Abstract
M.Tech.
Purpose: Chiropractic adjustment has been shown to be an effective treatment for low back pain (Cox, 1999 and Lawrence et al, 2008). The role that the transverse abdominus plays in low back pain is not clear. Sacroiliac adjustment changes the activation speed (Marshall and Murphy, 2006) and the strength of contraction of transverse abdominus.
This study aims to determine the short-term effects of chiropractic manipulative treatment on the feed-forward activation of the deep abdominal muscles in patients with chronic low back pain.
Method: Forty five participants with chronic mechanical low back pain were used in this study. The primary cause of their back pain was mechanical. The study consisted of three randomly selected groups of participants. Group one was treated using abdominal exercise only. Group two was treated using both chiropractic manipulation and abdominal exercise. Group three was treated using chiropractic manipulation only.
Procedure: The effect on the feed-forward activation of transverse abdominus and internal oblique was measured and recorded using surface electromyography in each group. The participants also completed an Oswestry Low Back Pain and Disability Questionnaire and a Numerical Pain Rating Scale in order to record any change in back pain. Participants were seen seven times over a maximum four week period. Readings were taken on the first, third and fifth and seventh visits.
Results: Statistically significant (p<0.05) results were seen in all three groups for the Oswestry Pain and Disability Questionnaire and Numerical Pain Rating Scale. Minimum EMG results were not statistically significant, however group three showed improvement clinically. Maximum EMG results were also did not show a statistically significant change. Feed-forward activation of the transverse abdominus muscle showed no statistically significant change.
Conclusion: Favourable results were obtained clinically for all three groups. Group three (chiropractic manipulation only) was shown to be the most effective in terms of patient perception of pain and disability. Objectively, the results were less definitive. Chiropractic manipulation alone had the most favourable effect on the resting surface EMG readings of
the transverse abdominus, while chiropractic manipulation combined with abdominal exercises and abdominal exercises alone did not show this change. This too was seen in the results for the maximum EMG readings. Onset times of the transverse abdominus muscle showed no improvement.