Clinical Testing for Cervical Mechanical Disorders which Produce Ischemic Vertigo.
The primary purpose of this paper is to outline the reasons for certain questions to be considered during the subjective examination if dizziness is a complaint. A gradual progression of clinical tests performed during the physical examination is proposed to detect vertebral artery signs and symptoms. The tests themselves create a risk as they are all applying stress to the vertebral artery. This progression will produce minimal vertebral artery signs and symptoms, by applying first the test which requires the least stress on the vertebral artery. These clinical tests are based on a pathological mechanical rationale. It is proposed that this clinical judgment process of testing for ischemic vertigo, will enable the clinician to select the most appropriate assessment and treatment techniques for patients with either cervical or upper quadrant syndromes. The upper quarter consists of the head, neck, and upper extremities including the clavicles and scapula. Upper quadrant syndromes involve both a spinal and peripheral dysfunction which are pathologically related. J Orthop Sports Phys Ther 1989;11(5):176-182.
Aspinall
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