44 research outputs found
The effect of lumbar spine manipulation on the muscle activity of the quadriceps femoris and hamstring muscle groups
No full textDissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2020.Background: The clinical use of spinal manipulative therapy is becoming increasingly
evident in the treatment of musculoskeletal conditions. However, the exact
neurophysiological mechanisms behind spinal manipulative therapy and its effects on
muscle activity require further investigation. Fixated joints within the spine have been
shown to cause changes in muscle activity in both segmentally related muscles and
extremity muscles. When present in symptomatic or asymptomatic individuals,
fixations in the spine may not only lead to local neurophysiological changes but may
affect global neurophysiology. Chronic lower back pain has been associated with the
presence of arthrogenic muscle inhibition in lower limb musculature which prevents an
individual from fully activating the affected muscle. Although this form of inhibition is
predominately present in symptomatic individuals, there is evidence to suggest that
asymptomatic individuals undergo a similar neuromuscular change. However, further
research is needed to determine if the extent of the effects of arthrogenic muscle
inhibition differs between symptomatic and asymptomatic subjects.
Aim: This study aims to determine and compare the effects of a lumbar spine
manipulation on the muscle activity in the quadriceps femoris and hamstring muscle
groups in asymptomatic and symptomatic participants.
Method: This study was a randomised controlled trial which utilised a pre- and postexperimental design. A total of 48 participants between the ages of 18-45 years of both
genders and all races were recruited. The sample population included a symptomatic
and asymptomatic clinical group. Each clinical group had a treatment and control
group. Once placed into their respective groups, individuals were randomly allocated
to the intervention or control group. Muscle activity readings of the quadriceps femoris
and hamstring muscles were obtained during sets of maximum voluntary contractions
that occurred at the pre-intervention/control, post-intervention/control and post 10-
minute intervention/control. IBM SPSS version 26 was used to analyse the data.
Repeated measures ANOVA tests were used to compare each outcome between preand immediate post-treatment between the intervention and control groups for
immediate effects, and pre- and 10-minute post-treatment between the intervention and control groups for short-term effects. This was initially done within the
asymptomatic and symptomatic participants separately.
Results: There were no statistically significant differences between the age and
gender of the symptomatic and asymptomatic groups. With regards to muscle activity,
no significant changes in the quadriceps femoris or hamstring muscle groups were
identified in the asymptomatic group. Significant changes were detected in the right
rectus femoris of the quadriceps muscle demonstrating evidence of a treatment effect
(p=0.047). However, this change did not persist in the 10-minute readings. Although
not statistically significant, there was clear evidence of a clinical trend that presented
in the quadriceps femoris muscle (rectus femoris and vastus medialis) of the
symptomatic group, as the overall muscle activity of the participants who received the
intervention increased bilaterally. There were no statistically significant differences
found when comparing the data between the symptomatic and asymptomatic clinical
groups.
Conclusion: The results showed that lumbar spine manipulation did not produce
significant differences in the immediate post-readings and the 10-minute readings in
the quadriceps femoris and hamstring muscles of the symptomatic and asymptomatic
groups. When comparing the clinical groups, there was no significant difference
between the asymptomatic and symptomatic groups in terms of the pre-intervention
readings of muscle activity and the post-intervention measures immediately and at the
10-minute interval following lumbar spine manipulation.
The effect of a unilateral sacroiliac joint manipulation on muscle activity and force output in the posterior oblique sling muscles
No full textDissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2019.Objective: The effects of spinal manipulation have been well documented, however,
current literature poses a gap regarding the neurophysiological mechanisms
responsible for these effects. Further evidence is required in order to uncover the
specific neurophysiological mechanisms of spinal manipulative therapy (SMT) and its
effect on muscle activity. The study aimed to investigate the immediate effect of a
unilateral sacroiliac joint (SIJ) manipulation compared to a control on muscle activity
(EMG in mV) and maximum voluntary force output (dynamometer in kg) in the posterior
oblique sling (POS) muscles in asymptomatic participants.
