Workshop: Neck Manipulation & Stroke / Cervicogenic Dizziness

Date: Saturday, December 8, 2018
Time: 8:30 AM – 12:30 PM
CE Hours: 3.5
Facilitator: Dr. Shawn Thistle

A. Neck Manipulation & Stroke – Reconciling Evidence & Clinical Practice (1.5 hours)

This is an important topic, yet chiropractors are normally only exposed to it one paper at a time, or via the language contained in our consent forms. In this session, we will finally discuss all the pertinent evidence in the context of day-to-day chiropractic practice. It is important for us to understand the strengths and limitations of the types of research we have conducted on this topic, so we can appropriately discuss it with our patients and colleagues in other health disciplines. We will also focus on timely recognition of concerning patient presentations to facilitate appropriate communication strategies and management.

B. Cervicogenic Dizziness – Clinical Implications (2 hours)

From post-concussion cases in athletes to geriatric patients with degenerative neck conditions, dizziness, vertigo and unsteadiness can occur in isolation, or in conjunction with other symptoms or syndromes. This workshop session reviews literature on the complex interplay between cervical spine function, dizziness and vertigo; emphasizing clinical decision making via evidence-based assessment techniques and case examples. The current state of the evidence for employing manual therapy interventions (including spinal manipulation) in the dizzy patient to enhance best practices for patient care will be discussed.

Learning Objectives

Participants will be able to:

Neck Manipulation & Stroke – Reconciling Evidence & Clinical Practice

  1. Achieve enhanced understanding of the classification & epidemiology of cervical artery strokes as well as the concepts of real-world and research considerations pertaining to causation and association.
  2. Summarize the current state of knowledge regarding potential mechanisms of injury for cervical arteries.
  3. Explain existing evidence investigating whether SMT can damage arteries or change cranial blood flow.
  4. Explore potential signs and clinical presentations that should alert us to potentially dangerous cases presenting to our offices, including informed consent and communication strategies as well as practical patient management advice.

Cervicogenic Dizziness – Clinical Implications

  1. Summarize common differential diagnoses for the dizzy patient.
  2. Navigate the literature pertaining to sensorimotor integration, specifically the complex interplay between cervical spine function and dizziness or vertigo.
  3. Apply current evidence on the appropriateness and efficacy of manual therapy for cervicogenic dizziness once this diagnosis is established.


Neck Manipulation & Stroke – Reconciling Evidence & Clinical Practice

8:30 am            Introduction and classification of cervical artery strokes

8:50 am            Studying the relationship between neck manipulation and stroke

9:10 am            Epidemiology of cervical artery strokes and mechanisms of injury

9:30 am            Clinical aspects and practical considerations

Cervicogenic Dizziness – Clinical Implications

10:00 am          Break

10:30 am          Definitions, causes and differential diagnosis of dizziness/vertigo

10:45 am          Cervical somatosensory integration – pathophysiology of cervicogenic dizziness

11:00 am          Clinical aspects of cervicogenic dizziness – history and examination

11:30 am          Management considerations for cervicogenic dizziness – evidence review and case examples

About the Facilitator

Shawn Thistle, DC


Dr. Shawn Thistle is a practicing chiropractor, educator, international speaker, knowledge-transfer leader, entrepreneur & medicolegal consultant. He is the Founder & CEO of RRS Education, a continuing education company providing weekly Research Reviews, informative Seminars & convenient Online Courses for chiropractors, physiotherapists & osteopaths around the world. He has also lectured as a part-time faculty member at the Canadian Memorial Chiropractic College in the Orthopedics Department for 14 years. His skillset as an educator and consultant is further strengthened by my experience in expert medicolegal reporting in chiropractic malpractice cases.

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