Abstract
M.Tech. (Chiropractic)
Purpose: A kinematic chain consists of a succession of joints linking several fixed components (Levangie and Norkin, 2005). Any tension or restriction within a component of this chain increases the load placed on the remaining components (Commorford and Mottram, 2001). Pathomechanics of the hip may have an effect on the areas of pressure exerted by the plantar surface of the foot during gait through the kinematic chain (Levangie and Norkin, 2005). Chiropractic manipulative therapy restores the correct biomechanical function to a joint (Gatterman, 2005). No previous research to determine the effect of hip manipulation on lower limb biomechanics and gait patterns has been identified. The purpose of this study was to determine the effect of chiropractic manipulative therapy of the hip on gait patterns, particularly the degrees of foot rotation and the pathway of the centre of pressure of the foot.
Method: Sixty participants matching the inclusion and exclusion criteria for this study were recruited. The procedure, risks and benefits were explained to each of them and they were required to sign an information and consent form. The participants then underwent a full case history accompanied by a physical and hip regional examination, including motion palpation of the hip. This ensured that none of the participants matched the exclusion criteria consisting of serious gait abnormalities, contraindications to manipulation and the receipt of simultaneous forms of treatment. Individual gait analysis by the Zebris FDM-System was performed for each participant before they received a hip manipulation. A second gait analysis was then conducted to determine a change.
Procedure: Each participant was required to walk barefoot over the Zebris platform for approximately 2 minutes while 3 – 5 gait cycles were recorded for gait analysis. The participant then received manipulative therapy of the restricted hip. A second gait analysis was performed just as the first. The Zebris software calculated the average results from before and after the hip manipulation and displayed the changes of foot rotation and the parameters of the pathway of the centre of pressure in a report for each participant. The focus of this study was the manipulated hip. Changes of the non-manipulated hip were mentioned only where applicable. The Zebris FDM-System allows for accurate gait analysis due to its “capacitive force sensors,” each of which possesses its own calibration curve (Zebris Medical GmbH, 2006).
Results: Statistically significant changes were found for certain gait parameters representing the pathway of the centre of pressure. These included anterior/posterior variability, lateral symmetry and lateral symmetry variability.
Conclusion: This study demonstrates that chiropractic manipulative therapy of the hip has an effect on certain centre of pressure parameters and chiropractors, therefore, should be consulted for the treatment of gait abnormalities. The study trial involved only a single treatment per participant. Further studies should be conducted to determine whether multiple treatments and manipulation of other kinematic chain components have an effect.