procedimientos HVLAT en el sacro (en las posiciones pronación y decúbito lateral) también se darán tres variaciones diferentes del procedimiento de manipulación clásica de la faja lumbar incluyendo: proceso transverso de thrust y descenso del cuerpo, proceso espinoso de thrust y descenso, y la clásica manipulación thrust osteopático "surco" para las articulares lumbares. Cuatro técnicas para abordar la articulación toracolumbar (T10-L2) en dos variaciones en decúbito supino, una en pronación, y una en decúbito lateral. Revisaremos el diagnóstico clínico tradicional de la inestabilidad de la columna lumbar basado en la evidencia actual. Además, se tomará un enfoque basado en la evidencia para el entrenamiento de fuerza y resistencia de los músculos multifidus lumbar; es decir, los ejercicios más eficaces, como se muestra por la evidencia empírica, para la formación de estos transversospinals lumbares profundos serán instruidos y esto serán apoyados y respaldados por la reciente MRI, CT, y los estudios de ultrasonido. La evidencia actual (ECA y revisiones sistemáticas) será mostrada para apoyar la eficacia de la manipulación HVLAT y el ejercicio en el tratamiento del dolor lumbar agudo y crónico, dolor pélvico después del parto, y la disfunción de la articulación sacroilíaca. Este curso es de 70% práctica y 30% instrucción didáctica.



COURSE DESCRIPTION SMTP-4: Entitles the successful candidate to use the Cert. SMT™ credential--that is, Certification in Spinal Manipulative Therapy™. This certification recognizes those practitioners (PT, MD or DO) that have demonstrated:

9 Safe and competent performance in the delivery of HVLA thrust manipulation procedures in all spinal, pelvic and thorax regions.

9 An in depth understanding of the rationale for (or against) the use of HVLA thrust manipulation.

9 An understanding of the empirical evidence surrounding the use of HVLAT manipulation in a variety of neuromusculoskeletal conditions.

This is a two-day (15 contact hours) course consisting of:

1. Review of the biomechanical theory and neurophysiological effects of HVLA thrust manipulation.

2. Review of the evidence underpinning the practice of HVLA thrust manipulation and its effectiveness (and limitations) in the management of cervicogenic headaches, idiopathic neck pain, whiplash associated disorder, post-partum pelvic pain, sacroiliac joint dysfunction, and facet and rib syndromes of the cervical, thoracic, lumbar and four junctional zones.

3. Review of the best available evidence on the most effective methods to train strength and endurance of the deep cervical flexors and the lumbar multifidi muscles.

4. Comprehensive oral, practical and written examination of all materials in all three prerequisite courses (SMT-1, SMT-2, and SMT-3).

5. Successful candidates must be able to demonstrate mastery in the performance of HVLAT manipulation procedures to the cervical, thoracic, lumbar & pelvic regions, and all four junctional zones; furthermore, they must demonstrate an ability to defend their diagnostic and treatment decisions with sound clinical reasoning and use of the best available empirical evidence.

DESCRIPCIÓN DEL CURSO SMTP-4: Da derecho al candidato elegido utilizar el Cert. Credencial SMT ™ - es decir, la Certificación en Terapia de manipulación espinal ™. Esta certificación reconoce aquellos practicantes (PT, MD o DO) que han demostrado:

9 Funcionamiento seguro y competente en los procedimientos de manipulación HVLA en todas las regiones de la columna vertebral, la pelvis y el tórax.

9 Una comprensión profunda de la razón de ser (o en contra) el uso de HVLA.

9 Una comprensión de la evidencia empírica que rodea el uso de la manipulación HVLAT en una variedad de condiciones neuromusculoesqueléticos.

Este es un curso de dos días (15 horas presenciales) consiste en:

1. Revisión de la teoría y efectos neurofisiológicos biomecánicos de HVLA.

2. Revisión de la evidencia que sustenta la práctica de HVLA empujó manipulación y su eficacia (y limitaciones) en el tratamiento de dolores de cabeza, dolor de cuello cervicogénicos idiopática, trastorno asociado latigazo cervical, post-parto dolor pélvico, disfunción articulación sacroilíaca y de faceta y costillas síndromes de la cervical, torácica, lumbar y cuatro zonas de unión.

3. Revisión de la mejor evidencia disponible sobre los métodos más eficaces para entrenar la fuerza y resistencia de los flexores cervicales profundos y los músculos multifidus lumbar.

4. Comprensión oral, práctica y examen por escrito de todos los materiales en los tres cursos (SMT-1, SMT-2, y SMT-3).

5. Los candidatos deben ser capaces de demostrar el dominio en la realización de procedimientos de manipulación HVLAT en las regiones cervical, torácica, lumbar y la pelvis, y las cuatro zonas de unión; además, deben demostrar su capacidad de defender sus decisiones de diagnóstico y tratamiento con el razonamiento clínico sonido y el uso de la mejor evidencia empírica disponible.



