CASE REPORT Manual therapy and therapeutic exercise in patient with symptomatic cervical spondylotic myelopathy: A case report Gabriel Peixoto Lea ˜o Almeida, MSc Candidate a, * ,1 , Kysia Karine Almeida Carneiro, Postgraduate Student b , Ame´lia Pasqual Marques, PhD, Associate Professor a,1 a Physical Therapy, Communications Disorders and Occupational Therapy Department, School of Medicine, University of Sa˜o Paulo, Cipotaˆnea Street, 51 e Butanta˜, 05360-160 Sa˜o Paulo, SP, Brazil b Functional Rehabilitation Center, Onofre Sampaio Cavalcante Street, 381 e A ´ gua Fria, 60834-450 Fortaleza, CE, Brazil Received 30 October 2012; received in revised form 14 January 2013; accepted 10 March 2013 KEYWORDS Musculoskeletal manipulations; Rehabilitation; Exercise therapy; Spinal cord diseases Summary Cervical spondylotic myelopathy (CSM) is caused by narrowing of the cervical spi- nal canal, although surgical decompression is an obvious indication for spinal cord stenosis, there are not enough data to determine that surgery is the most indicated intervention for milder forms. The purpose of the present case report was to describe the outcomes results of the physical therapy treatment with emphasis on manual therapy and therapeutic exercise for a patient with CSM. A 58-year-old male patient attended the physical therapy clinic due to pain and paresthesia in the upper and lower limbs. The magnetic resonance imaging was compatible with spondylotic myelopathy. Following physical therapy treatment, the patient exhibited an improvement in functional capacity (triangle step test and timed 10-m walk), pain, paresthesia, mJOA scale and Neck Disability Index. Based on the lack of rapid evolution of neurological impairment, physical therapy treatment was indicated, which achieved satis- factory results. ª 2013 Elsevier Ltd. All rights reserved. * Corresponding author. Botelho Street, 245 e Vila Guarani, 04313-200 Sa˜o Paulo, SP, Brazil. Tel.: þ55 11 87708321, 55 11 55395090; fax: þ55 11 55395090. E-mail addresses: gabriel_alm@hotmail.com (G.P.L. Almeida), kysiakarine@hotmail.com (K.K.A. Carneiro), pasqual@usp.br (A.P. Marques). 1 Physical Therapy, Speech and Occupational Therapy Department, School of Medicine, University of Sa ˜o Paulo, Cipota ˆnea street, 51 e Butanta ˜, 05360-160 Sa ˜o Paulo, SP, Brazil. 1360-8592/$ - see front matter ª 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jbmt.2013.03.009 Available online at www.sciencedirect.com journal homepage: www.elsevier.com/jbmt Journal of Bodywork & Movement Therapies (2013) 17, 504e509