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This study provides a sound basis for future research by affording insight into the construct of masters level manipulative physiotherapy clinical practice. Convergence of data with the Delphi study supported validation of the construct. The trustworthiness of the findings appeared good, and therefore provides justification for use of the construct in informing curriculum development at masters level. (Source: Manual Therapy)

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Abstract: Thoracic outlet syndrome (TOS) is a challenging condition to diagnose correctly and manage appropriately. This is the result of a number of factors including the multifaceted contribution to the syndrome, the limitations of current clinical diagnostic tests, the insufficient recognition of the sub-types of TOS and the dearth of research into the optimal treatment approach. This masterclass identifies the subtypes of TOS, highlights the possible factors that contribute to the condition and outlines the clinical examination required to diagnose the presence of TOS. (Source: Manual Therapy)

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The publication of this book in English generated much anticipation and excitement in the osteopathic profession. This could be attributed to the growing interest and scope of pediatric osteopathic practice and the need for a comprehensive textbook in this field. In producing this book, the editors, Eva Moeckel and Noori Mitha, have made a substantial contribution to osteopathy by drawing together a breadth and wealth of knowledge from twenty-eight highly qualified contributors with expertise in a variety of fields, all of which, impact on the growing baby and child, and are of interest to the osteopath. (Source: Manual Therapy)

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We acknowledge the efforts made by the authors of this article in researching this important topic and would like to make the following comments: Thomas incorrectly used a criteria of a 50% increase or decrease in peak systolic velocities with the duplex scan (). Haynes data suggested that an 85% or more could indicate such, while there was no data to support any percentage less than this (). The duplex results in Haynes’s study for the peak systolic velocities of the 5 arteries that showed marked decreases at end rotation were: 10.1cm/s, 22.3cm/s, 21.6cm/s, 20.2cm/s, 22.9cm/s, which indicates that when peak systolic velocities are in the low 20s or lower, velocimetry will likely indicate a positive finding (). It is a better way of defining the criteria for positive duplex results. This i…

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We thank the authors of this letter for their comments. Our choice of the duplex criteria of a greater than 50% increase or decrease in peak systolic (PS) velocity between the neutral head position and contralateral rotation position was based on study () in which he suggests marked changes in PS velocity could be considered abnormal (his 2000 study reported decreases between 35% and 68%) and suggestion that a greater than 50% change in PS velocity in the vertebral artery (VA) between neutral and contralateral head positions is indicative of stenosis. In our study the average PS values in the neutral head position for the left and right vertebral arteries were 33.6 and 35.16cm/s respectively and we did not observe the high values which the authors suggested may have made a 50% change less…

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