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Faculty of Health Sciences

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    The effect of sacroiliac joint manipulation on gluteus maximus muscle activity in asymptomatic participants
    (2020-06-10) Worth, Kevin; Kretzmann, Heidi
    Purpose: The effects of spinal manipulation are well documented; however there is a gap in the current literature regarding the exact mechanisms underlying the effectiveness of spinal manipulation. Further evidence is required to improve the understanding of the neurophysiological effects of spinal manipulative therapy and its effect on muscle activity. The objectives of this study were to investigate the effects of sacroiliac joint manipulation on gluteus maximus muscle activity in an asymptomatic sample group when compared to a placebo group Methods: A randomized, controlled, pre-test, post-test repeated measures design allowed for 28 participants, aged 18-40 years old, with sacroiliac joint dysfunction to be allocated into either a sacroiliac joint manipulation or a placebo group. Muscle activity of the gluteus maximus was measured before intervention and again 10 minutes post intervention. IBM SPSS was used to analyse the data with significance set at (p=0.05). Repeated measures ANOVA testing was used to determine the significance within and between groups. Results: There was evidence of an improvement in the intervention compared with the placebo group from pre to post for outcomes of Channel A mean and maximum values, and for Channel B maximum values. In the other measures there was a trend observed but insufficient evidence to conclude that it was a real effect. The partial eta squared values were relatively small for these non-significant effects and medium to large for the significant effects. Conclusion: Analysis of the results revealed that there was evidence of an improvement in the intervention group when compared with the placebo group in some of the outcomes measured while other outcomes measured trended towards an improvement but lacked a sufficiently large sample size to conclude that it was a statistically significant effect.
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    The effect of lumbar spine, sacro-iliac and/or hip joint manipulation on muscle activity and performance in road cycling
    (2018) Fuller, Pia Alexa; Matkovich, Grant; Puckree, Threethambal
    BACKGROUND Cycling is a highly competitive sport where athletes are continuously looking for ways to improve their performances in order to gain what might be seconds over their components. Chiropractic manipulation has been shown to restore the balances of the kinematic chain and stimulate motoneuron pools and therefore by implementing this technique into their training regime, it may show improvement in muscle activity distributions, demands and efficiency thus resulting in better cycling performance. OBJECTIVES To determine the participants muscle activity (amplitude of surface EMG) and cycling performance in terms of power output (W), cycling speed (km/h), cadence (rpm), and completion time (seconds) before and after lumbar spine, sacro-iliac joint and/or hip joint manipulation intervention. METHOD Sixty-one asymptomatic amateur cyclists performed two 1.5km time-trials pre- and post- manipulative intervention. The pre- and post-intervention data of muscle activity (amplitude of surface EMG) and cycling performance (power output (W), cycling speed (km/h), cadence (rpm), and completion time (seconds)) were captured. IBM SPSS version 24 was used to analyse the data. A p value <0.05 was considered as statistically significant. RESULTS There was no significant change in muscle activity post-lumbar spine manipulation. There was a significant decrease in cycling performance post-lumbar spine manipulation. Sacro-iliac joint showed no significant change in muscle activity post-manipulation. The study data demonstrated a significant decrease in cycling performance post sacro-iliac joint manipulation. There was no significant change in muscle activity post hip joint manipulation. A significant decrease in power output and speed post hip joint manipulation, no significant effect of overall performance. Combination manipulation intervention showed a significant decrease in muscle activity of iliopsoas muscle. Combination manipulation showed no significant change in cycling performance. CONCLUSIONS There was a visual trend that showed, although there was a decrease in overall cycling performance in the lumbar spine and sacro-iliac joint manipulation groups post-intervention, with no significant changes in the hip joint and combination manipulation groups post- intervention – these athletes were more efficient cyclists post manipulative intervention particularly those who received the combination of adjustments.
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    The efficacy of detuned ultrasound compared to proprioceptive neuromuscular facilitation of the gluteal musculature both used in conjunction with manipulation in the treatment of sacroiliac syndrome
    (2001) Paton, Jaqueline; Myburgh, Cornelius
    The purpose of this study was to determine the relative efficacy of chiropractic manipulation used in conjunction with detuned ultrasound over the gluteal muscles compared to manipulation used in conjunction with proprioceptive neuromuscular facilitation stretching of the gluteal muscle group in the treatment of sacroiliac syndrome. It was hypothesised that both treatment groups would be effective in the treatment of sacroiliac syndrome but that manipulation used in conjunction with proprioceptive neuromuscular facilitation of the gluteal musculature would be more effective than manipulation used in conjunction with detuned ultrasound, in terms of subjective and objective clinical findings.
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    A study to determine the usefulness of the Gonstead Listing System as an indicator of the direction of adjusting the sacroiliac joint in the treatment of sacroiliac syndrome
    (1997) Moorcroft, Rayne; Peers, Anthony V.
