<p> This pilot study was performed in order to examine the potential beneficial effects of cervical spinal manipulative therapy on volunteers suffering from post-concussive neck syndrome. The study of concussions and post-concussive neck syndrome is still a relatively new topic in the existing literature. Little research has been done in the area of spinal manipulation and the treatment of volunteers suffering from post-concussive neck syndrome, from a biomechanical standpoint.</p> <p> Forty-one volunteers who were suffering from post-concussive neck syndrome were recruited from McMaster University in Hamilton, Ontario to participate in the study. In order to assess the severity of neck complaints, the severity of their post-concussive symptoms and overall general health, the volunteers completed the Neck Disability Index, the Visual Analog Scale, the Standardized Assessment of Concussion
and the Short Form-36 Health Survey. During testing sessions, volunteers were fitted with several light emitting markers placed strategically on the head, mid-back, sacrum and heels of the volunteers' footwear. Each volunteer would then walk on a treadmill for four separate five minute trials, after an initial familiarization period. The 3D position of these markers during gait were recorded by a rear-mounted kinematic data acquisition system (Optotrak 3020). After the initial five minute walk (trial 1), the volunteer was treated with a cervical spinal manipulation, and immediately resumed walking for the second trial on the treadmill. The volunteers performed four walking trials in total.</p> <p> Both manual and automated procedures were used to identify the multiple right-heel treadmill surface contacts during each five minute walk. Objective biomechanical outcome measures used in the study included relative phase measurements between the head and thorax in the transverse plane, the Biomechanical Efficiency Quotient and the Neck-Walk Index.</p> <p> Clinically significant results in relative measurements, post-intervention, were found when certain volunteers were removed (due to slow walking velocity). These differences can be attributed to the intervention of spinal manipulation which caused a significant increase in cervico-thoracic spinal motion, which appeared to decrease again at 35 minutes. This is clinically significant because it poses the theory that initial short-term biomechanical changes in the cervical spine are caused by SMT.</p> <p> Clinically significant results in the Biomechanical Efficiency Quotient were found when specific volunteers were removed. The results however, were in the opposite direction than was previously hypothesized. The reason for the increase in BEQ post-manipulation compared to pre-manipulation could be a result of the familiarization walking period before the initial trial. By allowing volunteers several minutes to get accustomed to walking on the treadmill, a learning effect had taken place, decreasing the variability in their gait in the initial pre-intervention trial. Although BEQ increased in the second and third trials, it decreased again at 35 minutes post-intervention, meaning the walking economy had once again increased.</p> <p> The specific intervention of cervical spinal manipulative therapy was hypothesized to change the variability of head movement disturbances during gait (Neck-Walk Index). No reference in the literature is made in relation to Neck-Walk Index and how it evaluates change in head carriage, post-intervention. This study suggests however, that although results approached significance, cervical manipulative therapy did not change biomechanical head carriage in this volunteer population.</p> <p> With respect to future studies, several recommendations have been made in this thesis which are aimed at increasing the clinical significance of the results. This would be done through the incorporation of more affected volunteers (increase in functional disability due to post-concussive neck syndrome), the incorporation of a more lengthy and specific treatment protocol (to sustain biomechanical and physical changes), and an increased treadmill walking velocity (to assess antiphasic movements more easily).</p> / Thesis / Master of Science (MSc)
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/21684 |
| Date | 08 1900 |
| Creators | Rick, David |
| Contributors | Pierrynowski, Michael R., Human Biodynamics |
| Source Sets | McMaster University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis |
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