Abstract
Introduction: Back pain can have a significantly negative influence on people’s lives, whether it be at work, during exercise, social activities or even during sleep. There has been a lot of research which confirms the positive effects of lumbar spine manipulation in the treatment of mechanical back pain and re-establishing optimal joint performance, however, very limited research has been done on the effectiveness of dynamic tape in the treatment of mechanical low back pain, in isolation or combined with manipulation of the lumbar spine. Dynamic tape is a bio-mechanical tape which reduces the load or work placed on a joint. Aim: The aim of this study was to determine the efficacy of chiropractic manipulation and dynamic taping of the lumbar spine in isolation and then as a combined therapy in the treatment of chronic mechanical low back pain. The results were based on the use of the numerical pain rating scale (NPRS) and the Oswestry and Pain disability Index questionnaire (ODI) on low back pain to assess subjective pain and disability as well as the digital inclinometer to assess objective lumbar ROM. This study also aimed to provide chiropractic practitioners with an alternative protocol in treating chronic mechanical low back pain. Method: This was a comparative study utilising convenience sampling and random group allocation methods to separate participants between the ages of 18 and 56 years into three groups of ten participants each. All the recruited participants presented with chronic mechanical low back pain. Group one received lumbar spinal manipulative therapy, while the second group received dynamic taping to the lumbar spine, and third group of participants received a combination of both treatments. Procedure: This study consisted of six treatment consultations and a seventh consultation that was for obtaining the final objective data and subjective data only. All the participants were individually assessed over a four-week clinical trial period. Objective data was obtained using a Digital Inclinometer to assess lumbar spine range of motion. Subjective data was obtained using two methods which were the NPRS and the ODI. The subjective and objective data were recorded at the beginning of the first, fourth and seventh consultations. vi Results: The subjective and objective data that was collected by the researcher was analysed by statisticians from STATKON at the University of Johannesburg. With regards to the intragroup and intergroup analysis of this study, non-parametric tests were used to analyse the raw data obtained by the researcher as the Shapiro-Wilk test for normality indicated that the data was not normally distributed. The intragroup analysis was done using the non-parametric Friedman test and post-hoc Wilcoxon Signed Ranks test. The intergroup analysis was done using the Kruskal-Wallis test. There were statistically significant improvements in the NPRS and the ODI scores for all the groups, with special mention given to group 1 and group 3, whose results were most impressive. The groups that included spinal manipulative therapy as part of their protocols had the most effect on decreasing pain from visits 4-7 but showed similar trends for visits 1-4 when compared to the group with dynamic taping. All the groups had statistically significant improvements when increasing the range of motion in these participants. The groups that included spinal manipulative therapy had a greater effect on increasing extension compared to the dynamic taping group. Conclusion: This study showed that the two groups that included spinal manipulative therapy showed very similar and superior trends/outcomes through the trial when compared to just the dynamic taping group alone. The reason for this could be that the spinal manipulative therapy had a direct as well as indirect effect on the spinal joints, which may have been the root cause for the participants chronic low back pain. The dynamic tape may have had an indirect (offloading) and generalized effect on muscles but may not have treated the root cause of the mechanical low back pain. All the treatment protocols proved to be effective in treating chronic mechanical low back pain as all the groups showed impressive statistically significant results in decreasing and improving range of motion in the participants. This research may have provided an alternative independent treatment protocol for chronic mechanical low back pain sufferers, especially in the case of patients with any contra-indications to manipulation and other chiropractic techniques.
M.Tech. (Chiropractic)