Theses and dissertations (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12
Browse
3 results
Search Results
Item Chiropractic manipulation and mobilization for postpartum low back pain : a systematic review(2024) Phakathi, Londeka Nokulunga; Thandar, Yasmeen; Venketsamy, YomikaBackground: Prior research has documented empirical support for the effectiveness of chiropractic treatment for postpartum low back pain (PLBP), mostly in pregnancy but very few in postpartum. Nevertheless, the trustworthiness and calibre of the evidence from these studies has not been adequately scrutinised to authenticate their conclusions and determine whether clinical efficacy or effectiveness is present. Therefore, the objective of this study was to assess the current evidence in the literature about the therapeutic effectiveness of chiropractic manipulation and mobilisation for chronic lower back pain/pelvic girdle pain in postpartum women. Method: This study employed a qualitative evidence synthesis methodology, specifically utilising the Cochrane systematic review strategy. The literature was sourced via an electronic literature search (e.g. Google Scholar, PubMed, Medline, ProQuest Health, etc). The key search terms used were ‘low back pain’, ‘pelvic girdle pain’ together with ‘postpartum’, ‘chiropractic’, ‘manipulation’, and ‘mobilisation’. In addition to the key terms listed above, the search strategy for postpartum low back pain encompassed the following terms: ‘post-natal mechanical low back-ache’ or ‘sacroiliac syndrome/dysfunction’ or ‘sacral subluxation’ or ‘sacral pain’ or ‘lumbopelvic’ or ‘lumbar facet syndrome’. For manipulation and mobilisation, the search encompassed ‘sacral adjustment’ or ‘spinal manipulative therapy’ or ‘manual therapy’. A total of 2127 articles were identified, however 8 were suitable for inclusion. Data was extracted from each included study onto a prepared data extraction sheet. There were 4 reviewers that reviewed the 8 (4 RCTs and 4 CRs) articles included. The independent reviewers only reviewed the 4 RCTs. For Critical Appraisal and Quality of Evidence, Rev Man “Risk of Bias” was used tool for randomised controlled trials (RCTs) and for case reports (CRs), the Joanna Briggs Institute Critical Appraisal Tool (JBICAT) was selected was used. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used to rank the evidence on various levels of clinical strength in relation to treatment outcomes. Results: While 3 of the 4 RCTs demonstrated no significant evidence to support a superior effectiveness of chiropractic manipulation and mobilisation in postpartum low back pain, Pritchard (2001) showed statistically significant evidence in supporting the improvement chiropractic manipulation and mobilisation provided in this demographic. The outcomes in all 4 CRs showed large degrees of favourability to the effectiveness of chiropractic manipulation and mobilisation. However, the quality of the evidence was low to moderate at most, thus affecting the extent to which generalizability can be made, in to relation to postpartum low back pain. Conclusion: This study highlighted a dearth in literature and the need for conducting research of higher quality within this demographic. There were also discrepancies in the utilisation of the LBP term and its clinical scope. It is highly important that these discrepancies are resolved by establishing a more concrete and deliberate guideline or definition of this phrase. The production of more RCTs with larger sample sizes that include a variety of demographic characteristics (race, socioeconomic status, age, etc.), was recommended.Item A systematic review on the effectiveness of manipulation and mobilisation in the treatment of osteoarthritis(2023-05-31) Khamissa, Ahmed; Korporaal, Charmaine MariaOsteoarthritis (OA) is an increasing condition globally as the population ages and the number of elderly increases. However, there is a lack of relevant evidence-based guidelines for manual therapy in the treatment of OA especially involving OA of the spine, wrist, temporomandibular joint (TMJ), and the glenohumeral joint (GHJ). A systematic review organises and critiques literature in a more concise form for practitioners. This study aimed to briefly provide practitioners the evidence available on the effectiveness of manipulation and mobilisation on OA. Methods: A systematic review of available literature was performed using keywords including “manipulation”; “mobilization”; “manual therapy” and “osteoarthritis”; “spondylosis”; “degenerative joint disease”; “degenerative disc disease”. The database searches were through CINAHL, DUT summons, Google scholar, Pubmed and Scopus. Following a screening using inclusion criteria, 20 articles were chosen for review. Each of the studies were than reviewed by three reviewers using the Newcastle-Ottawa scale, the PEDRO scale, the Joanna Briggs Institute (JBI) scale for case series and the JBI scale for case reports. These scales evaluated the methodological rigour (internal validity) of the chosen articles. In addition, the external validity was determined through a critique of each article. The internal and external validity formed the basis for decisions on the level of evidence provided in support of manual therapy. Results: Of those chosen articles, 13 provided evidence of treatment programmes and could not contribute to evidence specific to mobilisation and manipulation. In contrast, four articles assessed the efficacy of mobilisation, one study assessed the efficacy of manipulation, and two studies assessed the efficacy of neural mobilisation. There was moderate evidence in support of mobilisation on thumb carpometacarpal (CMC) OA, but only limited evidence in support of its use on cervical spine OA and no evidence in support of its use on lumbar spine OA, GHJ OA and TMJ OA. Manipulation was suggested to have moderate to limited evidence in support of its use on lumbar spine OA, but no evidence for cervical spine OA. Neural mobilisation was suggested to have limited evidence in support of its use for treating thumb CMC OA. Conclusion: It was evident in this systematic review that there is limited evidence for mobilisation, manipulation and neural mobilisation. Further research is required to expand on the limited areas, as well as strengthen the current evidence for clinical use.Item The effect of sacroiliac joint manipulation on gluteus maximus muscle activity in asymptomatic participants(2020-06-10) Worth, Kevin; Kretzmann, HeidiPurpose: The effects of spinal manipulation are well documented; however there is a gap in the current literature regarding the exact mechanisms underlying the effectiveness of spinal manipulation. Further evidence is required to improve the understanding of the neurophysiological effects of spinal manipulative therapy and its effect on muscle activity. The objectives of this study were to investigate the effects of sacroiliac joint manipulation on gluteus maximus muscle activity in an asymptomatic sample group when compared to a placebo group Methods: A randomized, controlled, pre-test, post-test repeated measures design allowed for 28 participants, aged 18-40 years old, with sacroiliac joint dysfunction to be allocated into either a sacroiliac joint manipulation or a placebo group. Muscle activity of the gluteus maximus was measured before intervention and again 10 minutes post intervention. IBM SPSS was used to analyse the data with significance set at (p=0.05). Repeated measures ANOVA testing was used to determine the significance within and between groups. Results: There was evidence of an improvement in the intervention compared with the placebo group from pre to post for outcomes of Channel A mean and maximum values, and for Channel B maximum values. In the other measures there was a trend observed but insufficient evidence to conclude that it was a real effect. The partial eta squared values were relatively small for these non-significant effects and medium to large for the significant effects. Conclusion: Analysis of the results revealed that there was evidence of an improvement in the intervention group when compared with the placebo group in some of the outcomes measured while other outcomes measured trended towards an improvement but lacked a sufficiently large sample size to conclude that it was a statistically significant effect.