Narrative abstract: The Valsalva manoeuvre is a forced expiratory effort against a closed airway as one of several simple physical actions called vagal manoeuvres that act on the vagus nerve to slow heart rate.
This manoeuvre increases intrathecal pressure and may point to a space occupying lesion if pain about a spinal region is reported. There may also be dermatomal radiations indicative of neurological involvement.
Here I present several 'off label' clinical uses of the Valsalva manoeuvre and give an integration with manual muscle testing to increase the clinical tools available to the Chiropractor.
Author keywords: Chiropractic; Valsalva manoeuvre; Clinical assessment; Subluxation; Therapy localisation
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