COURSE OUTLINE: Day One: 9:00: Indications, precautions, contraindications for use of HVLAT manipulation 10:00: Cervical (C2-7) rotatory HVLA thrust manipulation technique 11:00: Cervicothoracic junction (C7-T3) HVLA thrust manipulation technique 12:00: Evidence based diagnosis and management of cervicogenic headaches 13:00: Lunch (on own) 14:00: Upper cervical HVLA thrust manipulation of Atlanto-Axial (C1-2) joint 15:00: Evidence for use of HVLA thrust manipulation in acute and chronic LBP 16:00: Mid-lumbar (L2-4) HVLA thrust manipulation technique 17:00: 1st rib HVLA thrust manipulation technique 17:30: 2nd & 3rd rib HVLA thrust manipulation technique 18:00: Conclusion of day one Day Two: 9:00: Upper thoracic (T1-3) HVLA thrust manipulation technique 10:00: Cervical (C2-7) lateral-flexion translatory HVLA thrust manipulation technique 11:00: Lumbo-sacral junction (L5/S1) HVLA thrust manipulation technique 12:00: Mid-thoracic (T4-9) HVLA thrust manipulation technique 13:00: Lunch (on own) 14:00: Upper cervical HVLA thrust manipulation of Occipito-Atlantal (C0-1) joint 15:00: Evidence based diagnosis of sacro-iliac dysfunction 16:00: Sacro-iliac joint HVLA thrust manipulation technique 17:00:Thoraco-lumbar junction (T11-L1) HVLA thrust manipulation technique 17:30: Rib 4-8 HVLA thrust manipulation technique 18:00: Conclusion of course & issue of certificates

PROGRAMA: Primer día 09:00: Indicaciones, precauciones, contraindicaciones para el uso de la manipulación HVLAT 10:00: técnica de manipulación de empuje HVLA rotatoria Cervical (C2-7) 11:00: técnica de manipulación de empuje HVLA de la unión cervicotorácica (C7-T3) 12:00: Diagnóstico y tratamiento de dolores de cabeza cervicogenic basada en la evidencia 13:00: Almuerzo 14:00: técnica de manipulación de empuje HVLA Atlanto-axial (C1-2) 15:00: La evidencia de uso de HVLA en el dolor lumbar agudo y crónico 16:00: técnica de manipulación de empuje HVLA de la zona lumbar media (L2-4) 17:00: técnica de manipulación de empuje HVLA de la primera costilla 17:30: técnica de manipulación de empuje HVLA de la segunda y tercera costilla 18:00: Fin de la clase Segundo día: 09:00: técnica de manipulación de empuje HVLA de la zona torácica superior (T1-3) 10:00: técnica de manipulación de empuje HVLA de la zona Cervical (C2-7) de traslación lateral-flexión 11:00: técnica de manipulación de empuje HVLA del cruce lumbar lumbosacra (L5 / S1) HVLA 12:00: técnica de manipulación de empuje HVLA de la zona Media torácica (T4-9) 13:00: Almuerzo 14:00: técnica de manipulación de empuje HVLA occipito-atlantal (C0-1) 15:00: Diagnóstico basado en la evidencia de la disfunción sacroilíaca 16:00: técnica de manipulación de empuje HVLA de la articulación sacro-ilíaca 17:00: técnica de manipulación de empuje HVLA del cruce toracico-lumbar (T11-L1) 17:30: técnica de manipulación de empuje HVLA de la costilla 4ª a 8ª 18:00: Fin curso



Evidence - Bronfort, G., Haas, M., Evans, R., Bouter, L. (2004) Efficacy of spinal manipulation and mobilization for low back pain and neck pain:

a systematic review and best evidence synthesis. The Spine Journal, 4 (3), 335-356. - Gross, A., Hoving, J., Haines, T., et al. (2004) A Cochrane Review of Manipulation and Mobilization for Mechanical Neck Disorders.

Spine, 29 (14), 1541-1548. - Fernandez-de-las-Penas, C., Downey, C., Miangolarra-Page, J. (2005) Validity of the lateral gliding test as tool for the diagnosis of

intervertebral joint dysfunction in the lower cervical spine. Journal of Manipulative and Physiological Therapeutics, 28 (8), 610-616. - Haas, M., Groupp, E., Panzer, D. (2003) Efficacy of cervical endplay assessment as an indicator for spinal manipulation. Spine, 28

(11), 1091-1096. - Haavik-Taylor, H., Murphy, B. (2006) Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked

potential study. Clinical Neurophysiology, 118 (2), 391-402. - Jull, G., Zito, G., Trott, P., Potter, H., Shirley, D., Richardson, C. (1997) Inter-examiner reliability to detect painful upper cervical joint

dysfunction. Australian Journal of Physiotherapy, 43 (2), 125-129. - Smedmark, V., Wallin, M., Arvidsson, I. (2000) Inter-examiner reliability in assessing passive intervertebral motion of the cervical

spine. Manual Therapy, 5 (2), 97-101. - Tseng, Y., Wang, W., Chen, W., Hou, T. [In Press] Predictors for the immediate responders to cervical manipulation in patients with

neck pain. Manual Therapy. - Van Schalkwyk, R., Parkin-Smith, G. (2000) A Clinical Trial Investigating the Possible Effect of the Supine Cervical Rotatory

Manipulation and the Supine Lateral Break Manipulation in the Treatment of Mechanical Neck Pain: A Pilot Study. Journal of Manipulative & Physiological Therapeutics, 23(5), 324-331.