Methods: A randomised, controlled, pre-test, post-test design allowed for 34
participants, aged 18-45 years old, with joint dysfunction at the SIJ to be allocated to
either a manipulation or a control group. Force output and muscle activity of the gluteus
maximus (GM) and latissimus dorsi (LD) muscles were measured before and after the
intervention. IBM SPSS was used to analyse the data with significance set at (p=0.05).
Independent samples t-tests were used to determine significance within, and between,
the groups, and Pearson correlation analysis looked for correlations between the
muscles in the two slings.
Results: There were no significant differences observed between the control and
intervention groups for age (p=0.355), gender (p=0.688), race (p=0.338), BMI
(p=0.142), and the side of joint fixation (p=0.473). The intra-group analysis and intergroup analysis showed no significant differences for peak amplitude and mean muscle
activity of the muscles of the POS when assessed for intra- or intergroup comparisons.
A significant difference between pre and post maximum force output in the right GM
for both groups (intervention: p=0.016; control: p=0.030), and in the right LD for the
control group only (p=0.032), was noted. However, there was no significant difference
between group results for any muscle in terms of force output when assessed for
intergroup comparisons.
Conclusion: The results of this study showed no treatment effect of SIJ manipulation
on the muscles of the POS in asymptomatic participants. Consideration should be given to the way SMT is administered, the type of sham intervention used and the
protocol followed to elicit maximum voluntary isometric contraction (MVIC).
The epidemiology of work-related neck pain in diagnostic radiographers working in the eThekwini Municipality
No full textDissertation submitted in partial compliance with the requirements for the Master’s in Health Science Degree: Chiropractic, Durban University of Technology, Durban, South Africa, 2023.Diagnostic radiography is a branch of radiography that is primarily
involved with the diagnosis of disease through diagnostic imaging.
Additionally, diagnostic radiographers are predisposed to work-related
risk factors due to the work that they perform daily and, as result, they
are at risk of developing work-related neck pain (WRNP). Investigating
the prevalence and work-related risk factors associated among
diagnostic radiographers will create awareness amongst diagnostic
radiographers and healthcare providers. Furthermore, in a South African
context, this will add updated knowledge to the current literature that
exists.
AIM
The aim of the study was to determine the epidemiology of work-related
neck pain in diagnostic radiographers working within the eThekwini
municipality.
METHODOLOGY
The study used a quantitative approach and a descriptive cross sectional
survey design. A total 130 participants were recruited for this study. The
population sample included qualified diagnostic radiographers who were
employed within the eThekwini municipality in the public and private
sectors. The questionnaire was distributed and answered either via
Hardcopies or QUESTIOPRO® link. All the data were then imported into
SPSS version 26 for analysis RESULTS
A total of 61 participants had reported WRNP and hence the prevalence
rate was 65.6%. The study also reported that females are more likely to
have WRNP. Furthermore, the selected risk factors showed that more
than 50% of radiographers with WRNP had worked over-time shifts,
75.4% of radiographers experienced neck pain from wearing lead
protective gear, 78.7% of radiographers from the study had neck pain
from lifting and positioning heavy equipment and machinery, and 47.5%
of the participants who had WRNP had a history of a previously
diagnosed neck condition. Additionally, 59% of participants had taken
leave from work because of WRNP.
CONCLUSION
This study revealed a high WRNP prevalence rate among diagnostic
radiographers working within the eThekwini municipality. The results
found in this study shared similar findings from various local and
international studies. Due to the high prevalence of WRNP, it is highly
recommended that management protocols at work should be
investigated to aid diagnostic radiographers.
