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Evidence-Based Assessment and Manual Therapy Treatment with a New Zealand Approach

There are a number of rationales addressing the treatment of the upper quarter. This course takes some of the New Zealand approaches and ties them into the eclectic evidence-based North American approach. This course is designed to equip the physical and occupational therapist with the ability to differentially assess the numerous causes of pain and dysfunction in the cervical spine and upper extremity. This involves looking for the ‘drivers’ not just the painful structure. A systematic hands-on approach to the assessment and manual therapy treatment of the neuromuscular and articular components of the cervical-thoracic spine and upper extremity is presented.

Participants will learn the interactions between these areas during movement, as well as the loading of different joints and soft tissues. They will also be taught how to execute joint play, neural tissue mobility and muscle balance tests, to indicate a structure’s involvement in the presenting condition, as well as assessment of irritability.

The assessment system taught will allow the participant to apply sound clinical skills to be more effective in this region. The participant will be taught effective manual therapy approaches, including disc centralization rationale, mobilization, physiological overpressure mobilizations (POMs), muscle energy and manual traction, along with strain and counter-strain.

This is a practical course for a clinician in the outpatient setting.


  • ·Incorporate vindication and provocation tests to differentially assess problems of cervical and thoracic spine and structures of the upper extremity
  • ·Assess conditions that are inappropriate to treat, or are non-musculoskeletal in nature
  • ·Identify ‘drivers’ that are contributing to the problem
  • ·Understand how different manual therapy rationales are best used in the treatment of the upper quarter
  • ·Perform an effective objective assessment examination that is timely to assist in treatment selection
  • ·Assessment joint stability and mobility
  • ·Perform appropriate manual therapy treatment techniques for each area, taking irritability into account



7:15 Sign In and Breakfast

8:00 Introduction to orthopedic manual therapy

8:30 Assessment and anatomical considerations of the neck and shoulder complex

10:00 Break

10:10 Assess and objective measurement of fibromyalgia

10:30 Assessment of the upper quarter, including the cervical and thoracic spine and the shoulder

12:00 Lunch

1:00 Manual therapy treatment of the cervical spine, based on five syndromes: derangement, dysfunction, combination, instability and stenosis

3:00 Break

3:10 Cervical spine treatment continued

4:00 Treatment of the upper thoracic spine

5:00 End of day one


7:30 Breakfast

8:00 Assessment and treatment of the scapular thoracic region

9:00 Treatment of the shoulder girdle with strain and counter-strain

10:00 Break

10:10 Treatment of the restricted shoulder

12:00 Lunch

12:30 Assessment and treatment of the elbow, including epicondylitis

1:45 Assessment and treatment of the wrist and hand

3:00 End of course


Day 1 – 7:40, Day 2 – 6:20, Total 14 hours

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