Resumen
La diferenciación de diagnósticos es crucial en fisioterapia, especialmente en el área de dolor cervical.
Se recomienda descartar patologías no musculoesqueléticas como causa de los síntomas del paciente.
Aunque el sistema nervioso autónomo (SNA) es importante y está involucrado en condiciones de dolor, muchos profesionales de la salud no están familiarizados con él.
Las condiciones autonómicas pueden ser una señal de alerta de una lesión a lo largo de la vía simpática.
Este curso introductorio proporciona la información esencial para comprender las disfunciones autonómicas cervicales y su evaluación clínica, lo que mejora la capacidad de razonamiento clínico y la identificación de patrones.
Avances en el diagnóstico diferencial y evaluación autonómica cervical en fisioterapia
Los fisioterapeutas pueden potenciar sus habilidades en el diagnóstico diferencial y la capacidad de evaluación autonómica cervical. Estos avances resultan valiosos para las clínicas de fisioterapia, ya que permiten mejorar el diagnóstico y tratamiento de patologías cervicales mediante un enfoque basado en el conocimiento autónomo. La implementación de estas técnicas promete un futuro promisorio en el campo de la fisioterapia.
Abstract original
A guide to identify cervical autonomic dysfunctions (and associated conditions) in patients with musculoskeletal disorders in physical therapy practice
Background: Differential diagnosis is a hot topic in physical therapy, especially for those working in a direct access setting dealing with neck pain and its associated disorders. All international guidelines agree in recommending to first rule out non-musculoskeletal pathologies as the cause of signs and symptoms in the patient. Although the autonomic nervous system (ANS) has a crucial role and is also involved in pain conditions, coverage of it in neuroscience textbooks and educational programmes is limited and most healthcare professionals are unfamiliar with it. Although autonomic conditions are benign in nature, they are clinically of great importance as they may be a 'red flag' warning of an injury along the sympathetic pathway. Therefore, sound knowledge of the ANS system is essential for clinicians.
Objective: To develop physical therapists' knowledge of and confidence in understanding cervical ANS function and dysfunction, thus enhancing clinical reasoning skills and the pattern recognition process, and performing and interpreting objective examinations.
Methods: This master class provides an introductory guide and essential knowledge to facilitate clinicians to understand cervical autonomic dysfunctions and their clinical evaluation. The optimal referral method is also handled.
Conclusions: Gaining knowledge and understanding of the ANS, its function, its dysfunction, and the related clinical manifestations is likely to lead to a decision-making process driven by 'science and conscience'. This will empower physical therapists to be aware of subtle clues that may be offered by patients during the interview and history intake leading to the appropriate physical examination and triage.
| Autores | Firas Mourad Andrea Giudice Giorgio Maritati Filippo Maselli Rik Kranenburg Alan Taylor Roger Kerry Nathan Hutting |
| revista | Braz J Phys Ther |
| DOI | 10.1016/j.bjpt.2023.100495 |