The effects of an upper cervico-thoracic segment manipulation on posture and muscle activity in participants with forward head and round-shouldered posture
No full textDissertation submitted in partial compliance with the requirements for the Master’s in Health Sciences Degree: Chiropractic, Durban University of Technology, Durban University of Technology, 2022.Background: Postural dysfunction in the cervico-thoracic spine often leads to
segmental restrictions and hypomobility, and this is often caused by biomechanical
alterations due to postural changes and over activity of skeletal muscles in that
region. These muscles include the pectoralis and trapezius muscles. Postural
dysfunction and joint restrictions are often treated by manual therapies, such as
spinal manipulation. Previous studies have established that joint manipulation
reduces postural dysfunction and improves joint mobility, which could be explained
by a combination of neurophysiological,and biomechanical effects.In literature, the
immediate benefitsof acervico-thoracicmanipulation on muscleactivityandposture
are not well understood and, therefore, an investigation into the immediate effects
of manipulation on muscle activity and posture was implemented in this study.
Aim: This study aimed to observe the immediate effect of an uppercervico-thoracic
segment manipulation on posture and muscle activity in participants with forward
head and round-shouldered posture.
Methods: This study was a quantitative, observational study with a pre-test posttest design. Surface electromyography was used to measure the muscle activity of
the pectoralis major, upper and middle trapezius muscles prior to and after the
cervico-thoracic intervention. A sample size of 40 asymptomatic participants were
recruited to participate. The participants were randomly divided into two groups:
group A, which was the control group, and group B, which was the intervention
group. The intervention group received a cervico-thoracic manipulation, but the
control group received no intervention and remained prone for 3 minutes between
the pre-test and post-test readings. The within-group comparisons of pre- and postmuscleactivity were achieved usingpairedT-tests. Within groupandbetween group
comparisonsof the change between pre- andpost-intervention wereachieved using
repeated ANOVA testing. A p-value below 0.05 was statistically significant. IBM
Statistical Package for Social Sciences (SPSS) version 26 software was used to
process the data.
Results: There was no statistically significant treatment effect of cervico-thoracic
spinal manipulation in the effects on muscle activity. Although there was not a statistically significant change in muscle activity, there was a positive change in
pectoralis major compared to the upper or middle trapezius. The upper and middle
trapezius muscles decrease activity followed an evident trend between the
participants who received the intervention compared to the control group. Postural
results were not statistically significant but positive correlations to treatment were
found. The craniovertebral angle was seen to decrease at a higher rate compared
to the control group. Additionally, the study provided evidence of a treatment effect
on the acromiovertebral angle, decreasing overall in severity.
Conclusion: The results of this study do not provide conclusive evidence that the
intervention has any immediate statistical effect on the three muscle activity
measurements outcomes observed. In terms of the Posture Pro Analysis System
measurements, changes (decrease in angles) between the pre- and postintervention were mostly significant in both groups, but statistically there was no
difference between the control and intervention groups. Posture Pro ratings did not
provide evidence of changes in categories within the groups. Therefore, the null
hypothesis was retained.
Perception of chiropractic students in their preparedness in the diagnoses and management of headache disorders at a selected University of Technology
No full textDissertation submitted in partial fulfilment of the requirements for the Master of Health Sciences Degree in Chiropractic, at the Durban University of Technology, Durban, South Africa, 2024.A headache is defined as “pain found in the head above the orbito-meatal line and or nuchal
ridge” and widely affects both males and females globally. Chiropractic treatment and the
management of headaches is substantial, with one in five new patients’ chief complaint being
a headache and, thus, the use of chiropractic care in the management and treatment of
headaches is popular. The term “self-perceived preparedness” refers to how people view
themselves in terms of confidence and competency with regard to certain skills. Self-perceived
preparedness is essential as it relates to one’s confidence and the ability to accurately
diagnose and manage headache disorders. There is a definite scarcity in South African
literature as to the self-perceived preparedness of students in the diagnosis and management
of headache disorders. In a South African chiropractic context, the literature, with regard to
students’ confidence, awareness and self-assessment of skills is lacking.
