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Evidence-Based Examination of the Thoracic Spine

presented by Chad Cook

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Disclosure Statement:

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:
Dr. Chad Cook presents this comprehensive evidence-based course on examination and assessment of the thoracic spine. A clinically relevant approach to assessing thoracic spine dysfunctions is covered, including proper patient history, outcomes measures, red-flag screening, differential diagnosis, and structural screening. Upon completion of this course, perform active and passive physiological and passive accessory movement examination, as well as appropriate palpatory, strength and endurance tests. Identify the most diagnostic thoracic 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 19 course comprehensive clinical series covering examination and intervention for the cervical, thoracic, as well as the upper (shoulder, elbow, wrist, and hand) and lower (hip, pelvis, knee, foot, and ankle) quarters.

Meet Your Instructor


Chad Cook, PT, PhD, MBA, FAPTA, FAAOMPT is professor at Duke University, the program director of the Doctor of Physical Therapy division with a category A appointment in the Duke Clinical Research Institute. He is a clinical researcher, physical therapist, and profession advocate with a long-term history of clinical care excellence and service and 19…

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Chapters & Learning Objectives

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1. Prevalence and Incidence

Define Thoracic Pain. Consider the prevalence/incidence of thoracic pain and how this influences clinical practice. Evaluate the economic impact of thoracic dysfunction.

2. Patient History and Outcomes Measures

Discuss the imperative patient history elements of a thoracic examination. Define which patient history components are affiliated with thoracic pathology. Discuss the most common forms of self-report patient outcomes measures for thoracic pain.

3. Observation

Identify the link between observation of posture and thoracic pain or dysfunction. Recognize selected observational findings that may be associated with disease processes.

4. Triage/Screening/Sensitive Tests (Referring Out)

Identify the best tests used to diagnosis red flag conditions of the thoracic and abdominal region. Compare and contrast different tests used for differential diagnosis. Identify structural screening tests to rule out competing diagnoses.

5. Motion Testing

Understand the nature of the patient’s condition. Reproduce the concordant sign and find movements or positions that improve the condition. Perform active and passive physiological and passive accessory movement examination.

6. Palpation and Muscle Testing and Performance

Perform an appropriate palpatory examination. Perform an appropriate strength and endurance examination.

7. Special Testing

Understand the language of diagnostic accuracy. Identify the most diagnostic thoracic oriented special tests. Apply the tests to the appropriate diagnoses.

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