- Van Trijffel, E., Anderegg, Q., Bossuyt, P., Lucas, C. (2005) Inter-examiner reliability of passive assessment of intervertebral motion in the cervical and lumbar spine: a systematic review. Manual Therapy, 10 (4), 256-269.

Cervicogenic Headache and Spinal Manipulation Evidence - Bogduk, N. (1990) The anatomy of headache. Unpublished manuscript p. 1-15. Dpt Medicine, University of Newcastle, Australia. - Bronfort, G., Assendelft, W., Evans, R., et al. (2001) Efficacy of Spinal Manipulation for Chronic Headache: A Systematic Review.

Journal of Manipulative & Physiological Therapeutics, 24 (7), 457-466. - Eldridge, L., Russell, J. (2005) Effectiveness of cervical spine manipulation and prescribed exercise in reduction of cervicogenic

headache pain and frequency. International Journal of Osteopathic Medicine, 8, 106-113 - Haas, M., Groupp, E., Aickin, M., et al. (2004) Dose response for chiropractic care of chronic cervicogenic headache and associated

neck pain: a randomized pilot study. Journal of Manipulative & Physiological Therapeutics, 27 (9), 547-553. - Haldeman, S., Dagenais, S. (2001) Cervicogenic headaches: a critical review. The Spine Journal, 1, 31-46. - Hall, T., Robinson, K. (2004) The flexion-rotation test and active cervical mobility--a comparative measurement study in

cervicogenic headache. Manual Therapy, 9, 197-202. - Jull, G. (1997) Management of cervical headache. Manual Therapy, 2 (4), 182-190. - Jull, G., Trott, P., Potter, H., et al. (2002) A Randomized Controlled Trial of Exercise and Manipulative Therapy for Cervicogenic

Headache. Spine, 27 (17), 1835-1843. - Jull, G. (2006) Diagnosis of Cervicogenic Headache: Guest Editorial. Journal of Manual & Manipulative Therapy, 14 (3), 136-138. - Lenssinck, M., Damen, L., Verhagen, A., et al. (2004) The effectiveness of physiotherapy and manipulation in patients with tension-

type headache: a systematic review. Pain, 112, 381-388. - Maigne, R. (2006) Cervicogenic Headache. Diagnosis and treatment of pain of vertebral origin. 2nd edition. Taylor and Francis

Group: Boca Raton, FL. - Moore, M. (2004) Upper crossed syndrome and its relationship to cervicogenic headache. Journal of Manipulative & Physiological

Therapeutics, 27 (6), 414-420. - Niere, K., Robinson, P. (1997) Determination of manipulative physiotherapy treatment outcome in headache patients. Manual

Therapy, 2 (4), 199-205. - Ogince, M., Hall, T., Robinson, K., Blackmore, A. (2007) The diagnostic validity of the cervical flexion-rotation test in C1/2 related

cervicogenic headache. Manual Therapy, 12 (3), 256-262. - Rodeghero, J., Smith, R. (2006) Role of Manual Physical Therapy and Specific Exercise Intervention in the Treatment of a Patient

with Cervicogenic Headaches: A Case Report. Journal of Manual & Manipulative Therapy, 14 (3), 159-167. - Zito, G., Jull, G., Story, I. (2006) Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Manual

Therapy, 11 (2), 118-129. - Immediate Hypoalgesic and Motor Effects of a Single Cervical Manipulation (2008)



Lumbar instability and stabilization training evidence - Cook, C., Brismee, J., Sizer, P. (2006) Subjective and objective descriptors of clinical lumbar spine instability: a Delphi study.

Manual Therapy, 11 (1), 11-21. - Cornwall, J., Harris, J., Mercer, S. (2006) The lumbar multifidus & patterns of pain. Manual Therapy, 11 (1), 40-45. - Danneels, L., Vanderstraeten, G., Cambier, D., Witvrouw, E., Dankaerts, W. (2001) Effects of three different training modalities on

the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain. British Journal of Sports Medicine, 35, 186-191.

- Cholewicki, J., McGill, S. (1996) Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain. Clinical Biomechanics, 11, 1-15.

- Gardner-Morse, M., Stokes, I., Laible, J. (1995) Role of muscles in lumbar spine stability in maximum extensor efforts. Journal of Orthopaedic Research, 13, 802.

- Kader, D., Wardlaw, D., Smith, F. (2000) Correlation between the MRI changes in the lumbar multifidus muscles and leg pain. Clinical Radiology, 55, 145-149.

- Kavcic, N., Grenier, S., McGill, S. (2004) Determining the stabilizing role of individual torso muscles during rehabilitation exercises. Spine, 29 (11), 1254-1265.

