Rehabilitation and Therapy Commons^™

Vestibular Influence On Cranio-Cervical Pain: A Case Report, Frank Gargano, Wayne Hing, Caroline Cross

Wayne Hing

This case report describes a 39 year old woman with a 10 month history of right-sided temporal headaches. In addition, she experienced a ‘wobble’ feeling when rolling toward her right side and reported suboccipital pain, tinnitus and a mild visual disturbance. Objective assessment revealed she had a positional upbeat clockwise torsional nystagmus, that is, a positive Dix-Hallpike test for benign paroxysmal positional vertigo. Furthermore, manual assessment revealed right upper cervical joint dysfunction. She was treated with a four stage canalith repositioning manoeuvre for the vestibular system which abolished her ‘wobble’ symptom. Subsequently, manual therapy techniques were applied to the cervical …

Clinical Predictors Of A Positive Response To Guided Diagnostic Block Into The Subacromial Bursa, Angela Cadogan, Mark Laslett, Wayne Hing, Peter Mcnair, Stephen Taylor

Wayne Hing

Objective: To compare the accuracy of combinations of clinical examination findings for predicting a positive response to injection of local anaesthetic into the subacromial bursa.

Design: Prospective, cohort, diagnostic validity design. Subjects: Consecutive patients with shoulder pain recruited from primary care physiotherapy and general medical practices.

Methods: All subjects underwent a standardised clinical examination (index test) followed by a diagnostic injection of xylocaineTM into the subacromial bursa (reference standard test) performed under ultrasound guidance. Clinical examination variables associated with a positive anaesthetic response (≥ 80% post-injection reduction in pain intensity) were identified (p

Results: Of the 196 subjects who received …

Shoulder Pain In Primary Care: Diagnostic Accuracy Of Clinical Examination Tests For Non-Traumatic Acromioclavicular Joint Pain, Angela Cadogan, Peter Mcnair, Mark Laslett, Wayne Hing

Wayne Hing

Background: Despite numerous methodological flaws in previous study designs and the lack of validation in primary care populations, clinical tests for identifying acromioclavicular joint (ACJ) pain are widely utilised without concern for such issues. The aim of this study was to estimate the diagnostic accuracy of traditional ACJ tests and to compare their accuracy with other clinical examination features for identifying a predominant ACJ pain source in a primary care cohort. Methods: Consecutive patients with shoulder pain were recruited prospectively from primary health care clinics. Following a standardised clinical examination and diagnostic injection into the subacromial bursa, all participants received …