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Faculty of Health Sciences

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    The immediate effect of chiropractic cervical spinal manipulative therapy on joint position sense and balance in elderly participants in the eThekwini Municipality
    (2023-05-31) Bonsma, Robyn Debra; Varatharajullu, Desiree; Prince, Cleo Kirsty
    Background The elderly population is growing due to medical advancements. Falls risk is one of the leading causes of death and injury in individuals over the age of 60 years, given that aging causes a degeneration of vestibular, visual and proprioceptive systems, aiding in balance. Chiropractic management has been identified as a strategy which may aid in the improvement of balance. There is a paucity in the literature when it comes to chiropractic treatment and its effect on joint position sense and balance, as well as paucity regarding the elderly population. Aim The aim of this study was to determine the immediate effect of cervical spine chiropractic manipulative therapy on joint position sense and sway index, as a part of balance in elderly participants in the eThekwini Municipality, in South Africa. Method This was a pre-post study in which 30 healthy participants with a mean age of 71 years of age participated. The elbow joint position sense was measured using a goniometer, and static balance was tested using the Biodex Biosway® portable balance system. The participants reproduced a predetermined angle of flexion of the elbow (blindfolded) pre- and post- intervention. The participants were tested for sway index on the Biodex Biosway® portable balance system with eyes open, pre- and post-intervention. The intervention of this study was a single cervical spine manipulation of the most restricted facet using the diversified technique. The location of the manipulation was not specific to a particular area of the cervical spine but the most restricted segment was adjustment. The joint position sense and balance of the pre- and post-intervention data were compared using statistical software IBM SPSS version 27. Results There was a significant improvement of joint position sense (p=0.032) after chiropractic spinal manipulation of the cervical spine; this was shown by the increase in accuracy of joint position sense. There was no significant improvement in static balance (p=0.683) after chiropractic spinal manipulation of the cervical spine. In this study, 76.7% of the participants were female and 23.3% were male and the ethnic distribution was as follows 90% white, 6.7% black and 3.3% Indian. Conclusion This study suggests that cervical spinal manipulation may alter sensorimotor functions associated with aspects of balance, such as joint position sense in the elderly, and thus decrease falls. This is due to the improvement in joint position sense post-chiropractic spinal manipulation however, it is unknown if this effect translates to the lower limb. Further studies need to be done to determine the effect of chiropractic manipulation on balance in the elderly as chiropractic spinal manipulation influences aspects of balance in the elderly but it is unclear as to the lasting length of its effects. It is also unclear as to the effect of longterm chiropractic treatment in both balance and falls prevention.
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    The relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of mechanical low back pain
    (1998) Myburgh, Cornelius; Mathews, Robert
    The absence oftested theory has resulted in the continued variation of treatment protocols in the treatment of mechanical low back pain. This study was designed to determine the relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of uncomplicated mechanical low back pain. It was hypothesized that both spinal manipulative therapy and specific passive mobilization would be effective, but that manipulation would be significantly more effective in terms of objective and subjective findings, over the same two week treatment period
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    The efficacy of motion palpation used as a post-adjustive assessment tool in the cervical spine to monitor patient progress
    (1999) Lakhani, Ekta; Nook, B. C.
    The purpose of this study was to evaluate the efficacy and reliability of motion palpation as a post-adjustive diagnostic tool in the evaluation of the cervical spine. This study attempts to assess motion palpation's ability to determine change in a motion segment fixation following manipulation
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    The relative effectiveness of adjusting the ipsilateral side of a fixation versus adjusting the contralateral side of a fixation in the management of facet syndrome of the cervical spine
    (1999) Kavonic, Brett Gidon; Cilliers, K. I.
    The purpose of this study was to determine the relative effectiveness of adjusting the ipsilateral side of the fixated segment versus adjusting the side contralateral to that of the fixated segment, in patients with facet syndrome of the cervical spine, in terms of subjective and objective clinical fmdings, as well as patient comfort. The rationale for adjusting the cervical spine on the side contralateral to fixation is that the spinal dysfunction is of a soft tissue nature, as opposed to joint or bone. Thus the effectiveness of the spinal adjustment may be due to a reprogramming of the central nervous system, whereby the principal effect seems to be to stretch muscles to their normal resting length before spinal mobility can be restored. Adjusting the side opposite to the fixation may cause a sudden stretch of the muscle spindle resulting in a barrage of afferent impulses to the central nervous system, which reflexly turns down the gamma motor neuron tone. The resetting of the gamma motor neuron tone and resultant restoration of the muscle spindle's normal resting length, thereby helps to relieve the associated muscle spasm and possibly removes the fixation. This study was comprised of 30 subjects, all of whom were diagnosed with cervical facet syndrome. The subjects were randomly divided into two groups of 15 each with ap average age of24 years per group. The average male:female ratio was 1,1:1.
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    The relative effectiveness of spinal manipulative therapy versus spinal manipulative therapy in conjunction with the administration of non-steroidal anti-inflammatory drugs in patients with facet syndrome
    (1999) Williamson, Andrew Roger; Till, A. G.
