Although there seems to be no causality between cervical spine (CS) manipulation and major adverse events (MAE), it remains important that manual therapists try to prevent every potential MAE. Although the validity of positional testing for vertebrobasilar insufficiency (VBI) has been questioned, recently, the use of these tests was recommended. However, based on the low sensitivity of the VBI tests, which may result in too many false-negative results, the VBI tests seem to be less valuable in pre-manipulative screening. Moreover, because the VBI tests are unable to consistently produce a decreased blood flow in the contralateral vertebral artery in (healthy people), the underlying mechanism of the test may not be a valid construct. There are numerous cases reporting MAE after a negative VBI test, indicating that the VBI tests do not have a role in assessing the risk of serious neurovascular pathology, such as cervical arterial dissection, the most frequently described MAE after CS manipulation. Symptoms of VBI can be identified in the patient interview and should be considered as red flags or warning signs and require further medical investigation. VBI tests are not able to predict MAE and seem not to have any added value to the patient interview with regard to detecting VBI or another vascular pathology. Furthermore, a negative VBI test can be wrongly interpreted as 'safe to manipulate'. Therefore, the use of VBI tests cannot be recommended and should be abandoned.
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Handboek voor MKB-ers die de eerste stappen willen zetten in het innoveren met AI.Ondernemers zien natuurlijk kansen in de ontwikkeling van nieuwe producten en/of diensten, ondersteund door AI (Artificial Intelligence). Want data blijkt immers ‘het nieuwe goud’ te zijn! Maar hoe doe je dat dan? Waar begin je? Wat zijn de do’s en wat zijn de dont’s?Voor MKB-ondernemingen, die hier vaak geen specialisten voor in huis hebben, zijn dit de relevante vragen. Speciaal voor deze doelgroep is, binnen het KI-AGIL project, het Handboek AI ontwikkeld. Dit Handboek gaat in op deze en meer vragen, en geeft diverse handreikingen (o.a. om de aanpak op een ‘business verantwoorde, agile manier’ te doen), waardoor een MKB-onderneming goed op weg geholpen wordt met AI.
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