Can the risk of Vertebral Artery Dissection be determined with pre-manipulative screening?

August 14, 2015 by Sian Smale

Cervical manipulation has inherent risks. One of the the most dangerous adverse effects following cervical manipulation is vertebral artery dissection (VAD). For the past two decades, functional pre-manipulative screening tests have been used by Physiotherapists to identify patients at risk of vertebral artery insufficiency (VBI). Many experts in the field of VAD and cervical manipulation have started to question the clinical validity of these tests and currently there is great uncertainty if the tests themselves are potentially dangerous enough to cause VAD.

This blog aims to review the risk of cervical manipulation, the clinical presentation of VBI and the current assessment recommended by the Australian Physiotherapy Association. I'm also pleased to include the thoughts and recommendations of Dr. Mark Percy, Specialist Radiologist from MIA Lilydale, Victoria.

Lumbar disc herniation with radiculopathy - a case study

February 27, 2015 by Sian Smale

How would you treat a patient presenting with severe low back pain radiating into their leg? What treatments do you fall back on day 1? Lets take a look at my clinical reasoning of a young female with lumbar disc herniation with radiculopathy.

Functional assessment of a water skiing injury

February 07, 2015 by Sian Smale

The aim of this blog is to outline a case study on a lower back injury sustained from waterskiing and the importance of performing a thorough functional assessment. After completing my Masters I developed a framework for performing a initial musculoskeletal assessment, which I could apply to almost all presentations. For this presentation however my main focus was on the functionally task and mechanism of injury.

Day 2 Treatment...what now??

August 22, 2014 by Alicia Rayner

A lot of emphasis is placed on a thorough initial assessment, with treatment targeted towards the impairments discovered. But what direction should your treatment take after that initial treatment?

Visceral Pain

July 14, 2014 by Sian Smale

Recently I attended a PD lecture presented by my colleague Daniel Zwolak, who is a APA titled Musculoskeletal Physiotherapist. His lecture was on the clinical signs of visceral pain. It was a great opportunity to reflect on my clinical reasoning process and understanding of specific non-musculoskeletal pain conditions. Inspired by his lecture, I have chosen to write this blog on some of the more common conditions which may present to a physiotherapy private practice clinic.

Clinical Reasoning Reflection

June 23, 2014 by Sian Smale

Clinical reasoning has been defined throughout the literature as a problem-solving process, in which the therapist uses clinical data, client choices, professional judgment and knowledge to evaluate, diagnose and manage a patient’s problem (Butler, 2000; Jones, Rivett, & Twomey, 2004). This blog shares the key points I learnt from Andrew Dalwood during his lecture on clinical reasoning.