Abstract
M. Tech.
Background: No substantiated theory exists by which chiropractic adjustments are known to
correct myofascial trigger points (MTrPs). Myofascial trigger points are theorized to be either a
primary muscle dysfunction or a secondary manifestation to central/ peripheral neurological
mechanisms. Chiropractic adjustments are theorized to exert their therapeutic influence either
primarily through biomechanical effects and/ or via neurophysiological mechanisms.
Objective: The objective of this study was to investigate the effects of chiropractic adjustments
on chronic, active rhomboid MTrPs, by comparing the clinical effects attained with rhomboid
attachment-segment (C7-T5) relative to rhomboid innervation-segment (C4 and/ or C5)
chiropractic adjustments.
Setting: University of Johannesburg Chiropractic Day Clinic in Johannesburg, Gauteng.
Participants: Thirty female subjects selected from the general population (from 18 to 40 years)
were randomly divided into two different treatment groups of 15 each.
Methods: The subjective information required the completion of the Subjective Pain and
Discomfort Questionnaire, including the Numerical Pain Rating Scale (NPRS). The objective
measures collected were pressure-pain threshold (PPT) and range of motion measurements
using the algometer and digital inclinometer, respectively. Additionally, the change in the number
of active MTrPs over the treatment period was recorded. All measurements were recorded at the
first, third and fifth consultations, over a 3 to 4 week period. The data gathered were then
statistically analyzed with the use of a 95% confidence interval. The nonparametric Friedman and
Wilcoxon Signed Rank tests were used for the intragroup comparisons, and the Mann Whitney- U
test was used for the intergroup comparisons.
Interventions: Treatment group 1 received upper-thoracic/ attachment- segment chiropractic
adjustments, and treatment group 2 received mid-cervical/ innervation-segment chiropractic
adjustments. The research project was carried out so that both groups received 5 treatment
sessions over 3 to 4 weeks.
Results: There were no statistically significant results obtained for intergroup comparisons.
Attachment-segment chiropractic adjustments revealed statistically significant changes in NPRS
values (p=0.000), PPT values (p=0.000), cervical spine right lateral flexion range (p=0.004),
thoracic spine extension (p=0.005) and left rotation range (p=0.003) over time. Innervationsegment
chiropractic adjustments revealed statistically significant changes in NPRS values
v ii
(p=0.001), cervical spine right rotation (p=0.003), thoracic spine flexion (p=0.001) right lateral
flexion (p=0.001) and left rotation (p=0.005) over time.
Conclusions: This study does not suggest that attachment-segment or innervation-segment
chiropractic adjustments possess greater clinical efficacy relative to one another in terms of
improving the clinical picture associated with chronic, active rhomboid MTrP activity. In a further
study, a larger sample size will be necessary to identify subtle changes in measurement parameters.