CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
CCGI Best Practice Collaborators
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
In April 2016, CCGI Opinion Leaders were joined by a new team of CCGI Best Practice Collaborators. These are influential evidence-informed clinicians recently nominated by their colleagues in a nationwide survey. They are assisting Opinion Leaders in their area with reaching out to other chiropractors and teaching them about critical thinking, proper interpretation of evidence-informed clinical practice guidelines, and evidence-informed practice in general.
CCGI is delighted to have them on board and looks forward to collaborating with them to take the best practices forward in Canada.
Roles and Activities of CCGI Best Practice Collaborators
-
understanding how clinical practice guidelines are developed;
-
discussing best practices and guidelines with colleagues;
-
having a presence on social media to raise awareness of resources on evidence-informed practice;
-
encouraging clinicians and patients to use the CCGI website and resources;
-
making presentations on evidence-informed practice at continuing education events and conferences in collaboration with their local opinion leaders team.
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Are you interested in getting involved with CCGI?
We are always looking to get people involved in our projects. No experience necessary - we provide training!
Contact us today!
Tension-type and Cervicogenic Headache Care Pathway
Date of last update: April, 2024
Report of Findings (ROF)
Clinical Cornerstone:
- The ROF aims to educate the patient about their condition, set a common understanding of expectations, and build trust. It's essential to communicate effectively, using language that the patient can comprehend, and to create an environment where the patient feels comfortable asking questions and participating in their care. Depending on the patient, it may be necessary to involve family or caregivers at this stage.
1. Review of Patient's History: Summarize main complaints, concerns, and relevant history.
2. Clinical Examination Findings: Discuss key results that shaped your understanding or planning.
3. Diagnostic Results: If applicable, explain imaging or test results in plain language.
4. Diagnosis: State the diagnosis and explain contributing factors through a biopsychosocial approach, particularly for persistent cases. It may include summarizing the following sections of their History assessment as well: Narrative (how the issue affects their daily living, PSFS), Social History (support system), Social determinants of health (occupational or domestic stressors), Lifestyle (exercise, nutrition/smoking, stress). It may also include summarizing relevant outcome questionnaires (e.g. NDI).
5. Prognosis: Outline the expected course, discuss negative prognostic factors, and provide an anticipated recovery time.
6. Treatment Recommendations: Engage in shared decision-making for the management plan treatment goals and expected outcomes, discuss benefits and risks of treatment, discuss alternate treatment options (e.g., medication, CBT, self-management only, treatment with other providers/disciplines), explain how any proposed interventions fit with the set treatment goals and expected outcomes (e.g., manual therapy, exercises, modalities).
7. Patient's Role in Recovery: Engage conversation emphasizing the importance of patient involvement and self-management; suggest home exercises, lifestyle modifications, behaviour changes, and any other self-care measures; emphasize adherence to recommendations.
8. Address Concerns and Questions: Encourage patient queries and provide clear answers.
Conclusion: Summarize the ROF and emphasize collaborative care.
Documentation: Record all findings, discussions, and recommendations in the patient's record.
Disclaimer:
These care pathways are intended to provide information to practitioners who provide care to people with musculoskeletal conditions. The care pathways on this website are 'living' documents, reflecting the state of clinical practice and research evidence to our best knowledge at the time of development. As knowledge and healthcare practices evolve, these pathways may be updated to ensure they remain current and evidence driven. These pathways are not intended to replace advice from a qualified healthcare provider.
Conduct patient assessment
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Red flags or Orange flags present
Red flags or Orange flags present
Refer to appropriate emergency or healthcare provider
No
Yes
Diagnosis
Headache Associated with Neck Pain
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Structured patient education
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Assurance
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Self care
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Emotional/social support
Additionally for Persistent Tension-type Headaches
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Specific neck and shoulder exercises
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Manual therapy
Additionally for Persistent Cervicogenic Headaches
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Specific neck and shoulder exercises
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Manual therapy
Follow-up
Follow-up
Major symptom/sign change
Goals not achieved
Re-evaluate
Adjust treatment and management plan or refer
Differential Diagnosis
(Primary headaches, secondary headaches, cranial neuralgias)
Discharge
No
Yes
References or links to primary sources
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Bussières A.E, et al. Diagnostic imaging practice guidelines for musculoskeletal complaints in adults-an evidence-based approach-part 3: spinal disorders. Journal of manipulative and physiological therapeutics. 2008;31(1):33-88. doi:10.1016/j.jmpt.2007.11.003.
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Bussières A.E, et al. The treatment of neck pain -associated disorders and whiplash-associated disorders: A clinical practice guideline. J Man Phys Ther. 2016; 39(8):P523-564.
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Berman D., et al Comparison of Clinical Guidelines for Authorization of MRI in the Evaluation of Neck Pain and Cervical Radiculopathy in the United States. Journal of the American Academy of Orthopaedic Surgeons 31(2):p 64-70, January 15, 2023. | DOI: 10.5435/JAAOS-D-22-00517.
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Côté P, et al. Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England). 2019;23(6):1051-1070.
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Côté P, et al. Management of neck pain and associated disorders: A clinical practice guidelines from the Ontario Protocol for Traffic Injury (OPTIMa) Collaboration. Eur Spine J. 2016; 28:2000-2022.
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Demont A., et al. Cervicogenic headache, an easy diagnosis? A systematic review and meta-analysis of diagnostic studies. Musculoskelet Sci Pract. 2022 Dec;62:102640.
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Fernandez M., et al. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta-analysis. European Journal of Pain. 2020;24(9):1687-1702.
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Knackstedt H, et al. Cervicogenic headache in the general population: the Akershus study of chronic headache. Cephalalgia : an international journal of headache. 2010;30(12):1468-147.
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Núñez CP, Leirós RR. Effectiveness of manual therapy in the treatment of cervicogenic headache: A systematic review. Headache: The Journal of Head & Face Pain. 2022;62(3):271-283.
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Rubio-Ochoa J., et al. Physical examination tests for screening and diagnosis of cervicogenic headache: A systematic review. Manual Therapy. 2016;21:35-40.
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Shearer H.M., et al. The course and factors associated with recovery of whiplash-associated disorders: an updated systematic review by the Ontario protocol for traffic injury management (OPTIMa) collaboration. European Journal of Physiotherapy. 2021 Sep 3;23(5):279-94.
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Sjaastad O, Bakketeig LS. Prevalence of cervicogenic headache: Vågå study of headache epidemiology. Acta neurologica Scandinavica. 2008;117(3):173-180.
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Stiell I.G., et al. The Canadian C-Spine Rule for Radiography in Alert and Stable Trauma Patients. JAMA. 2001;286(15):1841–1848. doi:10.1001/jama.286.15.1841.
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Stovner LJ,, et al. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2018 Nov 1;17(11):954-76.
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Stovner LJ, et al. The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. The journal of headache and pain. 2022 Dec;23(1):34.
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