Abstract
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.