There are a number of advantages that can come from exploring the concept of self-perceived
preparedness. The benefits include, but are not limited to, the assessment of whether or not
the curricula goals have been achieved, the readiness of chiropractic students to confidently
and correctly diagnose and manage patients sufficiently, and the different aspects that can
lead to one feeling unprepared.
Aim
The aim of this study was to explore and describe the self-perceived preparedness of the
chiropractic students’ in the diagnosis and management of headache disorders.
Methodology
This study design employed a qualitative, explorative and descriptive design. Purposeful
sampling was utilised and individual, semi-structured interviews were conducted with 13
Master’s degree students in the chiropractic programme. These interviews took place “in person” and an interview guide was utilised in each interview. The interviews were conducted
over a week from the 18th to the 23rd of September 2023. The questions surrounded the topics
of self-perceived preparedness, confidence, challenges (whether educational or personal) and
the effect of clinical exposure on one’s confidence and skills. The interviews were analysed
and themes were extracted utilising Tesch’s eight-step approach of data analysis.
Results
The chief themes that emerged from the data collection included the level of preparedness,
educational and environmental challenges, as well as the positive role that clinical exposure
had on students’ views of their self-perceived preparedness. The participants felt largely
unprepared to deal clinically with headache disorders. This stemmed from the feeling of
isolation within academia, lack of support from staff and clinicians, lack of practical aspects
within the curriculum and the COVID-19 pandemic, which resulted in a lack of in-person
interaction.
Conclusion
The findings of this study highlighted the lack of confidence and feeling of under-preparedness
to deal with headache disorders within a clinic setting by chiropractic Master’s students. This
was mainly attributed to educational and environmental challenges. However, the exposure
students gained within a clinical environment greatly improved their feeling of overall self-perceived preparedness
An investigation into musculoskeletal pain associated with primary dysmenorrhea in students at a University of Technology : a descriptive study
No full textThis work is submitted in partial compliance with the requirements for the Master’s Degree in Health Sciences: Chiropractic at the Durban University of Technology, Durban, South Africa, 2023.Primary dysmenorrhea (PD) is the most frequent
gynaecological complaint affecting women across different backgrounds.
Growing evidence has demonstrated a strong link between PD and
comorbid musculoskeletal pain (MSK), carrying significant impact for the
lives of sufferers. Despite this, few studies have isolated and investigated
this association, particularly in a South African context.
Aim: The aim of this study was to determine the prevalence, risk factors,
management, and impact that MSK pain associated with PD has on female
university students.
Methodology: A quantitative, descriptive cross-sectional survey was
conducted at a university of technology in KwaZulu-Natal, South Africa. Data
were obtained through voluntary self-administered surveys from 324
participants. The surveys consisted of six parts: demographic
characteristics, menstrual history, MSK pain characteristics, risk factors,
management approaches and impact. Data were analysed using IBM SPSS
version 27.
Results: A total of 300 participants were included. A high prevalence of MSK
pain was noted. Clinical characteristics showed that the pain was moderate
and distributed across anatomical regions, with low back pain being most
affected. There was a high prevalence of headaches and myofascial pain.
The mode of transportation, as well as heaviness of menstrual flow were
significant risk factors. Various management approaches, including home
remedies, allopathic and complementary healthcare, were utilised by
participants. Overall impact was high across personal, social, and academic
domains.
Conclusion: This study showed a strong correlation between PD and
comorbid MSK pain among female university students, with various
management approaches for participants. Pain appeared to carry significant
impact across all aspects of life.
