M.Tech.

M.Tech.

M.Tech. / Purpose: This study aims to compare the effects of a manual high velocity, low amplitude spinal manipulation and a mechanical force, manually assisted spinal manipulation in the treatment of sub acute lumbar facet syndrome with regards to pain, disability, lumbar spine range of motion and pressure pain threshold. These effects were based on two questionnaires, the McGill Pain Questionnaire and the Oswestry Low Back Pain and Disability Questionnaire, lumbar spine range of motion readings using a digital inclinometer and pressure pain threshold readings taken with an algometer. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of two groups. One group received a manual lumbar spine manipulation using the Diversified Technique. The second group received lumbar spine manipulative therapy with the use of the Activator Adjusting Instrument. Treatment occurred over a three week period, with participants receiving treatment six times out of a total of seven consultations. Procedure: Subjective data was collected using both the McGill Pain Questionnaire and the Oswestry Low Back Pain and Disability Questionnaire. Objective data was collected using a digital inclinometer to measure lumbar spine range of motion, and an algometer to measure pressure pain threshold. The questionnaires and all readings were recorded prior to treatment on the first, fourth and seventh visits. The data was then analysed by a statistician. Results: Clinical improvements in both groups were noted over the duration of the study with regards to pain, disability, left rotation and left and right lateral flexion. The group receiving a spinal manipulation with the Activator Adjusting Instrument also showed clinical improvement for flexion and right rotation and only the manual manipulation group improved in algometer measurements. Both groups displayed a decrease in lumbar extension readings over time. Statistical significance was observed for subjective measurements only. Conclusion: The results show that both spinal manipulative therapies are effective in the treatment of sub acute lumbar facet syndrome, however neither proved to be preferential over the other for subjective and objective measurements.

M.Tech.

M. Tech. / Abstract Purpose: The purpose of this study was to assess the effects of Diversified Chiropractic adjustments versus Flexion-Distraction Technique in the management and treatment of chronic Lumbar Facet Syndrome. Method: This study consisted of two groups, Group A and Group B, each consisting of 15 participants with chronic Lumbar Facet Syndrome. The participants were between the ages of 20 and 45 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Group A received Diversified Chiropractic Adjustments and Group B received Flexion-Distraction Technique to the lumbar facets. Procedure: Each participant was treated eight times over a period of four weeks. Before the commencement of treatment one, four and eight, the participants completed the Oswestry Low Back Pain and Disability Index questionnaire and the Visual Analogue Scale. A Digital Inclinometer was used to measure lumbar spine ranges of motion. Diversified Chiropractic adjustments were then administered to Group A based on the restrictions obtained during motion palpation. Flexion-Distraction Technique was administered to Group B based also on the restrictions that were obtained during motion palpation. Results: Objective statistically significant differences were noted on flexion and left lateral flexion ranges of motion before treatment, and clinically significant differences we noted on flexion and right lateral flexion after treatment, in favour of Group A. Subjective readings also showed statistically significant differences with regards to Oswestry Low Back Pain and Disability Index and Visual Analogue Scale in favour of both Group A and Group B. Conclusion: The results of the study indicate that both Diversified Chiropractic adjustments and Flexion-Distraction Technique have a positive effect on patients suffering from chronic Lumbar Facet Syndrome. However, Diversified Chiropractic adjustments proved to have a greater overall benefit compared to Flexion-Distraction Technique in the management and treatment of Lumbar Facet Syndrome.

M.Tech. / Purpose: To determine what effects flexion distraction will have on males with chronic lumbar facet syndrome, in reference to intersegmental range of motion and pain. Method: Thirty male participants with chronic lumbar facet syndrome received flexion distraction technique. The trail consisted of seven visits over two to three weeks. Treatment was performed on the first to sixth visit, readings and questionnaires were completed on the first, fourth and seventh visits. Data collection was concluded before treatment on the mentioned visits. Subjective data consisted of the Oswestry Disability Index (ODI) and the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2). Objective data included global lumbar range of motion measurements using the Baseline Digital Inclinometer, and segmental lumbar range of motion by means of the Radiographical Midplane Angle method. Results: Objectively, clinical significance of the intersegmental lumbar range of motion increased from the L1/L2 to the L4/L5 level (2.2% - 17.7%), but showed no statistical significance. In relation to the maximal motion possible at these levels, the increase in motion escalated from 0.8% at the L1/L2 segment to 9.2% at the L4/L5 segment. The global lumbar range of motion showed clinical significant increase in all of the ranges except for extension, however statistical significance was found in right lateral flexion only (p = 0.045). The greatest increase in motion was observed in left lateral flexion (15.72%) and a decrease in extension (3.72%) was illustrated. Subjectively, the group showed statistical significant improvement in both the SF-MPQ-2 (p = 0.000) and ODI (p = 0.000). Clinical meaningful change was noted throughout the subjective data, which resultantly showed a 66% and a 67% change in pain respectively. Conclusion: Flexion distraction has shown to have clinical significant effects on segmental and thus global range of motion, and great clinical meaningful change in pain levels and pain perception. Thus specific segmental mobilisation does affect the segmental motion.