- Hides, J., Richardson, C., Jull, G., (1996). Multifidus recovery is not automatic following - resolution of acute first episode of low back pain. Spine, 21 (23), 2763-2769. - Hides, J., Jull, G., Richardson, C. (2001) Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine, 26

(11), E243-E248. - Holm, S., Indahl, A., Solomonow, M. (2002) Sensorimotor control of the spine. Journal of Electromyography and Kinesiology, 12,

219-234. - Maigne, J., Lapeyre, E., Morvan, G. (2003) Pain immediately upon sitting down and relieved by standing is often associated with

radiologic lumbar instability or marked anterior loss of disc space. Spine, 28, 1327-1334. - Mannion, A. (1999) Fibre type characteristics and function of the human paraspinal muscles: normal values and changes in

association with low back pain. Journal of Electromyography and Kinesiology, 9 (4), 363-377. - McGill, S., Childs, A., Liebenson, C. (1999) Endurance times for low back stabilization exercises: clinical targets for testing and

training from a normal database. Archives of Physical Medicine & Rehabilitation, 80, 941-944. - Mens, J., Snijders, C., Stam, H. (2000) Diagonal trunk muscle exercises in peripartum pelvic - pain: a randomized clinical trial. Physical Therapy, 80 (12), 1164-1173. - Nachemson, A. (1985) Lumbar spine instability: a critical update and symposium summary. Spine, 10, 290-291. - Ogon, M., Bender, B., Hooper, D. (1997) A dynamic approach to spinal instability, part II: hesitation and giving way during

interspinal motion. Spine, 22, 2859-2866. - O’Sullivan, P., Twomey, L., Allison, G. (1997) Evaluation of specific stabilizing exercise in the treatment of chronic low back pain

with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine, 22 (24), 2959-2967. - O’Sullivan, P. (2000) Lumbar segmental instability: clinical presentation and specific stabilizing exercise management. Manual

Therapy, 5 (1), 2-12. - O’Sullivan, P., Beales, D., Beetham, J. (2002) Altered motor control strategies in subjects with sacroiliac joint pain during the active

straight-leg-raise test. Spine, 27 (1), E1-E8. - O’Sullivan, P., Burnett, A., Floyd, A., et al. (2003) Lumbar repositioning deficit in a specific low back pain population. Spine, 28,

1074-1079. - O’Sullivan, P. (2005) Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control

impairments as underlying mechanism. Manual Therapy, 10 (7), 242-255. - Paris, S. (1985) Physical signs of instability. Spine, 10, 277-279. - Richardson, C., Jull, G. (1995) Muscle control – pain control. What exercises would you prescribe? Manual Therapy, 1 (1), 2-10. - Richardson, C., Jull, G., Hodges, P., Hides, J. (1999) Therapeutic exercise for spinal segmental stabilization in low back pain.

Edinburgh: Churchill Livingstone. - Stuge, B., Veierod, M., Vollestad, N. (2004) The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic

girdle pain after pregnancy. Spine, 29 (10), E197-E203. - Stuge, B., Holm, I., Vollestad, N. (2006) To treat or not to treat postpartum pelvic girdle pain with stabilizing exercises? Manual

Therapy, 11 (4), 337-343.



Lumbar Spine Manipulation Evidence (1/3) - Assendelft, W., Morton, S., Yu, E., et al. (2003) Spinal Manipulative Therapy for Low Back Pain: A meta-analysis of effectiveness

relative to other therapies. Annals of Internal Medicine, 138, 871-881. - Assendelft, W., Morton, S., Yu, E., et al. (2004) Spinal Manipulative Therapy for Low Back Pain. The Cochrane Database of

Systematic Reviews, Issue 1. Art. No.: CD000447.pub.2. DOI: 10.1002/14651858.CD000447. - Aure, O., Nilsen, J., Vasseljen, O. (2003) Manual Therapy and Exercise Therapy in Patients with Chronic Low Back Pain. Spine, 28 (6),

525-532. - Avery, S., O’Driscoll, M. (2004) Randomised Controlled Trials on the Efficacy of Spinal Manipulation Therapy in the Treatment of

Low Back Pain. Physical Therapy Reviews, 9, 146-152. - Begg, C., Cho, M., Eastwood, S., et al. (1996) Improving the quality of reporting of randomised controlled trials: the CONSORT

statement. Journal of the American Medical Association, 276, 637-9. - Bogduk, N. (1989) Lumbar Dorsal Ramus Syndrome. Medical Journal of Australia, 15, 537-541. - Brenner, A., Gill, N., Buscema, C., Kiesel, K. (2007) Improved activation of lumbar multifidus following spinal manipulation: a case

report applying rehabilitative ultrasound imaging. Journal of Orthopaedic and Sports Physical Therapy, 37 (10), 613-619. - Bronfort, G., Haas, M., Evans, R., et al. (2004) Efficacy of Spinal Manipulation and Mobilisation for low back Pain and Neck pain: A

systematic review and best evidence synthesis. The Spine Journal, 4, 335-356. - Chaitow, L., Comeaux, Z., Dommerholt, J., et al. (2004). Efficacy of manipulation in Low Back Pain Treatment: The validity of meta-

analysis conclusions. Journal of Bodywork and Movement Therapies, 8, 25-31. - Cherkin, D., Deyo, R., Battie, M., et al.eet, J. & Barlow, W. (1998). A Comparison of Physical Therapy, Chiropractic Manipulation,

and Provision of an Educational Booklet for the Treatment of Patients with Low Back Pain. The New England Journal of Medicine, 339 (15), 1021-1029.

