Abstract
M.Tech. (Chiropractic)
Purpose: The pelvis, femur, tibia, fibula, ankle and foot form a closed kinematic chain during gait. According to biomechanical principles any restriction or tension in one part of the kinematic chain will create increased load on the other parts of the same chain (Comerford and Mottram, 2001; Sahrmann, 2000). This increased load can lead to dysfunction and compensation along the chain and also lead to gait anomalies. A chiropractic adjustment is utilised for the treatment of sacroiliac joint restrictions. There has not been research conducted to establish the effects that a chiropractic adjustment has on lower limb biomechanics and gait. The purpose of this study was to determine whether a sacroiliac adjustment had an effect on gait by looking at the gait parameters.
Method: Sixty participants who were between the ages of 18 and 40 years were recruited. The participants were asked to sign a consent form and then a thorough history and physical examination was performed to ensure that participants did not have any disease or pathology that may have excluded them from the study. These included foot pathologies, knee pathologies, hip pathologies, structural leg length discrepancies, or any contraindications to chiropractic adjustment. A lumbar spine regional examination as well as motion palpation of the sacroiliac joints was performed to determine which joints were restricted. Each participant then underwent a gait assessment before and after they received a chiropractic adjustment to the restricted sacroiliac joint.
Procedure: Participants only received one adjustment. Objective measurements were obtained using the Zebris FDM gait analysis system. This system uses high-quality capacitive force sensors that are arranged in matrix form. As a result, each sensor produces its own calibration curve. The measuring plates enable the static and dynamic force distribution to be analysed under the feet while standing and walking. The measuring plate is integrated in a level walking area. The measuring parameters are automatically calculated in the WinFDM program and a printable, easy to read report of the measuring results is then available (Zebris Medical GmbH, Germany). Each participant walked over the measuring plate for 4 times. This was done before and after the adjustment.Results: Statistically significant changes were seen between the pre and post treatment measurements of foot rotation on the treatment side, the step length on the treatment side, the stride length, the stance phase on both the treatment and non-treatment sides, the swing phase on the treatment and non-treatment side and the total double support.
Conclusion: This study shows that a chiropractic adjustment to the sacroiliac joint does change certain gait parameters and it should therefore be part of any treatment regime for gait abnormalities. Podiatrists, biokineticists and chiropractors should work together when treating patients with gait abnormalities. As the study only recruited asymptomatic participants, further studies are necessary to determine the effect a chiropractic adjustment has on the gait of symptomatic patients.