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Risks associated with manual therapy

The risks of major adverse events associated with manual therapy are low, but the relative risk of adverse events appears to be greater with drug
therapy. Mrs Dorothy Beecham is on multiple medication that will affect the way, she will be treated in our clinic. She's also been diagnosed with DVT,
osteoarthritis, COPD, myocardial infarction and type II diabetes that would be an absolute contraindication for several techniques employed in Manual
therapy for use in the local region. Below are the techniques that should be avoided for Mrs. Dorothy Beecham
1. Soft tissue Techniques are to be avoided due to DVT as this can increase the risk of a clot being dislodged and travelling to the lungs. High blood
pressure is associated with carotid plaque formation which could then be ruptured in case of soft tissues manipulation causing internal bleeding.
2. Lymphatic drainage technique are to be avoided in general and specifically pedal pump and thoracic pump technique is to be avoided. Thoracic
pump needs to be avoided as she's got Osteoarthritis and exerting pressure over the thoracic cage could potentially cause a fracture. Pedal pump should
be avoided as this can dislodge the blood clot and can cause pulmonary embolism.
3. Articulatory techniques are absolutely contraindicated in student clinic in the presence of DVT as this can dislodge the blood clot.
4. HVLA techniques should be avoided in patients on anticoagulants and with osteoporosis. Thus HVLA techniques are contraindicated in this case,
even though risk of a stroke or tissue damage amongst the seniors and healthy subjects is extremely low. Due to osteoporosis, patient is also susceptible
to cauda equina after the spinal manipulation.

1.
Carnes D, Mars Ts Fau - Mullinger B, Mullinger B Fau - Froud R, Froud R Fau - Underwood M, Underwood M. Adverse events and manual
therapy: a systematic review. (1532-2769 (Electronic)).
2.
Department RH. Clinic Manual 2013. Melbourne, Australia: RMIT; 2013 [cited 2016 20/04/2016].
3.
Anthony Chila AOA. FOUNDATIONS OF OSTEOPATHIC MEDICINE. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2010. 1158 p.
4.
Yan B, Peng L, Han D, Sun L, Dong Q, Yang P, et al. Blood Pressure Reverse-Dipping is Associated With Early Formation of Carotid Plaque in
Senior Hypertensive Patients. Medicine. 2015;94(10):e604.
5.
Tosch H. Massage + Medication US: American Massage Therapy Association; 2014 [cited 2016 20/04/2016]. Available from:
https://www.amtamassage.org/articles/3/MTJ/detail/3051.
6.
Alexander S. Nicholas EAN. Atlas of Osteopathic Techniques. Third ed. Philadelphia: Wolters Kluwer; 2016.
7.
Zachary Nye JML, Stockton M. Mayer, Rachel Laven. First Aid for the COMLEX. New York: McGraw-Hill Companies Inc.; 2007. 249 p.
8.
Whedon JM, Song Y, Mackenzie TA, Phillips RB, Lukovits TG, Lurie JD. Risk of Stroke After Chiropractic Spinal Manipulation in Medicare B
Beneficiaries Aged 66 to 99 Years With Neck Pain. Journal of Manipulative & Physiological Therapeutics. 2016;38(2):93-101.
9.
Achalandabaso A, Plaza-Manzano G, Lomas-Vega R, Mart, #xed, nez-Amat A, et al. Tissue Damage Markers after a Spinal Manipulation in
Healthy Subjects: A Preliminary Report of a Randomized Controlled Trial. Disease Markers. 2014;2014:7.
10.
Tamburrelli FC, Genitiempo M, Logroscino CA. Cauda equina syndrome and spine manipulation: case report and review of the literature.
European Spine Journal. 2011;20(1):128-31.
Document: 317058751.doc
Author: Sonja Cleary Test User
Save Date: RMIT University

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