Evidence-Based Examination of the Thoracic Spine: An Update

Presented by Chad Cook

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Video Runtime: 67 Minutes; Learning Assessment Time: 62 Minutes

In this course, users will evaluate the impact and prevalence of thoracic dysfunction, understand the imperative patient history elements of a thoracic examination, and identify which patient history components are affiliated with thoracic pathology. The most common forms of self-report outcome measures for the thoracic spine are presented and discussed. Viewers will also identify the most prevalent red flags germane to the thoracic spine examination and differentiate the purposes of each diagnostic test for sinister problems. An objective is to synthesize the importance of specific, meaningful clinical findings during the examination process and evaluate the benefit of palpation and manual muscle testing as part of a dedicated clinical examination. Lastly, viewers will identify the most diagnostic thoracic-spine-oriented special tests and apply the tests to the appropriate diagnoses. Current research is presented throughout the course to provide learners with the proper tools for evidence-based management of these patients. This course is part of a comprehensive clinical series covering examination and intervention for the cervical, thoracic, and lumbar spine, as well as the upper (shoulder, elbow, wrist, and hand) and lower (hip, pelvis, knee, foot, and ankle) quarters.

Meet your instructor

Chad Cook

Dr. Cook is a professor at Duke University with a Category A appointment in the Duke Clinical Research Institute and an adjunct appointment in the Department of Population Health Sciences. He is a clinical researcher, physical therapist, and profession advocate with a long history of clinical care excellence and service and…

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Chapters & learning objectives

Thoracic Spine Dysfunction: Prevalence and Economic Impact

1. Thoracic Spine Dysfunction: Prevalence and Economic Impact

In this chapter, learners will evaluate the economic impact of thoracic dysfunction and consider the prevalence/incidence of thoracic pain and how this influences clinical practice. The overall burden of thoracic pain is discussed in comparison to other musculoskeletal and nonmusculoskeletal conditions worldwide.

Patient History and Outcome Measures

2. Patient History and Outcome Measures

In this chapter, learners will discuss the imperative patient history elements of a thoracic examination and define which patient history components are affiliated with thoracic pathology. Learners will also discuss the most common forms of self-report patient outcome measures as well as their validity.

Observation

3. Observation

In this chapter, learners will identify the link between observed posture and thoracic pain or dysfunction. Learners will also identify benefits of general observation of a patient’s expression of fear, anxiety, or distress.

Triage and Screening

4. Triage and Screening

In this chapter, learners will identify the most prevalent red flags germane to the thoracic spine examination. The chapter will compare and contrast the purposes of each diagnostic test for sinister problems. Learners will also analyze the triggers that would prompt the use of a test for ruling out a condition and evaluate the benefit of performing these “ruling out” actions first within the examination. Lastly, learners will understand structural differentiation.

The Movement Examination of the Thoracic Spine

5. The Movement Examination of the Thoracic Spine

This chapter will synthesize the importance of the movement assessment and will contrast the goals of the three primary phases of the initial examination.

Palpation, Muscle Endurance, and Physical Performance Measures

6. Palpation, Muscle Endurance, and Physical Performance Measures

This chapter will evaluate the benefit of palpation as part of a dedicated clinical examination. Learners will also evaluate the benefit and types of manual muscle testing for the thoracic spine.

Confirmation-Based Special Tests

7. Confirmation-Based Special Tests

In this chapter, learners will understand the language of diagnostic accuracy and will identify the most diagnostic thoracic-oriented special tests. The purpose of the chapter is to apply the tests to the appropriate diagnoses for better patient management.

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