Theses and dissertations (Health Sciences)
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Item The effect of spinal manipulative therapy and ischaemic compression versus muscle energy technique in chronic nonspecific neck pain(2022-05-13) Dicks, Tyron D.; Varatharajullu, Desiree; Abdul-Rasheed, AshuraNeck pain has become a problem experienced worldwide and it poses a global healthcare challenge to practising medical professions. There are numerous manual and non-manual treatments available for this frequently encountered problem. Frequently utilised and effective therapies are spinal manipulative therapy (SMT) and ischaemic compression (IC); however, these have been associated with several contraindications. An alternative form of treatment with less contraindications that may be of benefit to the patient is muscle energy technique (MET). Therefore, the aim of this study was to determine the effect of spinal manipulative therapy and ischaemic compression compared to muscle energy technique in chronic nonspecific neck pain. Methodology: This study was a quantitative randomised, single blinded clinical trial. Forty participants with nonspecific pain, aged 20-50 years, were randomly allocated into two groups using a random allocation chart provided by a statistician. Group one received SMT and IC, whereas group two received MET alone. The numerical pain rating scale (NRS) was used to determine the level of neck pain. The cervical range of motion (CROM) goniometer was used to calculate the degree of lateral flexion occurring at the neck. The pain pressure algometer was used to determine the pain pressure thresholds (PPT). The Canadian Memorial Chiropractic College (CMCC) Neck Disability Index (NDI) was used to assess the disability in activities of daily living as a consequence of neck pain. Each participant had four consultations over a two-week period, receiving treatment on the first three consultations with the fourth being purely subjective and objective measurements. Results: Repeated measures ANOVA testing was utilised to examine the changes over time in each group. Profile plots were used to visually explore the trends of each group over time. Intra-group analysis of subjective and objective measurements revealed that both groups had a beneficial response to the treatment over time. Inter-group analysis showed that there were no statistically significant differences between the two groups in terms of subjective and objective measurements. Conclusion: In conclusion, this study revealed that the use of MET is as equally effective as a combination of SMT and IC in the treatment of chronic nonspecific neck painItem The effect of cervical spine manipulation compared to muscle energy technique on neck muscle activity and range of motion in asymptomatic participants(2020-06-10) King, Sasha Lee; Docrat, Aadil; Abdul-Rasheed, AshuraBackground: 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.