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Evidence-Based Examination of the Thoracic Spine

presented by Chad Cook

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

    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 years of academic experience. His passions include refining and improving the patient examination process and validating tools used in day-to-day physical therapist practice. He received his BS in Physical Therapy from Maryville University (St. Louis) in 1990 and PhD (2003) from Texas Tech University. Dr. Cook received fellowship status at the American Academy of Orthopedic Manual Therapy in 2006. He is a Catherine Worthingham Fellow of the American Physical Therapy Association. Dr. Cook has published over 250 peer reviewed papers and has keynoted in 6 continents and numerous countries. He has two textbooks in their 2nd edition and a third textbook in its first edition. Dr. Cook has a long-standing history of service roles as an editor-in-chief or associate/special topics editor for multiple journals including JOSPT and BJSM. Dr. Cook has won numerous awards locally at Duke for teaching, is the 2009 Baethke-Carlin award winner for the American Physical Therapy Association, is the 2008 recipient of the Helen Bradley career achievement award, and is the 2005 winner of the J Warren Perry Distinguished Authorship Award. Dr. Cook was the Pauline Cerasoli Lecturer in 2017. In addition, Dr. Cook is also the 2011 winner and was the 2012 and 2013 co-winner of the AAOMPT Excellence in Research Award.

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Chapters & Learning Objectives

Download Learning Objectives
  1. Prevalence and Incidence

    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

    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

    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)

    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

    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

    6. Palpation and Muscle Testing and Performance

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

  7. Special Testing

    7. Special Testing

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