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In the field of physical therapy, there is debate as to the clinical utility of premanipulative vascular assessments. Cervical artery dysfunction (CAD) risk assessment involves a multi-system approach to differentiate between spontaneous versus mechanical events. The purposes of this inductive analysis of the literature are to discuss the link between cervical spine manipulation (CSM) and CAD, to examine the literature on premanipulative vascular tests, and to suggest an optimal sequence of premanipulative testing based on the differentiation of a spontaneous versus mechanical vascular event. Knowing what premanipulative vascular tests assess and the associated clinical application facilitates an evidence-informed decision for clinical application of vascular assessment before CSM.


This article was originally published in Journal of Physical Therapy Science, volume 32, issue 11, in 2020.

Peer Reviewed



The Society of Physical Therapy Science

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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