An exploration into the knowledge, understanding and management of the female athlete triad and the triad risk factors among elite swimmers in KwaZulu-Natal (KZN)
No full textDissertation submitted in partial fulfillment of the requirements for the
Master’s Degree of Technology in Chiropractic, Durban University of Technology, Durban, 2022.The Female Athlete Triad (FAT) includes a spectrum of dysfunction referring
specifically to three health complications, which primarily are energy deficiency,
menstrual disturbances, and low bone mineral density. Women’s participation in
sport has drastically increased over the last four decades but women are still facing
stereotyping and are often expected to look a certain way, on and off the sporting
grounds. The female athlete triad is common and is widely researched in land
sports, such as athletics and endurance running, but the majority of the studies
focus on the prevalence of the condition, instead of its knowledge and/or
management. Despite FAT being widely researched in various sporting disciplines,
there was an apparent gap in the literature, and especially under investigated in elite
swimmers. Despite swimming being a popular endurance-type discipline, with
similar outcomes to land sporting disciplines, there is paucity in the current literature
on FAT in swimmers in South Africa.
The benefits of understanding the knowledge of FAT in an elite swimmer includes
optimizing energy availability by ensuring adequate caloric intake whilst exercising,
encouraging regular weight bearing exercise, improving the triad’s identification,
and preventing its occurrence.
Aim of the study
The aim of this study was to explore the knowledge, understanding and
management of FAT and the triad risk factors among elite swimmers in KwaZuluNatal (KZN).
Methodology
A qualitative, exploratory, descriptive approach was used to guide the study. A semistructured interview guide was used to conduct in-depth interviews with nine elite
female swimmers in KwaZulu-Natal (KZN). The main research questions for this
study were “Describe your understanding of the female athlete triad”, “Can you
expand/elaborate on what makes an individual at risk for the triad?” and “Describe the management options that you, or someone that you know that has had FAT
used”. The data were analysed using Tesch’s (Creswell 2007) method to identify
themes and sub-themes.
Results
The main themes that emerged from the study were the lack of knowledge on the
female athlete triad, the understanding of the female athlete triad risk factors, the
understanding of the impact of fat on health and performance, the lack of education
surrounding the management of FAT and the lack in choice of healthcare. The
participants had poor knowledge of the term the Female Athlete Triad however, the
understanding of the triad risk factors was well understood. Participants in this study
lacked appropriate choices in healthcare, if they were to have been presented with
components of the triad.
Conclusion
The findings that emerged from this study indicate that there is a lack of knowledge
and understanding surrounding the female athlete triad, its associated risk factors
and the appropriate management interventions needed if an athlete were to be
diagnosed with FAT. Therefore, it is necessary for not only the chiropractic
community but for all health practitioners who may deal with elite female athletes to
educate and inform this population about the potential long term health
consequences of FAT.
The immediate effects of thoracic spine grade III mobilisation on the muscle activity of the middle and lower trapezius muscle
No full textDissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2021.Background: Thoracic spine dysfunction often presents with regional hypomobility
which is often caused by abnormal muscle activity in the overlying area. Such as
the trapezius muscle. Joint dysfunction is often treated by manual therapies such as
joint mobilisation. Previous studies have established that joint mobilisation improves
joint mobility, achieves hypoalgesia, improves stability, range of motion and
proprioception. Although documented in the literature, the direct benefits of joint
mobilisation on muscle activity are not well understood. Therefore, an investigation
into the effects of mobilisation on muscle activity was explored.
Aim: This study aim was to determine the immediate effects of thoracic spine grade
III mobilisation on the muscle activity of the middle and lower trapezius muscles.
Methods: This was a quantitative, experimental, study with a pre-test post-test
design. Surface electromyography was used to measure the muscle activity of the
middle and lower trapezius muscle. A sample size of 48 asymptomatic participants
were recruited and randomly divided into the intervention or control group. The
intervention group received thoracic grade III mobilisation and the control group
remained prone between the pre-test and post-test readings. Within group
comparisons was achieved using paired T-tests. Within group and between group
comparisons of the change between pre and post intervention was achieved using
repeated ANOVA testing. A p-value below 0.05 was considered significant.