    The purpose of this study is to evaluate the usefulness of the Gonstead Listing System as a reliable indicator of the direction in which to adjust the sacroiliac joint in subjects with sacroiliac joint dysfunction, in terms of their subjective and objective clinical findings. The hypothesis is that the direction of manipulation is clinically insignificant in causing a decrease in the subject's clinical findings. This information is necessary in order for chiropractors to formulate a more cost-effective treatment protocol for their patients.
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    A comparison of two manipulative techniques in the treatment of sacroiliac syndrome
    (1997) Reid, Alan Roger; Peers, Anthony V.
    Sacroiliac syndrome is a painful, debilitating condition that may cause considerable discomfort (Haldeman 1992), it is a common condition causing low back pain (Mierau, et al 1984, Guo and Zhao 1994), it is also believed by Bernard and Cassidy (1991) to be a frequently overlooked source of low back pain. Between 9 and 19.5 % of all sickness absence days are due to low back pain (Andersson 1981)
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    The relative effectiveness of manipulation with and without the contract-relax-antagonist-contract technique of proprioceptive neuromuscular facilitation stretching of the piriformis muscles in the treatment of sacroiliac syndrome
    (2001) Ranwell, Ivan Henry; Mac Dougall, Tarryn
    This study aims to provide insight into the relative effectiveness of two different approaches in the treatment of sacro - iliac syndrome. Until recently, the sacro - iliac joints were not commonly considered to be mobile enough to suffer from detectable restriction of motion (Panzer and Gatterman 1995:453). Kirkaldy - Willis et al. (1992:126) however, states that sacro - iliac syndrome is a well defined and common type of dysfunction. Frymoyer et al. (1991 :2114) also reports sacro - iliac syndrome to be common, although it is frequently overlooked as a source of low back pain. This study will attempt to determine whether manipulation of the sacro - iliac joints together with Proprioceptive Neuromuscular Facilitation (P.N.F.) stretching of the piriformis muscles is a more effective treatment for sacro - iliac syndrome, than manipulation alone. This will be accomplished by determining which approach yields the best patient response in terms of subjective and objective clinical findings. The study conducted was a randomised clinical trial consisting of two groups of 30 patients each. The patients were randomly allocated into the two groups. All patients received four treatments over a two - week period. Group one received manipulation of the sacro - iliac joints alone, while Group two received manipulation of the sacro - iliac joints together with P.N.F. stretching of the piriformis muscles. Only the sacro - iliac joint on the side of the sacro - iliac syndrome was manipulated, and only the piriformis muscle on the side of the sacro - iliac syndrome was stretched. If any patients became asymptomatic within the treatment period, then the treatment was terminated. The patients were however required to return for all the remaining consultations for observational purposes. The results of the Numerical Pain Rating Scale, Oswestry Low Back Disability Index questionnaire, inclinometer and algometer readings, as well as the sacro - iliac orthopaedic tests, were recorded before the first and second treatments, and immediately following the fourth (final) treatment.
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    The short-term effect of sacroiliac manipulation on hip muscle strength in patients suffering from chronic sacroiliac syndrome
    (2004) Terblanche, Melissa; White, Horace Lindsay; Jackson, Dennis R.
    Arthrogenic muscle inhibition (AMI) is the reflex inhibition of the muscles that surround an injured joint in consequence to disturbed afferent feedback originating from the receptors of that joint. The resultant altered afferent innervation of the motor neuron pool leads to a decrease in recruitment ability within the motor neuron pool, a decrease in contraction force of the muscles that fall within the motor neuron pool, and hence the clinical manifestation of AMI as a decrease in muscle strength. Spinal manipulation has been proposed to activate mechanoreceptors and proprioceptors within and around the manipulated joint. The altered afferent input arising from their stimulation is thought to cause changes in motor neuron excitability. In this respect, sacroiliac manipulation has been shown to effectively reduce muscle inhibition and increase muscle strength of the quadriceps muscle group in patients with anterior knee pain. The focus of AMI has been aimed primarily at the quadriceps muscle group whereas little information is available on the functional properties of the muscles moving the hip joint. Thus, the purpose of the present cohort study was to determine the short - term effect of sacroiliac manipulation on ipsilateral hip muscle strength and subjective low back pain intensity in thirty male subjects presenting with low back pain, attributable to chronic sacroiliac syndrome. The first objective of the study was to evaluate the short - term effect of sacroiliac manipulation on the strength of the musculature of the ipsilateral hip joint for the actions of flexion, extension, adduction and abduction by means of the Cybex Orthotren II Isokinetic Rehabilitation System, with respect to objective clinical findings.