- Cherkin, D., Sherman, K., Deyo, R., et al. (2003) A Review of the Evidence for the Effectiveness, Safety, and Cost of Acupuncture, Massage Therapy, and Spinal Manipulation for Back Pain. American College of Physicians, 138, 898-906.

- Childs, J., Fritz, J., Flynn, T., et al. (2004) A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Annals of Internal Medicine, 141 (12), 920-928.

- Childs, J., Flynn, T., Fritz, J. (2006) A perspective for considering the risks and benefits of spinal manipulation in patients with low back pain. Manual Therapy, 11 (4), 316-320.

- Christian, G., Stanton, G., Sissons, D., et al. (1988). Immunoreactive ACTH, beta-endorphin, and cortisol levels in plasma following Spinal Manipulative Therapy. Spine, 13 (12), 1411-1417.

- Clarke, M., Anderson, P., Chalmers, I. (2002) Discussion sections in reports of controlled trials published in general medical journals. Journal of the American Medical Association, 287, 2799-801.

- Croft, P., Macfarlane, G., Papegeorgiou, A., et al. (1998). Outcome of low back pain in general practice: A prospective study. British Medical Journal, 316 (7141), 1356-1359.

- Descarreaux, M., Blouin, J., Drolet, M., et al. (2004) Efficacy of Preventative Spinal Manipulation for Chronic Low Back Pain and Related Disabilities: A preliminary Study. Journal of Manipulative and Physiological Therapeutics, 27 (8), 509-514.

- Ernst, E., Harkness, E. (2001) Spinal Manipulation: A systematic Review of Sham- controlled, Double-blind, Randomised Clinical Trials. Journal of Pain and Symptom Management, 22 (4), 879-889.

- Ernst, E. (2003) The definitive meta-analysis of spinal manipulation for back pain. Focus on Alternative and Complimentary Therapies, 8, 436-7.

- Ernst, E., Canter, P. (2003) Chiropractic Spinal Manipulation Treatment for Back Pain? A systematic review of randomised clinical trials. Physical Therapy Reviews, 8, 85-91.

- Ernst, E., Canter, P. (2006) A systematic Review of Systematic Reviews of Spinal Manipulation. Journal of The Royal Society of Medicine, 99, 192-196.

- European Commission, Cost Action B13 Management Committee (2004) European Guidelines for the management of acute non-specific low back pain in primary care. Available from: http://www.backpaineurope.org.

- European Guidelines for the management of Chronic, Non-specific Low Back Pain (2004) Amended 14th June 2005. Accessed via http://ifomt.org on 28th April 2007.

- Fairbank, J., Couper, J., Davies, J., et al. (1980) The Oswestry Low Back Questionnaire. Physiotherapy, 66, 271-273. - Ferreira, M., Ferreira, P., Latimer, J., et al. (2002) Does Spinal Manipulative Therapy Help People with Chronic Low Back Pain?

Australian Journal of Physiotherapy, 48, 277-284. - Ferreira, P., Ferreira, M., Maher, C. et al. (2002) Effect of Applying Different Levels of Evidence Criteria on Conclusions of Cochrane

Reviews of Interventions for Low Back Pain. Journal of Clinical Epidemiology, 55, 1126-1129. - Flynn, T., Fritz, J., Whitman, J. (2002) A clinical prediction rule for classifying patients with low back pain who demonstrate short-

term improvement with spinal manipulation. Spine, 27 (24), 2835-2843.



Lumbar Spine Manipulation Evidence (2/3) - Flynn, T., Fritz, J., Wainner, R., Whitman, J. (2003) The audible pop is not necessary for successful spinal high-velocity thrust

manipulation in individuals with low back pain. Archives of Physical Medicine and Rehabilitation, 84, 1057-1060. - Flynn, T., Childs, J., Fritz, J. (2006) The audible pop from high velocity thrust manipulation and outcome in individuals with low

back pain. Journal of Manipulative and Physiological Therapeutics, 29 (1), 40-45. - Foster, N., Thompson, K., Baxter, G. et al. (1999) Management on Non-specific Low Back Pain by Physiotherapists in Britain and

Ireland; A descriptive questionnaire of current clinical practice. Spine, 24 (13), 1332-1342. - Fritz, J., Irrgang, J. (2001) A Comparison of a Modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain

Disability Scale. Physical Therapy, 81 (2), 776-789. - Fritz, J., Whitman, J., Childs, J. (2005) Lumbar spine segmental mobility assessment: an examination of validity for determining

intervention strategies in patients with low back pain. Archives of Physical Medicine & Rehabilitation, 86, 1745-1752. - Frost, H., Lamb, S., Doll, H., et al. (2004) Randomised Controlled Trial of Physiotherapy Compared with Advice for Low Back Pain.

