Cervical Thoracic Manipulation Course2019-07-10T10:22:22-04:00

Cervical Thoracic Manipulation Course


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All courses listed are emailed to OPA members on the third Friday of the month.

Questions? Please contact Becky MacDonald.


Custom Content
Course TypeOnline/On-site
Date11/30/2019 - 12/01/2019
Instructor NameJack Miler and Rob Werstine
Cost$650.00 + tax
AddressVitality Physiotherapy and Wellness Centre
4184 Spratt Road
Gloucester, ON K1V 0Z6
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DistrictEastern Ontario
Brief Description

This two-part course will review the theoretical knowledge and background learning related to manual therapy and manipulation of the cervical and thoracic spine with a 4- week online distance-learning program. The focus of the online courses are safety and theoretical preparation for the practical component. Then the participant will attend a practical, in-person course that will help them gain psycho-motor skill competency in the practice of manipulation of the cervical and thoracic spine.

References for review are provided at the beginning of the course.

The online course consists of 9 audio-power point presentations which include:

  • Vascular Risk in Cervical Manipulation and Treatment

The 2018 draft IFOMPT guidelines for Vascular screening are reviewed. The emphasis is placed on shared decision making and the importance of history in helping to define vascular risk in the absence of absolute certainty. The symptoms and signs of a vascular event are reviewed and a physical assessment, including blood pressure are outlined in context. Finally, risk assessment is discussed.

  • Red Flags for Cervical Manipulation and Treatment

Discussion of how to screen for specific Red Flags are discussed relevant to the existing literature on screening. Red Flags covered are Fractures, Infections, Neurological Diseases, Cancer, Congenital disorders, Inflammatory Diseases and Vascular Pathology. The most recent methods for screening from the literature are reviewed.

A multiple choice quiz will test the retention and knowledge before beginning the next unit.

  • Introduction to Manipulation and Proposed Effects of Manipulation

The definition of manipulation is reviewed and the proposed Neurophysiological effects of manipulation are outlined. Information on Likelihood ratios is reviewed along with the current Clinical Practice Guidelines for the use of Cervical and Thoracic manipulation.

  • Manipulation of the Cervical and Thoracic Spine- Efficacy

The literature regarding Cervical and Thoracic manipulation are reviewed. Manipulation efficacy is discussed and is compared to mobilization and self-guided techniques for Cervical pain, headaches and Thoracic spine pain.

A multiple choice quiz will test the retention and knowledge before beginning the next unit.

  • Cervical and Thoracic Manipulation- The Process

The philosophy and general approach to manipulation are reviewed. A step by step process for how to lock and how to manipulate the cervical spine is discussed in a point by point process.

  • Yellow Flag Screening

The signs and symptoms that are associated with Yellow Flags for neck pain and Whiplash Associated Disorders are highlighted based on the current literature. A Pain Neuroscience approach to education is discussed to address fear avoidance and catastrophizing. Screening tools and outcome measures are discussed with their psychometric properties.

  • Introduction to the Treatment-Based Classification (TBC) System of the Cervical Spine

The TBC is introduced. Three levels of screening are outlined- red flags/yellow flags, Staging and TBC category. The indications for each category and the treatment associated are reviewed with examples.

A multiple choice quiz will test the retention and knowledge before beginning the next unit.

  • Legislative Requirements for Manipulation

A multiple choice quiz will test the retention and knowledge before beginning the next unit.

  • Anatomy and Pathology in the Cervical and Thoracic Spine

The bony, ligament and disc anatomy for the cervical and thoracic spine is reviewed in terms of clinical relevance. Pathology related to Whiplash Associated Disorders and aging are discussed in the context of the effect on clinical reasoning and treatment.

The quizzes are marked automatically and a participant is only able to progress after scoring at least an 80% on the quizzes. The students are also required to review the three Physiotherapy Alberta on-line Power Point Presentations regarding the safety of manipulation.

As well, videos of the manipulations to be covered in the in-person course are provided for the participants to review including:

  • The side-lying gap manipulation of the Thoraco-lumbar region
  • The seated distraction manipulation of the Cervical-thoracic region
  • The supine distraction gap manipulation of the mid-Thoracic spine
  • The inferior extension manipulation of the mid-Cervical spine

Total of 20 minutes.

Following the online course, participants will attend a weekend intensive course to gain the skills of assessment and manipulation of the Cervical and Thoracic spine. This course will focus on the clinical reasoning and motor learning required to effectively integrate manual physical therapy examination and intervention techniques into the clinical management of these individuals. Safety and screening for appropriate candidates to discuss manipulation as an option are reviewed in detail. The evidence-based assessment of the cervical/thoracic region will be illustrated and practiced by participants to help classify patients into a treatment based category. The five categories include Mobility, Directional Preference, Exercise/Endurance, Pain Control and Headaches. The focus of the course will be on effective and safe assessment of patients to identify those patients who would most likely benefit from manipulation. Participants will have the opportunity to practice Cervical/Thoracic area manipulations including supine, side-lying and seated techniques. The techniques covered include but are not restricted to the manipulations listed above. Once students have been guided in the refinement of the motor strategies for manipulation, they will be asked to demonstrate competency for each manipulation covered in the course prior to having their skills checklist marked as competent. Audio-visual, demonstration, instructor guided application, peer-review feed-back and case studies will be employed to promote learning prior to assessment of competency. This course will provide 14 hours of direct contact teaching related to the skill acquisition of manipulation.

Contact NameRob Werstine
Contact EmailEmail hidden; Javascript is required.
Contact Phone(519) 200-4777