M.Tech. (Chiropractic) / This study aims to determine whether muscle energy technique of the psoas muscle can be used as an effective treatment for low back pain with lower crossed syndrome or whether it is better to be used alone or in conjunction with spinal adjustments with regards to pain and disability, lumbar range of motion and degree of lumbar lordosis. Thirty participants who met the inclusion criteria were randomly allocated to one of three different groups of ten participants each. Group 1 had muscle energy technique performed on the psoas muscle of each participant. Group 2 received spinal adjustment/s over the restricted joint/s in the lumbar spine. Group 3 received spinal adjustment/s over the restricted joint/s in the lumbar spine in conjunction with muscle energy technique on the psoas muscle. All participants were assessed over a four week period. All groups attended six treatment sessions over three weeks of which muscle energy technique and/or spinal manipulation was performed. In the fourth week only measurements were taken and no treatment was administered.Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire to assess pain and disability. Objective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a digital inclinometer for assessing active lumbar range of motion and a flexible ruler for measuring the degree of lumbar lordosis. Analysis of collected data was performed by a statistician.Statistically significant improvements were seen in Groups 1, 2 and 3 over the duration of the study with regards to pain, disability and lumbar range of motion as well as degree of lumbar lordosis. The data gathered in this study showed statistically significant changes in Groups 1, 2, 3 with regards to lumbar range of motion, lumbar lordosis, pain and disability, with Group 3 showing the most statistically significant changes with regard to pain and disability...

M.Tech. (Chiropractic) / Purpose: This study aims to determine the effect of Bruegger’s exercise on chronic low back pain in association with lower crossed syndrome and compare it to spinal manipulation alone or a combination of Bruegger’s exercise and spinal manipulation with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of three different groups of ten participants each. Group one was only instructed on how to perform Bruegger’s exercise. Group two only received a spinal manipulation/s over the restricted joint/s in the lumbar spine. Group three received a spinal manipulation/s over the restricted joint/s in the lumbar spine in conjunction to being instructed on how to perform Bruegger’s exercise. All participants were assessed over a four week period. All groups attended six treatment sessions over three weeks of which Bruegger’s exercise and/or spinal manipulation were performed. The participants who needed to perform Bruegger’s exercise were also advised to continue doing the exercise out of the treatment session where applicable. In the fourth week only measurements were taken and no treatment was administered. Procedure: Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire to assess pain and disability. Objective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a universal goniometer for assessing passive hip flexion and extension, a digital inclinometer for assessing active lumbar range of motion and a flexible ruler for measuring the degree of lumbar lordosis. Analysis of collected data was performed by a statician. Results: Clinically significant improvements in group 1, group 2 and group 3 were noted over the duration of the study with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Statistically significant changes were noted in group 1 and group 2 with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis, and in group 3 with regards to hip and lumbar range of motion as well as degree of lumbar lordosis. Conclusion: The results show that Bruegger’s exercise, spinal manipulation and the combination of Bruegger’s exercise and spinal manipulation are effective treatment protocols both clinically and significantly in decreasing pain and disability (not statistically for the combination of Bruegger’s exercise and spinal manipulation), increasing hip and lumbar range of motion as well as decreasing the degree of lumbar lordosis. However, there was no treatment protocol that proved to be preferential over the other. Because spinal manipulation alone showed the greatest overall clinical improvements, it may be suggested that spinal manipulation alone is the most effective in the treatment of chronic low back pain associated with lower crossed syndrome with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Also, the addition of Bruegger’s exercise may help in some instances to further assist in treatment once the full effects of the spinal manipulation has occurred and allowed for the muscles to be in their optimum state for exercise.

Title: The Occurrence of Lower Crossed Syndrome in Sprinters and the Possibilities of Influencing it in Physiotherapy Objectives: To determine the prevalence of lower crossed syndrome in specific group of sprinters and compare it with control group. To compare occurrence especially in men and women in sprint. Methods: To obtain informations from the research were used clinical tests- muscle test by Janda for testing muscle strength of m. rectus abdominis (trunk flexion test), m. gluteus maximus (test of extension in hip with contemporary flexion in knee), m. gluteus medius et minimus (test of abduction in the hip joint) and examination of frequently shortened muscle groups by Janda for examination shortening of the hip flexor muscles (m. iliopsoas, m. rectus femoris and m. tensor fascia latae) m. quadratus lumborum- lateral variant and paravertebral back muscles. To select probands into research and control groups was created nonstandard questionnaire with open and closed questions. In the research there were 40 probands. Results: The results show that the lower crossed syndrome by Janda is more common in sports recreationally individuals than sprinters. Furthermore the lower crossed syndrome by Janda is more common in sprinters- men than in sprinters- women, but here the results are not so clear....

M.Tech. / OBJECTIVE: To determine the most effective treatment protocol in the treatment of Lower-Crossed Syndrome by comparing objective results gained from a Rehabilitation program (group one), Spinal Manipulative Therapy (group two) and a combination of these therapies (group three) directed at the sacroiliac joints and lumbar spine. DESIGN: The study was a clinical trial in which three experimental groups of sixteen participants each were compared to each other. These participants were recruited from the local general population and were selected on the basis of inclusion and exclusion criteria, presenting with Lower-Crossed Syndrome and demonstrating unremarkable clinical and radiological findings. INTERVENTION AND DURATION: After randomisation, group one received a Rehabilitation program which consisted of a stretching and strengthening program only, group two received Spinal Manipulative Therapy only whereas group three received a combination of Spinal Manipulative Therapy and a Rehabilitation program. The frequency of the follow up consultations for this study was two consultations over the first two weeks of the trial and once a week for the following four weeks of the trial. MEASUREMENTS: Objective measurements included lumbar spine flexion and extension ranges of motion, hip flexor flexibility (hip extension), active and passive hamstring flexibility, gluteus maximus and abdominal strength tests and Sorenson’s Test (static back extensor strength test). Subjective measurements were the Oswestry Low Back Pain and Disability Index and McGill’s Questionnaire. Measurements were taken before (pre-) and after (post-) the first (initial), third, fifth and eighth (last) consultations. CONCLUSIONS: The aim of the study was to determine the most effective treatment protocol in the management of Lower Back Pain in athletes presenting with Lower-Crossed Syndrome. Although the combined group (group three) showed the greatest improvement these findings were statistically no greater than the statistical findings in group one and group two. All groups showed a statistically significant improvement over the trial period. This illustrates that both Spinal Manipulative Therapy and a Rehabilitation program (including stretching and strengthening) was effective in the management of Lower-Crossed Syndrome. From this study it can therefore be concluded that one treatment protocol did not prove to be more effective than that of the others.