British Medical Jounal, 329, 708-711. - Gibbons, P., Tehan, P. (2001) Patient positioning and spinal locking for lumbar spine rotation manipulation. Manual Therapy, 6

(3), 130-138. - Gibbons, P., Collins, A. (2001) Comparison of High Velocity Low Amplitude Manipulation with Cavitation versus Non-cavitation:

Effect upon atlanto-axial rotation asymmetry in asymptomatic subjects. The Journal of Orthopaedic Medicine, 23 (1), 2-8. - Giles, L., Muller, R. (2003) Chronic Spinal Pain: A randomised clinical trial comparing medication, acupuncture and spinal

manipulation. Spine, 28 (14), 1490-1503. - Gill, N., Teyhen, D., Lee, I. (2007) Improved contraction of the transversus abdominus immediately following spinal manipulation:

a case study using real-time ultrasound imaging. Manual Therapy, 12, 280-285. - Grieve, G. (1989) Contra-indications to Spinal Manipulation and Allied Treatments. Physiotherapy, 75 (8), 445-453. - Haas, M., Goldberg, B., Aickin, M., Ganger, B. & Attwood, M. (2004) A Practice-based Study of Patients with Acute and Chronic

Low back Pain Attending Primary Care and Chiropractic Physicians: Two-week to 48-month follow-up. Journal of Manipulative and Physiological Therapeutics, 27 (3), 160-169.

- Handoll, H., Howe, T., Madhok, R. (2002) The Cochrane database of systematic reviews. Physiotherapy, 88, 714-16. - Harvey, E., Burton, A., Moffet, J., et al. (2003) Spinal manipulation for low-back pain: a treatment package agreed by the UK

chiropractic, osteopathy and physiotherapy professional associations. Manual Therapy, 8 (1), 46-51. - Hemmila, H., Keinanen-Kiukaanniemi, S., Levoska, S., et al. (2002) Long-term effectiveness of bone-setting, light exercise therapy

and Physiotherapy for prolonged back pain: A randomised Controlled Trial. Journal of Manipulative and Physiological Therapeutics, 25 (2), 99-104.

- Hurwitz, E., Morgenstern, H., Harber, P., et al. (2002) The effectiveness of physical modalities among patients with Low Back Pain Randomised to Chiropractic Care: Findings from the UCLA Low Back Pain Society. Journal of Manipulative and Physiological Therapeutics, 25 (1), 10-20.

- Jadad, A., Moore, R., Carroll, D., et al. (1996) Assessing the Quality of Reports of Randomised Clinical trials: Is Blinding Necessary? Controlled Clinical Trials, 17, 1-12.

- Koes, B., van Tulder, M., Ostelo, R., Burton, A., Waddell, G. (2001) Clinical guidelines for the Management of Low Back in Primary Care. Spine, 26 (22), 2504-2515.

- Koes, B. (2004) How to evaluate manual therapy: value and pitfalls of randomised clinical trials. Manual Therapy, 9, 183-184. - Kotoulas, M. (2002) The use and misuse of the terms manipulation and mobilization in the literature establishing their efficacy in

the treatment of lumbar spine disorders. Physiotherapy Canada, Winter, 53-61. - Licciardone, J.C., Stoll, SS.T., Fulda, K.G., Russo, D.P., Siu, J., Winn, W. & Swift Jr, J. (2003) Osteopathic Manipulative Treatment for

Chronic Low Back Pain: A randomised control trial. Spine, 28 (13), 1355-1362. - McCarthy, C., Arnall, F., Strimpakos, N.,et al. (2004) The Biopsychosocial Classification of Non-specific Low Back Pain: A systematic

Review. Physical Therapy Reviews, 9, 17-30. - Meade, T., Dyer, S., Browne, W., et al. (1995) Low Back Pain of Mechanical Origin: Randomised comparison of chiropractic and

hospital outpatient treatment. British Medical Journal, 300, 1431-1437. - Moore, A., Petty, N. (2001) Evidence-based practice: getting a grip and finding a balance. Manual Therapy, 6, 195-6. - Mohensi-Bandpei, M., Critchley, J., Staunton, T., et al. (2006). A prospective randomised controlled trial of spinal manipulation

and ultrasound in the treatment of chronic low back pain. Physiotherapy, 92 (1), 34-42. - New Zealand Guidelines for Acute Low Back Pain (2004). AAC Wellington: New Zealand. - Niemisto, L., Lahtinen-Suopanki, T., Rissanen, P., et al. (2003a) A randomised Trial of Combined Manipulation, Stabilising

exercises, and Physician Consultation Compared to Physician Consultation Alone for Chronic Low Back Pain. Spine, 28 (19), 2185-2191.



Lumbar Spine Manipulation Evidence (3/3) - Niemisto, L., Rissanen, P., Sarna, S.,et al. (2003b) Cost Effectiveness of Combined Manipulation, Stabilising exercises, and

Physician Consultation Compared to Physician Consultation Alone for Chronic Low Back Pain: a prospective randomised trial with 2-year follow up. Spine, 30 (10), 1109-1115.

- Philips, D., Twomey, l. (1996) A comparison of manual diagnosis with a diagnosis established by a uni-level lumbar spinal block procedure. Manual Therapy, 2 (1), 82-87.

- Potter, L., McCarthy, C., Oldham, J. (2005) Physiological Effects of Spinal Manipulation: A review of proposed theories. Physical Therapy Reviews, 10, 163-170.

- O’Sullivan, P. (2005) Diagnosis and Classification of Chronic low back pain disorders: Maladaptive movement and motor control impairments as underlying mechanism. Manual Therapy, 10, 242-255.

