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Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in womenCastelo Branco, Kim Bianca 15 July 2015 (has links)
M.Tech. (Chiropractic) / Aim: The aim of this study was to determine the effectiveness of chiropractic spinal manipulative therapy to the thoracic spine or stretch and strengthening exercises (stretching the pectoralis major muscle and strengthening the rhomboid, middle and inferior trapezius muscles), versus the combined treatment of chiropractic spinal manipulative therapy to the thoracic spine in conjunction with the stretch and strengthening exercises. This would then establish which treatment approach was the most effective in improving postural kyphosis with regards to a change in thoracic curvature over time. Method: A total of thirty female participants volunteered to take part in this study. All the participants were between the ages of twenty and thirty nine. The participants were randomly placed into one of three groups, each group consisted of ten participants. Group 1 received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. Procedure: In this study group 1 participants received treatment once a week for 6 weeks. Groups 2 and 3 participants received 3 treatments a week for 6 weeks. Postural advice was given to all 3 groups. One final follow-up visit was done in the 7th week where no treatment was administered but only data collection was done. Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1 and the first, tenth and nineteenth consultations for groups 2 and 3. Objective data included the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal) view photographs at the beginning of the initial and final consultations. Results: Statistical analysis performed included the non-parametric tests to determine if significant results were found over time. The Friedman and Wilcoxon Signed Rank tests were performed for the intragroup analysis and the Kruskall-Wallis test for the intergroup analysis. Statistical analysis revealed significant statistical changes for the intragroup results for all 3 groups. No significant statistical difference was found between the groups for the intergroup analysis. Conclusion: The study showed that all three treatment protocols for groups 1, 2, and 3 were effective. However, group 1 had not shown a great improvement in their postural kyphosis. Group 3 had shown a VII relatively good improvement in their posture. Group 2 had shown the best results with regards to improvement of the participants’ posture. Therefore in conclusion group 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but group 2’s treatment protocol consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises will yield the best results.
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A comparison between chiropractic manipulation and Kinesio® Taping and the combination thereof on postural kyphosis15 July 2015 (has links)
M.Tech. (Chiropractic) / Postural kyphosis of the thoracic spine is a common condition which affects a large percentage of the population. With an increase in anteriorly orientated activities, such as working on a computer, driving and studying, postural kyphosis has become more prevalent. Currently, the gold standard for the treatment of postural kyphosis is the stretching of the involved anterior musculature (pectoralis major and minor) and the strengthening of the involved posterior musculature (mid trapezius, rhomboids and levator scapulae). This involves the compliance of patients in the completion of exercises and stretching routines. This often resulted in poor outcomes as routines were performed irregularly or incorrectly. Although, if properly executed, this treatment protocol is effective, chiropractors, and other manual therapists, continue to search adjunctive modalities to improve the positive outcomes of their treatments. With the introduction of Kinesio® taping, the problem of patient compliance could be reduced. The tape is applied by the practitioner and simply left for several days. It has very little effect on the patient’s day to day activities and should continue to have positive impact on the involved musculature with no additional effort required from the participant. The benefits of chiropractic manipulation on the biomechanical relationship between a joint/s and linked musculature has long been recognised. However, very little research has been done to ascertain the direct benefits of chiropractic manipulation to the cervical and upper thoracic regions on postural kyphosis. This study will not only provide valuable information on these two modalities used individually, but also on the effectiveness of the combination of the two treatments. Method: This study was a comparative study consisting of three groups of ten participants. The method of treatment was determined by random group allocation. Group 1 received spinal manipulation to restriction(s) of the cervical and upper thoracic regions only. Group 2 received Kinesio® taping to the rhomboid muscle group only. Group 3 received the combination of spinal manipulation and Kinesio® taping. Subjective measurements consisted of the measurement of the thoracic kyphosis with the use of flexicurve ruler, a series of lateral view plumb line photographs and a set of secondary measurements consisting of three inter scapular measurements, one inter acromioclavicular measurement and two C7 to acromioclavicular measurements on each side.
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