Results: Spinal mobilisation had no effect on muscle activity. Despite the lack of
statistical evidence, there was a positive trend in the effects of thoracic spine
mobilisation with a borderline treatment effect in the left middle trapezius muscle (p
= 0.063). There was an overall decrease in muscle activity in the intervention group.
Conclusion: The results showed that mobilisation did not produce a noteworthy
change in muscle activity of middle and lower trapezius muscles between the
intervention and control groups and the null hypothesis was not rejected.
An exploration into the self-reported experiences of musculoskeletal pain in females diagnosed with Long COVID within the eThekwini Municipality
No full textDissertation submitted in partial fulfilment of the requirements for the Master’s degree of Health Sciences in Chiropractic, at the Durban University of Technology, Durban, South Africa, 2024.BACKGROUND
The COVID-19 pandemic caused a worldwide health crisis that prompted an increase in the
output of research targeted at expanding the knowledge available about COVID-19, the
symptoms experienced and its consequences.
Post-acute sequelae of SARS-CoV-2 infection is described as the persistence of symptoms
since the initial diagnosis of COVID-19 for more than four weeks and, in most cases, lasting
for months at a time. It is also referred to as Long COVID. Musculoskeletal pain (MSP) in
relation to this condition is associated with tenderness, discomfort and stiffness of the joints,
bones or muscles. Amidst the various reports of symptoms experienced by those affected
by Long COVID, MSP has been identified as the most prevalent and debilitating
manifestation, common in patients diagnosed with Long COVID.
Despite current literature detailing the prevalence of various symptoms associated with
Long COVID, a gap in the literature remains in the understanding of the experiences of
individuals affected by MSP. Research has identified that women are more likely to endure
symptoms of Long COVID, especially MSP, as compared to males. Given that women share
a disproportionate burden of Long COVID, it is imperative to get a better understanding of
the unique difficulties and lived experiences of women suffering from MSP.
A thorough exploration into the various factors that play a role in the onset, development,
persistence, and consequences of this symptom is required to fully grasp the experiences
women have had whilst enduring MSP. Various factors play a vital role in the influence of
an individual’s experiences of MSP throughout their Long COVID journey; these include
pre-existing musculoskeletal conditions, the severity of the illness itself, biological changes
because of COVID-19, psychological stresses, social determinants of health and health
seeking approaches.
This qualitative investigation aimed to address this gap in the literature by conducting in
depth interviews amongst women with Long COVID experiencing MSP. This approach was
to capture the rich perspectives of the participants, detailing daily life experiences, and
methods of coping and challenges associated with MSP as a result of Long COVID. The benefits of a deeper understanding of the MSP experiences in women with Long COVID
include interventions and support services specifically designed to address the unique
challenges and needs that women encounter, resulting in a better quality of life and overall
well-being.
AIM OF STUDY
The aim of this study has been to explore the experiences of MSP as a clinical manifestation
of long COVID in women.
METHODOLOGY
A qualitative, exploratory, descriptive approach was utilised in this study(McLeod 2017).
The purpose of a qualitative approach is to obtain a greater understanding of the
experiences and perspectives of individuals who provide rich data without the use of
quantitative and statistical methods. The sampling strategy utilised in this study was
purposive sampling with the snowball method to obtain data. In this study, MSP was
explored through the first-hand experiences of women with Long COVID to further
understand how this clinical manifestation has affected their quality of life. This study
involved conducting individual in-person interviews with a sample size of 12 women with
Long COVID, with the purpose of providing personal, engaging interactions to obtain rich,
reliable data. The benefit of conducting personal interviews is that it gathers the personal
perspectives of individuals and explores responses to questions, which adds reliability to
the study. Data was collected until saturation was attained. Data saturation was reached
after interviewing the eighth participant, but four additional participants were interviewed
thereafter to confirm saturation was reached.
