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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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Subject: search.filters.subject.Force output

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    The relative effect of upper cervical spine manipulation, placebo and a control, on neck muscle activity, pain and disability in participants with cervicogenic headache
    (2020-11-30) Brann, William Edward; O’Connor, Laura; Venketsamy, Yomika
    Objectives: Cervical spinal manipulation (CSM) has been shown to be effective in treating cervicogenic headache (CGH) by reducing pain and disability. There is a paucity of research investigating whether changes in muscle activity account for the changes in patient reported outcomes in patients with CGH following CSM. The aim of this study was to determine the effect of upper CSM compared to a placebo and a control intervention in terms of subjective (pain and disability rating) and objective measures (muscle activity and force output of the trapezius, posterior cervical and sternocleidomastoid muscles) in the treatment of CGH. Methods: A randomized, controlled, pre-test, post-test, experimental design allowed for 45 participants, aged 18-50, with CGH to be allocated to a CSM, placebo or control group. Pain and disability were measured before and telephonically 48 hours after the intervention. Muscle activity and force output of the trapezius, posterior cervical and sternocleidomastoid (SCM) muscles were measured before and immediately after the intervention. IBM SPSS was used to analyse the data with significance set at p=0.05. The subjective and objective measures were not normally distributed and this resulted in nonparametric statistical tests being utilised to analyse the data. Wilcoxon Signed Rank Tests were used to determine significance within groups and Independent-samples KruskalWallis Tests and Pairwise multiple comparison tests were used to determine significance between groups. Results: No significant differences were found between the three groups for age (p=0.460) and gender (p=0.566), with a marginally significant finding for race (p=0.046). Subjective measure assessment found only a significant decrease in pain (p=0.001) and disability (p=0.001) from pre- post-test within the CSM group. Intergroup analysis found that the CSM group experienced the greatest reduction in pain (p=0.001) and disability (p=0.001) when compared to the placebo and control groups. Clinically, only pain in the CSM group decreased significantly. Objective findings showed significant intragroup increases in muscle activity, found bilaterally in the SCM (p=0.017 SCMR) (p=0.012 SCML) and trapezius muscles (p=0.041 TrapR) (p=0.041 TrapL) in the CSM group and only in the trapezius muscle (p=0.031 TrapR) (p=0.027 TrapL) bilaterally in the placebo group. Force output only increased in the trapezius muscle on the left (p=0.027) in the placebo group and bilaterally in the control group (p=0.031 TrapR) (p=0.041 TrapL) There were no significant intergroup differences between the groups for muscle activity and force output in the trapezius, posterior cervicals and SCM
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    The effect of a unilateral sacroiliac joint manipulation on muscle activity and force output in the posterior oblique sling muscles
    (2020-06-10) McNally, Aimee Paige; O’Connor, Laura; Abdul-Rasheed, Ashura
    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).