    The paucity of clinical research into the efficacy and effects of the different treatment protocols available for cervical facet syndrome has led to a continued variation in standard care for this condition. The aim of this study was to determine the relative effectiveness of spinal manipulative therapy in conjunction with the administration of a nonsteroidal antiinflammatory drug (NSAID) versus spinal manipulative therapy in conjunction with the administration of a placebo medication in the treatment of cervical facet syndrome. It was hypothesised that treatment with spinal manipulative therapy and NSAIDs over a two week period, with a further four week follow-up period, would be more effective than spinal manipulative therapy and placebo medication in terms of the objective and subjective clinical findings. The study design chosen was that of a double-blind, comparative, clinical trial. Thirty consecutive patients diagnosed with cervical facet syndrome were randomly assigned either to the manipulation and NSAID group or the manipulation and placebo group. The age range of the patients extended from nineteen to fifty-three years. Forty percent of patient occupations in both groups involved work on a computer. Each patient in the NSAID group received 139.5mg of diclofenac free acid a day over five days. The placebo group received the same dosage of similar appearance and taste over the same period. Each group of fifteen patients received treatment three times a week for two weeks. After a follow-up period of four weeks the patients were re-assessed. The patients were assessed by means of obtaining subjective information consisting of three questionnaires: the McGill Short-Form Pain Questionnaire, the Numerical Pain
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    The relative effectiveness of manipulating the superior vertebral segment compared to manipulating the inferior vertebral segment in facet syndrome of the lumbar spine
    (1998) Webb, Grant; Brantingham, James W.
    The purpose of this study was to evaluate the relative effectiveness of adjusting the superior vertebral segment as opposed to adjusting the inferior vertebral segment, of the two vertebral motion segments forming the facet joint responsible for the patient's symptoms and resulting in the diagnosis of facet syndrome, in the treatment of mechanical low back pain. Thirty subjects with mechanical low back pain were screened for facet syndrome and randomly divided into two groups of fifteen. Each patient received spinal manipulation for six treatments over 4 weeks, but the contact vertebra was different for each group. In the one group, contact was taken on the superior of the two vertebrae making up the facet syndrome, whereas contact was taken on the inferior of the two involved vertebrae in the second group. In the 'superior' group, the manipulative thrust was directed in the direction of the motion palpation findings, whereas in the 'inferior' group, the manipulative thrust was directed in the opposite direction to the motion palpation findings of the superior segment. Both groups were evaluated in terms of subjective and objective clinical findings by making use of questionnaires (Oswestry Back Pain and Disability Index; Numerical Pain Rating Scale-1 01; Short Form McGill) and goniometer measurements respectively.
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    The relative effectiveness of proprioceptive exercises as an adjunct to cervical spine manipulation in the treatment of chronic cervical spine pain and disability associated with whiplash injury
    (2003) Moulder, Nicole; Kruger, Brian
    Whiplash injuries are thought to occur in as many as one-fifth of all MVA’s in the United States and Canada. South Africa may have a higher incidence of whiplash injuries due to the exceptionally high road accident rate when compared with international norms (Burger 1996:478). The incidence rate is higher among female subjects and people aged 20-24 years (Teasell and Shapiro 1998: 72, Spitzer et al. 1995). Whiplash injuries or whiplash-associated disorders (WAD) often result in chronic pain with a poor response to conventional therapeutics. Manipulation, exercise and anti-inflammatories have been identified as the options with scientifically established validity in the management of WAD (Spitzer et al. 1995) Patients with WAD have a distortion of the posture control system as a result of disorganised neck proprioceptive activity. It would therefore appear that proprioceptive rehabilitative exercises would benefit WAD sufferers (Revel et al. 1994, Gimse et al. 1996). Spinal manipulation has also been shown to have a significant effect on proprioceptive-dependent abilities in subjects with chronic neck pain (Rogers 1997). This suggests that a combination of manipulation and proprioceptive rehabilitation may offer an improved treatment protocol for WAD (Fitz-Ritson 1995). The purpose of this investigation is to evaluate the relative effectiveness of proprioceptive exercises and cervical spine manipulation compared to manipulation alone, in terms of subjective and objective measures, in the treatment of whiplash-associated disorders.
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    The immediate effect of manipulation of selected cervical spinal segments on the peak torque of the rotator cuff muscles in asymptomatic patients with and without a mechanical cervical spine dysfunction
    (2005) Dixon, Tamsyn Louise; Korporaal, Charmaine Maria
    Although studies of manipulation-induced peripheral changes in the muscles have been done, inconsistencies noted by the author’s call for further investigation into the reflex effects of manipulation. Additionally, according to the literature, no effective treatment protocol for the painful shoulder has been found. Therefore this research aimed at addressing these discrepancies by quantifying the immediate effect of cervical spine manipulation in terms of peak torque on rotator cuff musculature in asymptomatic patients with both a cervical spine dysfunction and without. And thus by investigating cervical manipulation to the C4-C7 spinal segment, as a possible added intervention for improving rotator cuff muscle peak torque, a more efficient and effective management protocol for the painful shoulder could be attained. Thus the aims for this study included: 1) To evaluate whether manipulation has an effect on rotator cuff peak torque or not, utilizing the Cybex Orthotron II Isokinetic Rehabilitation System; 2) To ascertain whether manipulation of the specific levels has an effect on the rotator cuff peak torque or not and 3) To ascertain whether the presence or absence