Abstract
M.Tech.
OBJECTIVE: The aim of this study was to determine the electromyographic effect of flexion distraction therapy of the lumbar spine on the Erector Spinae muscles in participants with lumbar facet dysfunction.
STUDY DESIGN: Thirty participants with lumbar facet dysfunction underwent 6 flexion distraction therapy treatments on alternate days over a 2-week period (excluding weekends) to test the electromyographic effect on the Erector Spinae muscle.
SETTING: University of Johannesburg Chiropractic Clinic, Johannesburg, South Africa.
SUBJECTS: Thirty participants with lumbar facet dysfunction participated in this study. The participants were divided into two groups of fifteen participants each and matched according to age and gender. Group 1, the study group, received flexion distraction therapy to the restricted segments in the lumbar spine. Group 2, the control group, did not receive any flexion distraction therapy and rested during the duration of the treatment.
METHODS: Lumbar Erector Spinae muscle electrical activity was tested before and after treatment one, three and six using surface electromyography (sEMG). One pair of bipolar electrodes was placed bilaterally over the Erector Spinae muscles at the level of L3. Participants were asked to lie down in a prone position with their arms next to their sides. They were then instructed to perform five maximum voluntary lower back extension exercises by lifting their chests and shoulders as high off the plinth as possible. Each contraction lasted five seconds, with a rest period of ten seconds between each contraction. The average rest and work surface electromyography readings were recorded, analysed and compared for reference. Information regarding the intensity of the pain experienced by the
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subjects was also collected at the start of treatment one, three and five using the Numerical Pain Rating Scale.
RESULTS: Comparison of the results indicated a statistically significant difference between the two groups and their responses to the treatments. Subjectively, a statistically significant improvement was observed in Group 1 between the third and the sixth treatments and the first and the sixth treatments, with an overall 80% improvement in pain, thus demonstrating the medium to long term effects of flexion distraction therapy. Objectively, Group 1 demonstrated a statistically significant medium to long term improvement in the resting rate of the Erector Spinae muscles as observed between the first and sixth treatments. Statistically, the two groups responded differently over time with regards to the contraction ability of the Erector Spinae muscle. A statistically significant and immediate improvement was observed in the sixth treatment in Group 1, thus further supporting the long term effects and benefits of flexion distraction therapy.
CONCLUSION: In light of these findings it can be concluded that flexion distraction therapy, as represented by Group 1, demonstrated favourable treatment results in terms of the pain experienced by the subjects, the resting rate and contraction ability of the Erector Spinae muscles. The trends observed in this study should be used and tested in future research studies of a similar nature incorporating larger sample groups.