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The Effects of Spinal Manipulation on the Relationship Between Strength and Muscle Balance in Swimmers with Impingement Syndrome of the Shoulder
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The Effects of Spinal Manipulation on the Relationship Between Strength and Muscle Balance in Swimmers with Impingement Syndrome of the Shoulder
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The Effects of Spinal Manipulation on the Relationship Between Strength and Muscle Balance in Swimmers with Impingement Syndrome of the Shoulder
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Dissertation
The Effects of Spinal Manipulation on the Relationship Between Strength and Muscle Balance in Swimmers with Impingement Syndrome of the Shoulder
2009
Overview
PURPOSE: It has been described clinically that functional weakness of the external rotators of the shoulder occurs in patients with impingement syndrome. The purpose of this pilot study was to take swimmers with impingement syndrome and assess the immediate effects spinal manipulation had on strength and muscle balance readings. This was done by obtaining subjective and objective measurements before and after spinal manipulation therapy was administered to the lower cervical spine and upper thoracic spines. METHOD: This randomised controlled study consisted of two groups, one group consisting of fourteen swimmers with impingement syndrome of the shoulder and one group of sixteen asymptomatic swimmers, between the ages of eighteen and forty years of age. All the potential candidates for the trial were examined and cleared once all the exclusion and inclusion criterior had been met. Once joint restrictions had been picked up in the cervical and/or thoracic spine, Chiropractic diversified manipulative therapy was administered to all patients. PROCEDURE: The successful candidate was treated once. The patient underwent objective testing before the treatment, which · included muscle strength tests using an isokinetic dynomometer, the CYBEX Nonn, by recording the peak torque and fatigue ratio of internal and external rotation in neutral, as well as flexion and extension of the shoulder. Muscle balance readings were obtained by comparing the peak torque between agonist and antagonist muscles, in internal and external rotation in neutral as well as flexion and extension of the shoulder. Passive ranges of motion were measured using a Flexometer, in degrees of internal and external rotation at ninety degrees of abduction as well as flexion and extension. These tests were repeated again after the treatment. Subjective testing included a visual pain analogue scale that was completed before and after the treatment took place. RESULTS: The statistical analyses was conducted using the unpaired t-test as well as the Mann-Whitney Rank Sum Test to compare intragroup and intergroup data. CONCLUSIONS: Statistically significant as well as numerical changes were obtained for the visual pain analogue scale as well as the ranges of motion. Clinically significant changes in muscle strength and balance were obtained. This study therefore suggests that spinal manipulative therapy may have an effect on the muscle strength and muscle balance in swimmers with impingement syndrome of the shoulder. This however requires further research, as a larger sample size is required.
