Vascular risks in OMT interventions to the neck

Abstract

When performing orthopedic manual therapy (OMT) on the cervical spine, safety checks arenecessary. In this paper we provide an overview of the risks and their evaluation of the cervical vascularsystem, focusing on the IFOMPT framework published in 2020. Although adverse events after OMT onthe cervical spine are rare, efforts to reduce the risk are necessary. The current hypothesis is that adverseevents related to cervical vasculature after OMT may have an underlying pathology that worsens withtreatment. Therefore, it is necessary to consider risk factors, symptoms, and signs to reduce the risk. Onemajor change in the framework is the exclusion of the cervical positioning test because of its low sensitivityand difficulty in predicting adverse events. It is important to fully understand this framework as it providesimportant information for physical therapists to evaluate and manage patients with potential vascular lesionsand develop appropriate clinical reasoning.