- Rasmussen-Barr, E., Nilsson-Wikmar, L., Arvidsson, J. (2003) Stabilising Training Compared with Manual Treatment in Sub-acute and Chronic Low Back Pain. Manual Therapy, 8, 233-241.

- RCGP (1999) Clinical guidelines for the management of acute low back pain. http://www.rcgp.org.uk/rcgp/clinspec/guidelines/backpain.

- Roland, M., Morris, R. (1983) A study of the Natural History of low Back Pain: Part 1: Development of a Reliable and Sensitive measure of Disability in Low Back Pain. Spine, 8, 141-144.

- Sackett, D., Richardson, W., Rosenberg, W., et al. (1997) Evidence-based medicine. Churchill Livingstone: New York. - Skargren, E., Carlsson, P., Oberg, B. (1998a) One-year Follow-up Comparison of the Cost effectiveness of Chiropractic and

Physiotherapy as Primary Management for Back Pain: Subgroup analysis, recurrence, and additional health care utilisation. Spine, 23 (17), 1875-1884.

- Skargren, E., Carlsson, P., Oberg, B. (1998b) Predictive Factors for 1-year outcome of low-back and Neck Pain in Patients Treated in Primary Care: Comparison between the treatment strategies Chiropractic and Physiotherapy. Pain, 77, 201-207.

- Souvlis, T., Vincenzino, B., Wright, A. (2005) Neurophysiological effects of spinal manual therapy in Grieve’s modern manual therapy, The Vertebral Column. 3rd Ed. Churchill Livingstone: Edinburgh.

- Swinkels, I., van den Ende, C., van den Bosch.W., et al. (2005) Physiotherapy Management of Low Back Pain: Does Practice match the Dutch Guidelines? Australian Journal of Physiotherapy, 51, 35-41.

- Tonelli, M. (1999) In defense of expert opinion. Academic Medicine, 74, 1187-92. - Triano, J., McGregor, M., Hondras, M. et al. (1995) Manipulative Therapy versus education Programs in Chronic Low Back Pain.

Spine, 20, 948-955. - UK BEAM. (2004) United Kingdom Back Pain Exercise and Manipulation (UK BEAM) randomised trial: effectiveness of physical

treatments for back pain in primary care. British Medical Journal, doi:10.1136/bmj.38282.669225.AE (published 29 November 2004). http://bmj.com.

- van Trijffel, E., Anderegg, Q., Bossuyt, P., et al. (2005) Inter-examiner reliability of passive assessment of intervertebral motion in the cervical and lumbar spine: a systematic review. Manual Therapy, 10 (4), 256-269.

- van Tulder, M., Assendelft, W., Koes, B., et al. (1997) Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine, 22 (20), 2323-2330.

- van Tulder M., Furlan, A., Bombardier, C., et al. (2003) Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Spine, 28 (12), 1290-1299.

- Waagen, G., Halderman, S., Cook, G., et al. (1986) Short term Trial of Chiropractic Adjustments for the Relief of Chronic Low Back Pain. Manual Medicine, 2, 63-67.

- Waddell, G (1987) A new clinical model for the treatment of low-back pain. Spine, 12, 632-644. - Effectiveness of Acupuncture, Exercise, and Spinal Manipulation for Low Back Pain (2011)



Sacroiliac joint diagnosis and management evidence (1/2)

- Berthelot, J., Labat, J., Goff, B., Gouin, F., Maugars, Y. (2006) Provocative sacroiliac joint manoeuvres and sacroiliac joint block are

unreliable for diagnosing sacroiliac joint pain. Joint Bone Spine, 73, 17-23. - Broadhurst, N., Bond, M. (1998) Pain provocation tests for the assessment of sacroiliac joint dysfunction. Journal of Spinal

Disorders, 11, 341-345. - Buyruk, H., Stam, H., Snijders, C. (1999) Measurement of sacroiliac joint stiffness in peripartum pelvic pain patients with doppler

imaging of vibrations. European Journal of Obstetrics Gynecology & Reproduction Biology, 83 (2), 159-163. - Damen, L., Buyruk, H., Snijders, C., Stam, H. (2002) The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-

related pelvic pain. Spine, 27 (24), 2820-2824. - Dreyfuss, P., Michaelsen, M., Pauza, K, McLary, J, Bogduk, N. (1996) The value of medical history and physical examination in

diagnosing sacroiliac joint pain. Spine, 21, 2594-2602. - Freburger, J., Riddle, D. (2001) Using published evidence to guide the examination of the sacroiliac joint region. Physical Therapy,

81(5), 1135-1143 - Hillermann, B., Gomes, A., Korporaal, C., Jackson, D. (2006) A pilot study comparing the effects of spinal manipulative therapy with

those of extra-spinal manipulative therapy on quadriceps muscle strength. Journal of Manipulative and Physiological Therapeutics, 29 (2), 145-149.

- Holmgren, U, Waling, K. (2007) Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction. Manual Therapy.

- Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine, 28 (14), 1593-1600.

- Hungerford, B., Gilleard, W., Lee, D. (2004) Altered patterns of pelvic bone motion determined in subjects with posterior pelvic pain using skin markers. Clinical Biomechanics, 19, 456-464.