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    The relative effectiveness of manipulation used in conjunction with a non-stabilising sacroiliac orthotic versus manipulation used in conjunction with a stabilising sacroiliac orthotic in the treatment of sacroiliac syndrome
    (2000) Sawyer, Angela Hope; Myburgh, Cornelius
    There has previously been a significant number of clinical trials supporting the efficacy of manipulation for the treatment of low back pain. In addition, the use of manipulation for the treatment of sacroiliac syndrome is well recognised. However, the management protocols involving the use of orthotics, used alone, or in combination with manipulation were found to be controversial. Orthotics seem to be frequently used in the clinical setting and yet there is a paucity of controlled clinical research advocating their application. The aim of this study was to determine the relative effectiveness of chiropractic manipulation used in combination with a non-stabilising sacroiliac orthotic (strapping) versus chiropractic manipulation used in combination with a stabilising sacroiliac orthotic in the treatment of sacroiliac syndrome. It was hypothesised that both treatment protocols would be effective in the management of sacroiliac syndrome, and that manipulation used in combination with a stabilising sacroiliac orthotic over a two week period would be more effective than manipulation used in combination with a non-stabilising sacroiliac orthotic, in terms of subjective and objective clinical f-Indings. The study design chosen was a comparative, randomised, controlled clinical trial. Sixty consecutive patients diagnosed with sacroiliac syndrome were randomly assigned either to the group receiving manipulation used in combination with a non-stabilising sacroiliac orthotic or the group receiving manipulation used in combination with a stabilising sacroiliac orthotic. The age range of patients extencled from eighteen to forty-nine, and included thirty-one males and thirty-three females. Statistically patients\x8F\x8F
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    The effectiveness of manipulation of the symptomatic sacroiliac joint compared to manipulation of both the asymptomatic and symptomatic sacroiliac joints in the treatment of unilateral sacroiliac syndrome
    (2002) Marszalek, Norman Maciej; Kruger, Brian
    Low back pain (LBP) is a significant public health problem that has had a marked impact on quality of life and on health care costs (Weiner, et al. 2000:450). Toussaint, et al. (1999:134) established that the prevalence of sacroiliac joint dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. There is a lack of consensus among medical practitioners, chiropractors, osteopaths, physiotherapists and others as to the most appropriate therapy or management for sacroiliac syndrome. This study was designed to determine the effectiveness of manipulation of the symptomatic sacroiliac joint compared to manipulation of both the symptomatic and the asymptomatic sacroiliac joints in the treatment of unilateral sacroiliac syndrome. Anecdotal evidence would seem to indicate that the direction of the chiropractic manipulation is immaterial to clinical improvement (Till, 1994). Bilateral manipulation of the symptomatic and asymptomatic joints has been used in clinical practice in an attempt to increase the efficacy of chiropractic management for unilateral sacroiliac joint syndrome (Till, 1994, Lewis, 2001 and Nook, 2000). Walker (1992:914) was of the opinion that 'Unless reliability and validity of assessments and effectiveness of treatment procedures can be demonstrated, clinicians should temper their claims of measurement of, and direct effects on, the sacroiliac joint.' This randomized, comparative clinical trial consisted of sixty voluntary subjects each suffering from sacroiliac joint syndrome. There were two groups of thirty subjects, each of whom received five treatments within a three week period. Group one received manipulation of the symptomatic sacroiliac joint
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    The efficacy of a toggle recoil drop piece adjustment technique in the treatment of sacroiliac dysfunction
    (2005) Jacobs, Ronel C.; Korporaal, Charmaine Maria
    One of the most common clinical disorders known is mechanical low back pain (Painting et al. 1998:110). A significant source of low back pain is the sacroiliac joint and therefore, according to Schwarzer et al. (1995:31), it warrants further study. With respect to treatment, Gatterman (1995) states that specific manipulative therapy is the treatment of choice for sacroiliac dysfunction. This is supported by clinical studies (Cassidy et al., 1992), which have shown significant improvement with daily manipulation over a 2-3 week period in 90% of the patients suffering from sacroiliac dysfunction. Different adjusting techniques for the sacroiliac joint include side posture adjustment and prone drop piece adjustments (Bergmann, 1993). With respect to side posture, Bergmann (1993) further states that the side posture adjustment is the most common position used. However, it has been noted that side posture can produce unwanted rotation in the lumbar spine. This may be detrimental to patients who have contra-indications to torsioning such as abdominal aortic aneurisms, nerve root entrapment or disc pathology. Patients, who experience anterior catching of the hip capsule or decreased flexibility with side posture adjustments, experience more discomfort and could therefore benefit from a different technique (Gatterman, 1995). Hence the need for an effective adjustment technique that does not rely on torsioning (e.g. drop piece technique). (White, 2003; Pooke, 2003; Hyde, 2003; Pretorius, 2003; Haldeman, 2003; Cramer, 2003; Engelbrecht, 2003). Although drop table thrusting techniques were rated as being effective for the care of patients with neuromuskuloskeletal problems (Haldeman et al., 1993) as cited by Gatterman et al., (2001), it is still unknown which specific drop piece technique is the most appropriate for sacroiliac dysfunction. Therefore this study was aimed at determining the efficacy of a toggle recoil drop piece adjustment technique.