RESULTS
The data were analysed using Tesch’s method to identify themes and subthemes. This
involved the transcription and review of the participant responses, coding the responses
according to themes and further categorizing similar themes into subthemes. The main
themes that were identified in this study were the common clinical presentation of MSP
experience due to Long COVID, negative effects of MSP on the quality of life and the varied
and limited choice of healthcare treatment options. The participants shared a commonality
with regard to the clinical presentation MSP, as most of them experienced back pain, neck
pain, shoulder pain and headaches. The participants reported that they led a poor quality
of life due to the extent of MSP which negatively affected their ability to perform daily tasks
and resulted in constant fatigue. A high prevalence of anxiety, depression and frustration
was experienced by the participants as they were exhausted from trying to find an effective
treatment to resolve their pain. Most participants were highly reliant on pain medication to
find some type of relief. Others sought alternate methods of care in the form of chiropractic
treatment and lifestyle changes. This helped them better manage their pain and improve
their general well-being.
CONCLUSION
The results of this study revealed that MSP is a prevalent and debilitating symptom amongst
women with Long COVID. It affects various major aspects of lives, such as physical
functioning, socialisation and mental health. A multi-disciplinary approach is imperative to
provide efficient and effective health care to patients. Therefore, it is imperative that not only
chiropractors but all health care practitioners who come into contact with affected women
are able to create well-rounded treatment plans for those patients and converse easily with
them to find a solution to their pain.
The effect of cervical spine manipulation compared to muscle energy technique on neck muscle activity and range of motion in asymptomatic participants
No full textDissertation submitted in partial compliance with the requirements for the Master’s
Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2019.Background: Clinical evidence supports the use of spinal manipulative therapy (SMT)
and muscle energy technique (MET) for the treatment of cervical spine dysfunctions.
However, the physiologic mechanism behind their effectiveness is not well understood.
Joint dysfunctions are associated with hypertonicity of segmentally related muscles and
can occur in both symptomatic and asymptomatic individuals. Neck pain (NP) has been
associated with cervical muscle dysfunction, due to the presence of altered muscle
activity and impaired kinematics, demonstrated in NP patients. This includes the upper
trapezius and posterior cervical muscles, whose dysfunction can be a source of NP.
Spinal manipulative therapy and MET are mechanical interventions, that when applied to
joint dysfunctions, produce neurophysiological changes, specifically the modulation of
muscle activity and improved range of motion (ROM). However, the demonstration and
comparison of the neurophysiological effects of SMT and MET in the neck, and its related
musculature, are unknown.
Aim: The aim is to determine the effect of cervical spine manipulation compared to MET
on neck muscle activity and range of motion in asymptomatic participants.
Method: This is a quasi-experimental study utilising a pre-test, post-test design, which
employed 50 asymptomatic participants aged between 18 – 35 years of both genders and
all races. The participants were randomly allocated into one of two treatment groups.
Group 1 received cervical spine manipulation (CSM) and Group 2 received MET. Before
and after the respective interventions, resting upper trapezius and posterior cervical
electromyographic muscle activity and the cervical spine range of motion (CROM) (lateral
flexion and extension) were measured. The IBM SPSS version 24 was used to analyse
the data. The intra-group changes were compared pre- and post-intervention using paired
Wilcoxon signed ranks tests. Median changes between pre- and post- were compared
between the two treatment groups using Mann-Whitney U tests. A p value < 0.05 was
considered as statistically significant.
Results: None of the demographic or background variables differed significantly between
the two groups. Both treatments had an effect, although not all significant, involving mostly reductions in resting electromyographic muscle activity and improvements in
CROM. This was significant for the right posterior cervical muscles in the SMT group (p
= 0.012) and for ROM in both groups (p < 0.001). No evidence of a difference in treatment
effect was found.
Conclusion: The results of this study suggest that SMT and MET mostly decrease resting
neck muscle activity and improve CROM. Muscle energy technique may possibly be
equally as effective as CSM. Concurrent changes in both outcomes suggest that more
than one physiologic mechanism may likely explain these effects.