- Kokmeyer, D., Van der Wurff, P., Aufdemkampe, G. (2002) The Reliability of multi-test regimens with sacroiliac pain provocation tests. Journal of Manipulative and Physiological Therapeutics, 25 (1), 42-48.

- Laslett, M., Young, S., Aprill, C., McDonald, B. (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Australian Journal of Physiotherapy, 49 (2), 89-97.

- Laslett, M., Aprill, C., McDonald, B., Young, S. (2005) Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Manual Therapy, 10 (3), 207-218.

- Maigne, J., Aivaliklis, A., Pfefer, F. (1996) Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine, 21, 1889-1892.

- Marshall, P., Murphy, B. (2006) The effect of sacroiliac joint manipulation on feed-forward activation times of the deep abdominal musculature. Journal of Manipulative and Physiological Therapeutics, 29 (3), 196-202.

- McGrath, C. (2006) Palpation of the sacroiliac joint: an anatomical and sensory challenge. International Journal Osteopathic Medicine, 9, 103-107.

- Mens, J., Vleeming, A., Snijders, C., Stam, H., Ginai, A. (1999) The active straight leg raise test and mobility of the pelvic joints. European Spine Journal, 8, 468-473.

- Mens, J., Snijders, C., Stam, H. (2000) Diagonal trunk muscle exercises in peripartum pelvic pain: a randomized clinical trial. Physical Therapy, 80 (12), 1164-1173.

- Mens, J., Vleeming, A., Snijders, C. (2001) Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine, 26, 1167-1171.

- O’Sullivan, P., Beales, D., Beetham, J. (2002) Altered motor control strategies in subjects with sacroiliac jo int pain during the active straight-leg-raise test. Spine, 27 (1), E1-E8.

- Peace, S., Fryer, G. (2004) Methods used by members of the Australian osteopathic profession to assess the sacroiliac joint. Journal of Osteopathic Medicine, 7 (1), 25-32.

- Pool-Goudzwaard A., Van Dijke G., Snijders C. (2004) Contribution of pelvic floor muscles to stiffness of pelvic ring. Biomechanics, 19 (6), 564-571.

- Richardson, C., Snijders, C., Hides, J., Damen, L. (2002) The relation between the transverse abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine, 27 (4), 399-405.

- Riddle, D., Freburger, J. (2002) Evaluation of the presence of sacroiliac joint region dysfunction using a combination of tests: a multicenter intertester reliability study. Physical Therapy, 82 (8), 772-781.

- Robinson, H, Brox, J, Robinson, R, Bjelland, E, Solem, S, Telje, T. (2007) The reliability of selected motion and pain provocation tests for the sacroiliac joint. Manual Therapy, 12, 72-79.

- Schwarzer, A, Aprill, C, Bogduk, N. (1995) The sacroiliac joint in chronic low back pain. Spine, 20, 31-37.



Sacroiliac joint diagnosis and management evidence (2/2)

- Shearar, K., Colloca, C., White, H. (2005) A randomized clinical trial of manual versus mechanical force manipulation in the

treatment of sacroiliac joint syndrome. Journal of Manipulative and Physiological Therapeutics, 28 (7), 493-501. - Slipman, C., Sterenfeld, E., Chou, L., Herzog, R., Vresilovic, E. (1998) The predictive value of provocative sacroiliac joint stress

manoeuvres in the diagnosis of sacroiliac joint syndrome. Archives of Physical Medicine and Rehabilitation, 79, 288-292. - Snijders, C., Ribbers, M, de Bakker, H., Stoeckart, R., Stam, H. (1998) EMG recordings of abdominal and back muscles in various

standing postures: validation of a biomechanical model on sacroiliac joint stability. Journal of Electromyography and Kinesiology, 8, 205-214.

- Stuge, B., Veierod, M., Vollestad, N. (2004) The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy. Spine, 29 (10), E197-E203.

- Stuge B., Holm I., Vollestad N. (2006) To treat or not treat postpartum pelvic girdle pain with stabilizing exercises? Manual Therapy, 11 (4), 337-343.

- Suter E, McMorland G, Herzog W, Bray R. (1999) Decrease in quadriceps inhibition after sacroiliac joint manipulation in patients with anterior knee pain. Journal of Manipulative and Physiological Therapeutics, 22 (3), 149-153.

- Suter E, McMorland G, Herzog W, Bray R. (2000) Conservative lower back treatment reduces inhibition in knee-extensor muscles: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 23 (2), 76-80.

- Timgren, J., Soinila, S. (2006) Reversible pelvic asymmetry: an overlooked syndrome manifesting as scoliosis, apparent leg-length difference, and neurologic symptoms. Journal of Manipulative and Physiological Therapeutics, 29 (7), 561-565.

- Van der Wurff, P., Buijs, E., Groen, G. (2006a) Intensity mapping of pain referral areas in sacroiliac joint pain patients. Journal of Manipulative & Physiological Therapeutics, 29 (3), 190-195.

- Van der Wurff, P, Buijs, E, Groen, G. (2006b) A multitest regimen of pain provocation tests as an aid to reduce unnecessary minimally invasive sacroiliac joint procedures. Archives of Physical Medicine and Rehabilitation, 87, 10-14.

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