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    Immediate effects of cervical spine manipulation compared with muscle energy technique on neck muscle activity and range of motion in asymptomatic participants : a randomized study
    (Elsevier BV, 2022-07) King, Sasha Lee; Docrat, Aadil; Abdul-Rasheed, Ashura
    Objective: The purpose of this study was to investigate the immediate effects of cervical spine manipulation (SM) compared with muscle energy technique (MET) on neck muscle activity and range of motion in asymptomatic people. Methods: A randomized parallel-group study was conducted at a chiropractic teaching clinic in Durban, South Africa. Fifty asymptomatic participants between 18 and 35 years of age were randomly assigned into group 1 or group 2. Group 1 received cervical SM, and group 2 received MET. Participants were blinded to group allocation only. Baseline and post-test measurements consisted of resting upper trapezius and posterior cervical muscle activity and cervical spine range of motion (ROM) in lateral flexion and extension. Results: A significant difference was found in cervical ROM within groups (P < .001), with no significant difference observed between the 2 groups. The right posterior cervical muscles showed a significant difference in group 1 only (P = .012). No significant muscle activity changes occurred in group 2. Resting muscle activity measures showed no statistically significant changes between groups. Conclusion: A single application of SM and MET to the cervical spine immediately increased cervical ROM. Neither cervical SM nor MET changed resting posterior cervical and upper trapezius muscle activity.
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    An analysis of the combined effects of swimming and overhead throwing on the shoulder complexes of male first division waterpolo players
    (2021-05-10) Gibb, Conor Beckett; Matkovich, Grant
    Background Abstract Waterpolo is often compared to other sports, mainly swimming and overhead throwing sports. Swimming favours a posture of glenohumeral internal rotation and horizontal adduction. Overhead throwing sports can characteristically cause posterior shoulder immobility with a loss in glenohumeral internal rotation and horizontal adduction. Based on the fact that waterpolo players combine both swimming and overhead throwing whilst playing and training, it is the purpose of this study to investigate the sport-specific characteristics of the shoulder complexes of waterpolo players in an effort to determine how these unique characteristics may relate to the development of overuse injuries. Aim The aim of this study is to compare the dominant and non-dominant shoulder complexes of male water polo players in terms of posture, range of motion and sport- specific overuse injuries in order to develop an understanding of the combined effects of swimming and overhead throwing on the shoulders of water polo players. Methods The study used an observational based research design and consisted of 33 male waterpolo players currently competing in the Kwa-Zulu Natal mens 1st division waterpolo league. Participants underwent a shoulder digital posture examination as well as a shoulder-complex physical examination consisting of range of motion and orthopaedic testing which was then compared between the dominant and non- dominant shoulders. Participants were assessed for the presence of rotator cuff injury, glenoid labrum and LHBT injury, and anterior glenohumeral instability using the following physical tests: Empty can test, painful arc test, external rotation resistance, Hawkins-Kennedy test, Neer test, Yergassons test, Biceps Load test II, and the apprehension-relocation-surprise test. Glenohumeral range of motion was assessed using manual goniometry to measure passive internal and external rotation and horizontal adduction. Statistical analysis was performed using IBM SPSS version 27 statistical analysis software. Paired tests were used to compare outcomes from the dominant and non-dominant shoulders of the participants. To compare the posture measurements, as well as injuries present between the dominant and non-dominant shoulders, McNemar’s chi square tests were used. To compare the Range of motion measurements between the dominant and non-dominant shoulders, paired t-tests were used. A p value < 0.05 was considered statistically significant. Results Forward head posture with rounded shoulders was extremely common, with 73% of the participants in this study displaying a bilateral forward shoulder position ranging from moderate to severe, and 45% of participants displaying a bilateral forward head posture ranging from mild to severe. Glenohumeral internal and external rotation ROM measurements showed no difference between sides. There was a borderline significant difference (p=0.05) in the horizontal adduction measurements, with the non- dominant side showing greater values. The only injury test that yielded significant results was the empty can test for supraspinatus injury that had a higher prevalence for being positive on the dominant side. Conclusion The results of this study suggest that water polo players are prone to the development of a bilaterally equal forward head posture with rounded shoulders and are susceptible to similar mechanisms of bilateral overuse injury as swimmers. In addition, the dominant shoulders of these athletes are susceptible to damage caused by the repetitive, traumatic forces experienced by the posterior cuff musculature and posterior glenohumeral joint capsuloligamentous structures during the follow-through and deceleration phases of overhead throwing, resulting in an increased risk of supraspinatus-specific rotator cuff injury and a loss of glenohumeral horizontal adduction that potentially increases the risk of glenoid labrum and LHBT injury.
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    The immediate effect of lumbar spine manipulation, thoracic spine manipulation and placebo manipulation on range of motion and bowling speed in asymptomatic male and female indoor cricket bowlers
    (2020-11-30) Nayager, Prasanthi; Maharaj, Praveena; Sood, Kanwal
    Background: Cricket bowling is a manoeuvre that consists of a sequence of body motions utilising the entire kinematic chain. Cricket like many sports is played both indoor and outdoor. To eliminate the factors of weather (dew and wind) and nature (grass top pitchers) the following study was conducted on indoor cricket bowlers. The phrase ‘proximal stability for distal mobility’ is best suited, as the lower extremities, pelvis and trunk play a vital role and assist the upper extremities in the bowling action. Therefore, bowling should be known as a combined movement of the entire body, culminating with rapid motions of the upper extremity. Restricted motion within a joint segment could lead to adverse changes in the surrounding muscles, tendons, and ligaments of the trunk. Restricted motion of the trunk and pelvis may result in abnormal loads being applied on the peripheral joints, thus resulting in injuries or a decline in an athlete’s performance. Spinal manipulation therapy is a technique that is used to improve flexibility and mobility in a joint. This study focused on the effects of SMT on the joint range of motion (trunk) and bowling speed. Objectives: The main objective of this study was to assess the immediate effects of lumbar spine, thoracic spine, and placebo manipulation on the range of motion of the thoracic and lumbar spine, as well as the bowling speed of the participants. Methods: A sample of asymptomatic male and female cricket bowlers (60 in total), playing for schools, local clubs and at provincial level were divided into three groups of 10 each. Group 1a and Group 1b received thoracic spine manipulation, Group 2a and Group 2b received lumbar spine manipulation and Group 3a and Group 3b received placebo spinal manipulation. The range of motion of the thoracic and lumbar spine was measured pre and post manipulation using a digital inclinometer. Bowling speed was measured pre and post warm-up and manipulation using a speed radar. The participants’ perception of changes in bowling speed post manipulation were also recorded. SPSS version 25 was used to statistically analyse the data. Results: There were statistically significant increases in thoracic range of motion post thoracic manipulation in male and female participants. Thoracic spine manipulation enhanced bowling speed significantly in male and female participants. Lumbar spine manipulation increased lumbar range of motion and thoracic range of motion, especially in the female athletes. However, it did not impact bowling speed. Post placebo manipulation showed that there were no significant differences in range of motion and bowling speed. However, both thoracic and lumbar manipulation showed significant changes in range of motion, compared to placebo manipulation. Conclusion: This study supported the findings of several authors, that spinal manipulation significantly influences athletes’ performance. In this study, post thoracic spine manipulation bowling speed increased significantly in both male and female athletes. It was also evident that female participants’ range of motion increased overall except for extension of the lumbar spine more post manipulation, while male participants had a higher bowling speed average.
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    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, Ashura
    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.