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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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Start date: 2020Subject: search.filters.subject.Shoulder pain

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    Muscle recruitment patterns of selected upper extremity muscles in Chiropractors within the eThekwini Municipality while performing a simulated sacroiliac joint manipulation
    (2024) Luke Hardy, Benjamin; Murphy, Bernadette; O’Connor, Laura
    Background: Spinal manipulative therapy in the form of a high velocity, low amplitude manipulation, is a specialised therapeutic technique utilised by chiropractors and other manual therapists. Little is known about the shoulder muscular recruitment pattern utilised by practitioners/student’s to deliver this technique. This study aims to profile the muscle recruitment patterns of selected upper extremity musculature during a simulated sacroiliac joint manipulation to provide objective teaching material for future spinal manipulative therapy students regarding this specific manipulation. Methods: A quantitative, descriptive, observational design in which surface electromyography (sEMG) was used captured muscle activation patterns of 11 shoulder muscles in 20 qualified chiropractors who practiced in the eThekwini Municipality. Muscle activity was recorded while the chiropractors performed a simulated sacro-iliac joint manipulation, while simultaneous live video recording was obtained. The manipulation was assessed during its three phases: preload, thrust and resolution. Participants gave informed consent. Raw data was processed and normalised for comparability. Results: All 11 muscles displayed activity throughout the three phases of the adjustment. During preload, the clavicular and sternal pectoralis major and biceps brachii had the greatest mean and median muscle activation magnitude, with the middle and upper trapezius and clavicular pectoralis major showing the greatest maximum muscle activation magnitude. In the thrust phase all muscles showed high activity levels, except for the posterior deltoid which showed moderate activation. The middle and lower trapezius and infraspinatus had the greatest mean, median and maximum muscle activation magnitude. During the resolution phase, the greatest median muscle activation magnitude was found in the middle and lower trapezius and posterior deltoid muscle. This was similar to the greatest mean and maximum muscle activation with the triceps brachii replacing the lower trapezius. The maximum force output during the adjustment was averaged at ± 1.9 Kg. Conclusion: This study highlights the role of the shoulder muscles, specifically the pectoralis and the scapular stabilizer muscles, especially the middle trapezius, in the execution of the spinal manipulative technique investigated in this study. Future studies should confirm these findings in larger population where subgroup analysis can be undertaken.
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    The effectiveness of transcutaneous electrical nerve stimulation (TENS) therapy on shoulder impingement syndrome: a systematic review
    (2021-03-23) Maharaj, Shrishti; Korporaal, Charmaine Maria
    Background Shoulder impingement syndrome (SIS) is a common condition that causes pain and functional impairment in the shoulder. There have been various studies assessing methods of pain management in SIS, however, the knowledge around the association between transcutaneous electrical nerve stimulation (TENS) and SIS management has been found to be limited. A systematic review of the literature will provide healthcare providers and the public with an evidence-based summary of evidence regarding the effectiveness of TENS in treating SIS pain. Objective To systematically assess and review the methodological rigour of all available studies that have used TENS to treat SIS in order to provide evidence-based knowledge to either support or refute its use in clinical practice. Methods A literature search was conducted on electronic databases Google, Google scholar and DUT Summons (Pubmed, MEDLine, Mantis, ScienceDirect). The relevant key search words used at this stage of the study included the term “TENS” and each of the following: shoulder pain, frozen shoulder, calcific tendonitis, shoulder impingement syndrome, shoulder myofascial pain syndrome, brachial dysfunction, shoulder dysfunction and shoulder bursitis. It was identified that SIS would be the focus of this study and therefore, full-text articles relevant to SIS and TENS were included, based on the inclusion and exclusion criteria outlined in the study design. The final list of included articles was reviewed by a total of seven reviewers using either the PEDro and/or Newcastle-Ottawa scale, in order to establish the methodological rigour of the studies. Results During the data collection process that took place between August 2019 to January 2020, 106 articles were screened for eligibility. Patients included in these studies were adults who were required to have been diagnosed with SIS. These articles included randomized controlled trials (RCTs), non-RCT’s, case studies and case reports. The 106 articles were reduced to 20 articles meeting the inclusion criteria, consisting of 19 RCTs and 1 non-RCT. Following the conclusion of the data collection process, the articles collectively were divided into three groups. Screening and review of the articles were conducted by the three reviewers allocated to each group. Each article was then ranked according to the criteria outlined in the PEDro and/or Newcastle-Ottawa scale, and the limitations of each article were stated. Following this process, the findings of all articles were collated, with the results indicating that there is limited evidence to support the use of TENS in the management of SIS. Conclusion Even though TENS has been found to be effective in inducing pain relief in a variety of conditions, clinicians should use TENS with caution as the limited and conflicting evidence available does not advocate for its use (alone or in combination with other therapies) in treating SIS. Thus, there is a demand for more high-quality studies pertaining to TENS and SIS clinical subcategories. It is however recognised that the findings of this study may be limited to a specific time period and could be influenced by more recently published studies not included. Key words Shoulder pain, Frozen shoulder, Calcific tendonitis, Shoulder impingement syndrome, shoulder myofascial pain syndrome, Brachial dysfunction, shoulder dysfunction, shoulder bursitis, transcutaneous electrical nerve stimulation