Abstract
Purpose: The aim of this study was to determine the effectiveness of flexion-distraction therapy (FDT) compared to high frequency Interferential Current (IFC) therapy, as well as the combination of both protocols in the treatment of chronic mechanical low back pain with associated active erector spinae (ES) trigger points. Method: The study comprised of 30 participants between the ages of 18 and 65 years of age, who have had a history of low back pain present for more than 12 weeks as well as associated active MFTPs of the Iliocostalis lumborum muscle either unilaterally or bilaterally. The participants were separated in three groups. Group 1 participants received FDT during treatment. Group 2 received high frequency IFC therapy on the iliocostalis lumborum muscles that had active MFTPs. Group 3 received FDT as well as high frequency IFC therapy on the iliocostalis lumborum muscles that had active MFTPs. Each participant received 2 treatments per week during the 3 week trial period. Subjective and objective data collection was taken at the start of the trial period, during visit 4 and 7. On the 7th consultation only data collection was done, there was no treatment done. Objective measurements were performed by a digital inclinometer to measure lumbar range of motion (ROM) and by a pressure algometer to measure pain pressure threshold (PPT). Subjective measurements were performed by utilising a Visual Analogue Scale (VAS) to measure perceived pain. The data was captured and interpreted by the researcher. The results were sent to STATKON to be analysed. Results: The intra-group analysis of ROM revealed that group 2 had a greater improvement in flexion ROM of the lumbar spine and group 3 had a greater improvement in extension ROM of the lumbar spine. Inter-group analysis of ROM revealed that group 2 had a greater improvement in flexion ROM of the lumbar spine and group 3 had a greater improvement in extension ROM of the lumbar spine. The intra-group analysis of pressure algometer readings revealed that group 1 had a greater improvement in pain. Inter-group analysis of pressure algometer readings revealed that group 1 had a greater improvement in pain. The intragroup analysis for VAS readings revealed that all 3 groups had an improvement in perceived vii pain, on inter-group analysis it was revealed that group 3 had a greater improvement in perceived pain. Conclusion: There was evidence that FDT, high frequency IFC and the combination of both treatment protocols all have positive effects on lumbar ROM, PPT and perceived pain. Although this study suggests that FDT and high frequency IFC both have positive effects but on ROM, PPT and perceived pain, the combination of the two therapies showed a more significant improvement for the treatment of mechanical low back pain with associated MFTPs of the ES muscle, namely those of the iliocostalis lumborum muscle.
M.Tech. (Chiropractic)