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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
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    The effectiveness of needling of myofascial trigger points on internal- external muscle peak torque and total work ratios of the shoulder rotator myoatatic unit in overhead throwing athletes suffering from myofascial pain and dysfunction syndrome
    (2005) Royce, Nicholas; Kruger, Brian; Korporaal, Charmaine Maria
    The purpose of this study was to determine whether dry needling of myofascial trigger points (TrP's), found in the shoulder rotator myotatic unit, had an effect on the peak torque and total work parameters of the shoulder myotatic unit and by inference, the relative external rotation strength deficit in over-head throwing athletes. Athletes who perform overhead throwing sports such as: baseball, javelin, swimming/waterpolo and tennis, are susceptible to sustaining a micro-traumatic injury of the rotator myotatic unit of the shoulder, owing to repetitive high velocity mechanical stress placed on the shoulder at the extreme ranges of motion. The inherent structure of the shoulder, with three external rotators and five internal rotators, causes a muscle imbalance before an activity, such as throwing occurs, and this can predispose an athlete to Repetitive Stress Injuries (RSI) as a result of overuse or overload. The incidence and activation of TrP's in shoulder muscles can be accounted for on the basis of mechanical stress such as overuse / overload and thus could change muscle fiber co-ordination (muscle activity) and precipitate a painful lesion. It can be seen in current literature that TrP's produce a number of signs and symptoms such as: spasm of other muscles, weakness of involved muscle function, loss of co-ordination and decreased work tolerance of the involved muscle . Therefore the TrP's present in the shoulder rotator unit could contribute to changes in internal/external rotation ratios in over head athletes, and thus by deactivating or eliminating these TrP's, it is possible that these ratios may be
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    The association between active myofascial trigger points of the shoulder external rotator myotactic unit on altering internal/external peak torque and single repetition work ratios in overhead throwing athletes
    (2005) Audie, Gregg; Kruger, Brian
    The purpose of this study was to investigate the association between active Myofascial Trigger Points in the dominant shoulder external rotator muscle group in overhead throwing athletes and an altered internal/external rotation peak torque and single repetition work ratio of the involved shoulder.
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    The effectiveness of needling of myofascial trigger points on internal- external muscle peak torque and total work ratios of the shoulder rotator myoatatic unit in overhead throwing athletes suffering from myofascial pain and dysfunction syndrome
    (2005) Royce, Nicholas
    To assess and quantify the number, severity and specific location of myofascial trigger points within the shoulder rotator muscle group. To assess the internal/external ratio of the dominant shoulder in throwing athletes using a Cybex 700 dynamometer, after intervention and to establish a comparable clinical profile of the participants.
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    An investigation into the contributing factors associated with work related musculoskeletal disorders of the neck and shoulders in non- secretarial computer users in a selected corporate banking environment
    (2005) Peek, Nigel Richard
    Musculoskeletal injuries in computer users are an increasing concern. The computer has become an essential working tool that is used throughout all levels of companies and organisations. Management and professional personnel are required to use computers, often without training in typing skills, this combined with higher stress and responsibility levels and lengthy work hours. Potentially this makes them a high-risk group for work related injury. Previous research has focused mainly on data entry and secretarial workers, who are often competent in typing and keyboard skills. There is an increasing body of literature that implicates a wide variety of factors responsible for computer and office related musculoskeletal injury, however there is still much conflict as to what factors play the most influential role in development of these disorders. Conflict largely remains over the role of individual and constitutional factors versus workplace factors such as ergonomic design and patterns of computer use. The aim of this study was therefore to determine the prevalence of and related risk factors associated with work related musculoskeletal injuries of the neck and shoulder in non-secretarial computer users within the South African context.