title: Vascular profiling: should manual therapists take blood pressure?
abstract: Risk assessment of the cervical spine prior to manual therapy interventions is currently a contentious topic, highlighted by recent suggestions in the medical press (http://www.bmj.com/content/344/bmj.e3679), that manipulative therapy should be abandoned because of the perceived risk. This paper addresses the issue of manual therapists using blood pressure measurement as an aid to clinical reasoning and decision making. The authors' use a case series of three neuromusculoskeletal presentations, which support the contention that blood pressure recording can prove to be an appropriate objective test for assessment prior to manual therapy interventions. Furthermore, it is suggested that blood pressure testing may provide direction for risk assessment and/or the management of patients across all populations and age groups as part of a holistic 'vascular profiling' approach to clinical reasoning and decision making.
authors.affiliation: University of Nottingham, Division of Physiotherapy, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. alan.taylor@nottingham.ac.uk
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Taylor
authors.forename: Roger
authors.initials: R
authors.lastname: Kerry
mesh_terms: D000328:Adult; D000368:Aged; D001795:Blood Pressure Determination; D002574:Cervical Vertebrae / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D020393:Manipulation, Spinal / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000628:therapy; D019547:Neck Pain / Q000175:diagnosis / Q000628:therapy*; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome