IFOMPT - A Guide to Identify Cervical Autonomic Dysfunctions (and Associated Conditions) in Patients with Musculoskeletal Disorders in Physical Therapy Practice

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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. 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.

Learning outcomes: 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.

Firas Mourad

PT, PhD, MSc

Dr. Firas Mourad, PhD, PT, MSc, OMPT

Senior Lecturer in Musculoskeletal Physiotherapy

Programme Leader Master in Physiotherapy

LUNEX University, Physiotherapy Department

Former Vice-president of the Italian Manual Therapy and Musculoskeletal Physiotherapy

Association Former IFOMPT MO Delegate for Italy

Dr Firas Mourad was awarded an International PhD with honours in Ciencias de la Salud from the Universidad Rey Juan Carlos. Additionally, he completed an extensive manual therapy program granting the Orthopedic Manipulative Physical Therapist (IFOMPT) status from the University of Genova, a MSc in rehabilitation sciences of the health professions from the University of Milan “La Statale”, a Post-Graduate Diploma in Sport and Exercise Medicine from the Ulster University in Belfast, and a Post-Graduate Certificate in systematic review and meta-analysis (Cochrane) from the University of Modena and Reggio Emilia. He is an international guest lecturer and adjunct faculty for numerous musculoskeletal physiotherapy educational programs and conferences. Dr Mourad boasts more than fifteen years of clinical experience and administration of complex multidisciplinary healthcare centers. Dr Mourad has published original experimental research, clinical trials, case reports, and literature reviews in internationally recognized peer-reviewed journals. His topics of influence are neck pain assessment and management, differential diagnosis in physiotherapy, and spinal manipulation. Recently, he joined LUNEX University as Programme Leader for the Master in Physiotherapy with the aim of obtaining the IFOMPT credentials.

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